The Telegraph had previously published claims by doctors at 24 trusts that PAs illegally prescribed drugs and ordered scans with ionizing radiation. However, this is the first time an NHS hospital group has admitted that it had inadvertently given prescribing powers to employees.
Between July 2023 and January this year, PAs at the trust, which runs two hospitals, prescribed controlled drugs to patients, including the opiate painkillers oxycodone and codeine.
The sedatives lorazepam, diazepam, and midazolam are also prescribed, the latter often used in end-of-life care. These medicines are classified by the government as “controlled” because of the risk of harm and addiction.
This data was released in response to a FoI request from the public.
Calderdale and Huddersfield said “tight controls are currently in place to prevent further PA prescribing incidents” and insisted that no patients were harmed. But the revelations have raised concerns among critics about the amount of power being handed over to PAs.
Peers discussing PA regulations
On Monday, colleagues will debate a motion that could derail government plans to bring PAs under the General Medical Council (GMC). PAs could later be given the power to prescribe medicines if they are allowed to be regulated by the GMC.
Sean Caulfield, an attorney at Hodge, Jones & Allen, explained:
“However, if someone, whether a medical professional or not, attempts to supply or actually supplies a controlled substance knowing that it is illegal, that is a different story. , the Crown Prosecution Service may consider that it is in the public interest to prosecute.”
Calderdale and Huddersfield highlighted that PAs working in the medical, surgical and accident and emergency sectors are “taught to be legally unable to prescribe”.
Regulations on controlled substances in the medical field have been significantly tightened after an investigation revealed that serial killer Harold Shipman used powerful painkillers to kill at least 215 people without being detected.
However, this is not the first time the trust has been criticized for its management of controlled substances. In 2018, the Healthcare Quality Commission watchdog gave two hospitals, Calderdale Hospital and Huddersfield Royal Infirmary, safety ratings of ‘requires improvement’. Part of the reason was that “pharmaceuticals, including controlled substances, were not effectively managed in critical care or emergency care.” emergency services.”
“Back to square one”
In next Monday’s debate, Green Party colleague Baroness Bennett will “implore the government to go back to the drawing board to find a different way forward with the support of health professionals, communities and patients”. .
The British Medical Association argues that licensing doctors and non-physicians together “increases the risk that patients mistakenly believe that a PA’s care is equivalent to a doctor’s expertise”, and the Medical and Care Professions Council It wants the council to amend the bill so that it oversees the PA instead of the GMC. .
Baroness Brinton, a former Lib Dem health spokesperson who also opposes GMC regulation of PAs, said the “very disturbing” incident raised serious questions about governance, adding: “Hospital trusts have “There are very senior clinical managers who should have been involved in all of this.”
A spokesperson for the trust said it was “fully aware of its prescriptive rights to different sections of its workforce” and was “carrying out an investigation”. [any issues] and take immediate action based on appropriate policies and procedures. ”
The Department of Health and Social Care said the GMC’s employee regulations “have bipartisan support and enhance patient safety” and that the council “implements rigorous fitness-to-practice procedures and・Set training standards.”
They add that the PA’s role is “to support, not replace, the physician,” and that the staff “performs clinical duties such as taking medical histories, performing physical exams, and developing and implementing treatment and management plans.” Ta.
West Yorkshire Police said that if concerns were brought to their attention, they would work with the trust “to understand whether a criminal offense has been committed” and that all reports were “assessed according to threat, risk and harm”.
