BMA raises concerns over supervision for PA carrying out lumbar puncture

Library image. Getty/CasarsaGuru

By Daniel Pye

Doctors’ leaders have raised patient safety concerns following a report that a physician associate struggled to perform a lumbar puncture.

Wales Online said that a 21-year-old patient was booked in for the procedure at Newport’s Royal Gwent hospital in December.

Her family claimed she received seven punctures in one sitting during the failed procedure.

Aneurin Bevan University Hospital Board confirmed it is investigating the incident.

Dr Iona Collins, chair of the BMA’s Welsh council, said “we have continued to express our significant concerns about physician associates (PAs) and the risks to patient safety.”

“These roles require direct senior supervision, which this report suggests, was dangerously absent in this case,” Collins said.

Collins added: “We maintain that until physician assistants are employed strictly within their competency as assistants to doctors, patients will continue to face avoidable harm.

The British Medical Association’s scope of practice for PAs states that they should not be performing lumbar punctures.

“Last month, the BMA's Welsh Council voted unanimously to increase pressure on the Welsh Government to immediately pause the training and employment of PAs, replace their title from 'associate' to 'assistant' and adopt the Leng review recommendations at once”.

In a review on PAs last year, Professor Gillian Leng recommended changing the job title from associate to assistant to distinguish PAs from doctors who are medically trained.

This was accepted by the Welsh Government.

A spokesperson for Aneurin Bevan University Health Board said: “We’re very sorry to hear that [the family] are unhappy with the care she received.

“We did listen to concerns as they were raised, and actions were taken while the matter was investigated in line with our clinical governance processes.

“While the investigation is still ongoing, it would be inappropriate to comment further.”

Updated on 11:20 on 13 April.

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