‘One of the medics’: Dossier reveals examples of APs being used as doctor substitutes

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By Sarah Lowden

The British Medical Association is calling for a ban on advanced practitioners being used on doctors’ rotas, as it publishes a dossier of accounts of when patient safety has been put at risk.

It is the union’s latest action to highlight its concerns about doctor substitution – when advanced practitioners (APs) are placed in roles or given tasks which should be carried out by a doctor.

In January, the BMA launched a tool enabling doctors to report such cases. Since then medics have reported hundreds of patient safety incidents, it said.

One of the examples in the report includes an account from a consultant in the East Midlands who suspected her own child had meningitis:

“My daughter was seen by an ACP [advanced clinical practitioner] in Paeds Emergency Department. I took her with concerns that she had meningitis... The ACP discharged her with no bloods or referral.

“Daughter readmitted within 36 hours and diagnosed with meningitis, however delay in diagnosis resulted in Lemierre’s syndrome, surgery and 2 CT heads. On that evening, the ACP was the most senior clinician in paeds ED due to a rota gap for the paeds ED consultant.”