Review: Physician Assistants Banned from Diagnosing in Emergency Settings Amid Safety Concerns
July 17, 2025
There have been six recorded patient deaths linked to PAs, including cases of misdiagnosis such as a woman who was incorrectly diagnosed with anxiety instead of a pulmonary embolism.
A recent review has concluded that Physician Assistants (PAs) should not diagnose patients in emergency or general practice settings due to safety concerns and their limited training.
NHS England has instructed trusts that PAs must not triage or see patients without a prior diagnosis, reinforcing the new safety guidelines.
The review's 18 recommendations aim to clarify the roles of PAs and ensure patients are aware of who is treating them.
The review recommends developing national clinical protocols to clearly define the roles of PAs, emphasizing that they should not see undifferentiated or untriaged patients.
Health Secretary Wes Streeting announced full acceptance of the review's findings, which include renaming PAs as 'physician assistants' and restricting their roles to prevent misdiagnoses.
Streeting emphasized that PAs should never replace doctors, highlighting patient safety as the top priority within the NHS.
New guidelines will require newly qualified PAs to complete two years of hospital work before practicing in primary care or mental health settings.
Staffing shortages have led to PAs being used as substitutes in medical rotas, despite the associated risks.
Prof. Leng pointed out that PAs have often been used as substitutes for doctors despite their limited training and recommended they should not see undifferentiated or untriaged patients.
The review was initiated due to safety concerns and its impact on junior doctors’ training, following incidents of misdiagnosis and patient deaths.
Evidence supporting the safety of PAs acting as substitutes for doctors is currently lacking, raising questions about their role in primary care.
Summary based on 3 sources
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Sources

Oxford Mail • Jul 16, 2025
Physician associates should ‘never be used to replace doctors’ – Streeting
Reading Chronicle • Jul 16, 2025
Physician associates should ‘never be used to replace doctors’ – Streeting
Chester and District Standard • Jul 16, 2025
Physician associates should ‘never be used to replace doctors’ – Streeting