A new warning has been issued by a coroner regarding the role of physician associates in NHS hospitals, following the unfortunate death of a woman named Pauline Marking. The 77-year-old had severe abdominal issues but was mistakenly diagnosed with a nosebleed and passed away four days later. Mrs. Marking’s family believed she had been seen by a doctor rather than a less-trained physician associate (PA).

Surrey assistant coroner Karen Henderson has written to key health leaders, including the UK’s health secretary Wes Streeting and NHS England, to express her concerns about the insufficient training of PAs and the lack of public understanding regarding their roles.

In a report aimed at preventing future deaths, Henderson remarked that PAs lack the understanding needed to recognize the significance of abdominal pain. She criticized that PAs are effectively working independently without proper supervision, raising concerns that their limited training may lead to them operating outside their capabilities.

The correction of the misleading term “physician associate” is also emphasized by the coroner. She noted that there is a potential to confuse patients and their families since PAs are not doctors and their roles differ. This lack of clarity can also challenge patients and families seeking opinions from medical practitioners.

The report indicates these issues could affect public confidence in the medical profession. Further, the misleading titles of these roles could impact informed consent and the protection of patient rights.

The inquest into Mrs. Marking’s death concluded that the medical management provided on her first hospital visit and later the anesthesia issues during surgery contributed to her passing.

This incident has prompted the UK government to review the role of PAs in the NHS amid increasing concerns over patient safety. They analyze the safety of these roles and ensure patients understand that despite their capabilities, PAs are not doctors.

Physician associates, who conduct medical training for two years, are a part of the healthcare workforce in hospitals and GP surgeries in England. They can perform duties such as taking medical histories, conducting examinations, analyzing test results, diagnosing illnesses, and helping manage a patient’s condition, but their role is not equivalent to a fully trained doctor.

Source: https://www.theguardian.com/society/2025/feb/27/coroner-warns-about-nhs-physician-associates-after-misdiagnosis-and-death-of-woman