The British Medical Association (BMA) said the widespread use of non-doctors in medical roles is 'simply not safe' and may be driven by cost-saving. Advanced practitioners are mainly senior nurses undertaking roles usually performed by doctors in A&E, neonatal units, critical care and other areas, according to multiple reports.
Several NHS trusts have confirmed they use advanced practitioners in roles doctors would usually perform. Birmingham Women’s and Children’s NHS trust said advanced practitioners work on medical rotas at SHO or registrar level. Barking, Havering and Redbridge NHS trust said their coverage typically aligns to junior or middle grade doctors' roles. In Scotland, Dumfries and Galloway health board includes APs on medical rotas in critical care and out-of-hours GP service, while Forth Valley health board uses them in inpatient children’s and neonatal services. Several cases have occurred where mistakes by advanced practitioners led to patient harm or death, according to multiple reports.
The extent of doctor substitution shown by these figures is very concerning. It is startling to see close to half of NHS organisations reporting that they use APs in doctor staffing, holding the emergency bleeps and making referrals to different specialities.
NHS England guidelines state that advanced practitioners should not replace the roles of doctors. However, 55 NHS bodies across the UK allow APs to hold crash bleeps, traditionally a doctor-only role, while 32 said they do not. GB News described the approach as 'haphazard' and warned of 'potential disaster'. Dr Mel Ryan, a paediatric registrar and BMA lead on preventing doctor substitution, said: 'The extent of doctor substitution shown by these figures is very concerning. It is startling to see close to half of NHS organisations reporting that they use APs in doctor staffing, holding the emergency bleeps and making referrals to different specialities.'