Family of woman who died after misdiagnosis by ‘substitute doctor’ criticise govt review
The parents of a woman who died after her blood clot was misdiagnosed by someone who she thought was a doctor have called a government-ordered review “a missed opportunity”.
Marion and Brendan Chesterton have welcomed many of the recommendations in Professor Gillian Leng’s review of the role that physician associates (PAs) perform in the NHS, but say “they don’t go far enough”.
Emily, 30, died in November 2022 after suffering a pulmonary embolism. She went to see her GP at a north London surgery twice in the weeks before her death – and on both occasions was seen by a physician associate who missed the blood clot and instead prescribed propranolol for anxiety.
Marion and Brendan Chesterton
The actress from Salford had told her worried parents that she had been seen by a doctor, but she had not.
Her father Brendan told Sky News: “If she come out and said I’ve seen someone called the physician’s associate I’m sure we would have insisted that, you know, let’s go back and insist that you see a doctor. She never knew.”
Now, a government-ordered review led by Prof Leng, president of the Royal Society of Medicine, has recommended NHS physician associates should be banned from diagnosing patients who have not already had contact with a doctor for their illness.
The report suggests a major change to the role of PAs after it acknowledged they have been used as substitutes for doctors, despite having significantly less training.
Emily Chesterton. Pic: Family handout
More than 3,500 PAs and 100 anaesthesia associates (AAs) are working in the NHS and there have been previous calls for an expansion in their number.
But a general lack of support for the roles from the medical profession – plus high-profile deaths of patients who were misdiagnosed by PAs – led Health Secretary Wes Streeting to order a review.
Presenting her findings, Prof Leng said: “Crucially I’m recommending that PAs should not see undifferentiated or untriaged patients.
“If (patients) are triaged, they (PAs) should be able to see adult patients with minor ailments in line with relevant guidance from the Royal College of GPs.”
She said more detail was needed on which patients can be seen by PAs and national clinical protocols should be developed in this area.
She added: “Let’s be clear, (the role of PAs) is working well in some places, but there indeed has been some substitution and any substitution is clearly risky and confusing for patients.”
Prof Leng also recommended PAs should be renamed “physician assistants” to position them “as a supportive, complementary member of the medical team” – and have standardised uniforms to distinguish them from doctors – while AAs should be renamed “physician assistants in anaesthesia”.
Newly qualified PAs should also work in hospitals for two years before they are allowed to work in GP surgeries or mental health trusts.
The report said that while research suggests patients are satisfied after seeing a PA, some did not know they were not seeing a doctor.
Prof Leng concluded there were “no convincing reasons to abolish the roles of AA or PA”, but there is also no case “for continuing with the roles unchanged”.
Read more from Sky News:
Human scanning project hits milestone
Measles warning after child’s death
Doctors’ strikes are ‘gift to Nigel Farage’
She recommended that both PAs and AAs should have the opportunity for ongoing training and development, with potential to prescribe medicines in the future, and they should also have the opportunity to become an “advanced” PA or AA.
Six patient deaths linked to contact with PAs have been recorded by coroners in England.
Emily’s mother Marion said some of the review’s findings were significant and her daughter would still be alive if the recommendations had been in place when she fell ill.
Marion Chesterton
She said: “I think so, yes, which is so important, which is why we’re so pleased that this review has been made.”
But Mrs Chesterton added that more could have done, including stopping all PAs from prescribing drugs.
“We feel it’s a missed opportunity. It could have gone all the way there and cleared things up totally. Our daughter died. She was prescribed a drug that she should not have been prescribed. And it had absolutely catastrophic circumstances. She died for goodness sake.”
The Chestertons’ concerns are shared by the British Medical Association (BMA).
Dr Emma Runswick, the BMA’s deputy chair
Dr Emma Runswick, BMA’s deputy chair, said: “It is definitely a problem that the roles of doctors and now physician assistants has been blurred and it’s positive that their name is going to change, that there will be a uniform.
“But whilst they continue to be deployed in a way that mimics doctors at the behest of any local employer decision, we have to have ongoing concerns about their safety.”
But UMAPs, the trade union which represents both PAs and AAs, has warned the changes will undermine their qualifications and their role, lengthen waiting lists and worsen the impact of any strike action.
Steve Nash, who represents PAs and AAs
“By trying to placate them, at a time when they’re striking – and they want their strikes to bite the hardest by taking us out of the workforce – we’re now putting patients at risk,” said Steve Nash, general secretary of UMAPs.
“I think the biggest patient safety risk, out there right now, is the BMA,” he added.
Health Secretary Wes Streeting, who ordered this review, is expected to implement all the recommendations of the report.
Victims of grooming gangs and modern slavery are being denied compensation by a government scheme because of their criminal records, Sky News has learned.
Analysis of official figures by Sky News’ Data & Forensics team shows more than 11,000 victims of crime over the last decade have been denied payouts because of their unspent convictions, including children.
The Criminal Injuries Compensation Authority can award money to victims of violent crime, including sexual abuse.
It is the only government compensation scheme for victims – for those unable to work due to injuries, the money can be vital.
But, if an applicant has a criminal record, they are automatically refused compensation with limited exceptions.
Those with unspent convictions sometimes receive reduced sums.
Sky News has found that at least 130 children with criminal records have received reduced awards over the last 10 years, including 50 victims of sex abuse, four victims of brain damage, and one child who lost sight in an eye.
This rule on unspent convictions is based on the idea that public funds should only compensate blameless victims of crime and not, for example, a gang member who was injured in a fight.
But many argue the policy punishes those who have been forced to offend by exploiters, as well as victims of child sexual abuse.
‘I was frustrated that I wasn’t being believed’
Arthur Sherry, 43, from Perranporth in Cornwall was regularly abused by his babysitter from the age of five, including suffering rape.
In 2008, he reported it to Devon and Cornwall Police, alongside two other victims. He alleges the police did not believe him, and charges were not brought against his abuser.
Arthur Sherry, who was abused as a child, says he was denied compensation because of his criminal record
Arthur became angry and descended into addiction as a “coping mechanism”, becoming suicidal, and was repeatedly arrested for minor offences, such as making false calls to the emergency services.
“I wasn’t getting support from any agencies, and no one asked me, ‘Why is this man ringing the emergency services all the time?'”
“It was a cry for help. I was frustrated that I wasn’t being believed.”
Eventually, Arthur’s abuser, Shaun Burton, was convicted of multiple offences against children, including 11 counts of indecency with a child in relation to Mr Sherry.
But when Arthur, who suffers from complex PTSD, subsequently tried to make a claim through the Criminal Injuries Compensation Authority in 2013, it was rejected because of his criminal record and because he submitted his application beyond CICA’s time limit.
He was not allowed to appeal the decision.
Arthur, aged 12 in the picture, was regularly abused by his babysitter, Shaun Burton, from the age of five
Many survivors of grooming gangs have criminal records due to being exploited and coerced.
While the government recently announced plans to disregard child prostitution convictions for these victims, many are urging authorities to go further and pardon all related offences.
Former victims’ commissioner Dame Vera Baird said: “They were not exercising their own free will and voluntarily committing crime, so there should be a discretion to look at that and say, ‘No, that wasn’t their fault’.
“They should get compensation for all the evil that was done to them by that gang.”
In 2022, the Independent Inquiry into Child Sexual Abuse recommended that the government amend the Criminal Injuries Compensation Scheme so that “applicants with unspent convictions are not automatically excluded where offences are likely to be linked to the circumstances of their sexual abuse as a child”.
The government has refused to act on this recommendation.
However, Labour MP Sarah Champion has tabled an amendment to the upcoming Victims and Courts Bill, hoping to implement it, as well as widen eligibility to the scheme.
“Victims are seen as running a cannabis farm and get a conviction, before it actually turns out that they were a victim of modern slavery.
“These people, who are very clearly recognised as victims and survivors, aren’t getting the money that’s owed to them. The system is broken and the ministers need to get rid of it.”
‘I was frustrated that I wasn’t being believed,’ Arthur tells Sky News’ Alice Porter
Read more from Sky News:
Wintry blast ‘could be a dry run for a cold December’
What does Trump’s Gaza peace plan look like?
A government spokesperson said: “Last year, more than £164m was paid out under the Criminal Injuries Compensation Scheme to victims, and we are going further by removing the time limit for civil personal injury claims and doubling Home Office funding for services supporting adult victims and survivors of child sexual abuse.
“Changes to the way we compensate victims have been considered by successive governments, and our priority must always be to treat all victims of violence equally.”
Devon and Cornwall Police said: “Tackling sexual offending is a key priority for Devon & Cornwall Police and we are working hard to bring offenders to justice.
“We take reports of all sexual offences seriously and will carry out thorough investigations into reports, looking at all viable lines of enquiry.”
Nathan Gill was at Manchester airport, about to board a flight to Russia, when accepting bribes finally caught up with him.
Gill, the former leader of Reform UK Wales and a one-time member of the European Parliament, who on Friday was jailed for 10-a-half-years, was stopped by police before boarding and had his phone seized in 2021.
While they interrogated him, his home in Anglesey was raided, with detectives discovering more electronics and cash piles of €5,000 (£4,400) and $5,000 (£3,800) respectively.
Nathan Gill being questioned. Pic: Met Police
The evidence on Gill’s phone would damn him – he was in contact with a pro-Russian politician in Ukraine, Oleg Voloshyn, and had agreed to boost pro-Russia viewpoints in exchange for money.
Voloshyn would dictate the statement, and Gill would repeat it – in some cases, almost word for word – in the media or the European Parliament.
In one instance, Gill appeared on the now-banned Ukrainian TV channel, 112 Ukraine, which was known for its pro-Russian stance.
In the interview, he was critical of the Ukrainian decision to open criminal proceedings against Viktor Medvedchuk, the owner of the television channel and a personal friend of Vladimir Putin.
Nathan Gill. Pic: Met Police
Speaking to the outlet, he said he was “very concerned” about the investigation, and wondered whether it was meant to silence “opposition politicians”.
Prosecutors said messages on Gill’s phone showed that this was at his paymaster’s instruction, with Voloshyn offering a “reward” if he would say that it was unacceptable to persecute a person for their political convictions.
Read more:
Reform UK’s former Wales leader jailed
Trump’s 28-point Ukraine peace plan in full
Voloshyn also offered the MEP €2,000 (£1,750) if he would express concern that Mr Medvedchuk could no longer mediate with Russia on Ukraine’s behalf, the court heard.
He added that “V” – understood to be Mr Medvedchuk – did not believe Ukrainian President Volodymyr Zelenskyy had “true intentions to pursue a peace agenda”, prosecutors said.
Bundles of cash were recovered from Gill’s home. Pic: Met Police
Sure enough, Gill appeared on 112 Ukraine saying it was “very sad” that Mr Medvedchuk felt he no longer had Mr Zelensky’s backing to act as a mediator with Russia, and suggested that using him “would be a sensible thing to do”.
The messages traded in innuendo, referring to the exchange of “Xmas gifts” or “postcards” instead of money.
But as the pair grew more comfortable with each other, they bargained more explicitly, with the sum of “£5k” quoted for Gill’s work.
Dominic Murphy, head of Counter Terrorism Command at the Met Police, said Gill had also offered access to other MEPs.
“This is where we get into that slightly odd situation where it feels very much like a real effort to undermine democracy here,” he said.
“This is Nathan Gill reaching out to individuals that he knows, who are Brits, who might be willing to be paid to go and make speeches.”
Commander Murphy declined to name names, but said there was an ongoing investigation and that other people had been spoken to.
None of the pro-Brexit MEPs Gill allegedly approached have been interviewed under caution.
Pic: Met Police
Police confirmed there was no evidence to suggest Reform UK leader Nigel Farage was involved.
Gill was stopped at Manchester Airport on 13 September 2021, under schedule 3 of the Counter Terrorism and Borders Security Act 2019.
He offered police no explanation for his actions and answered no comment in a March 2022 police interview.
But the 52-year-old is believed to have had financial problems.
Mr Murphy added that while Gill appeared to have pro-Russian sympathies, he was primarily motivated by money.
The ex-MEP has been jailed for 10-and-a-half years after pleading guilty to eight counts of bribery between December 2018 and July 2019.
Following an investigation by counter-terrorism police, officers said they believe Gill likely took a minimum of £40,000 in cash and was offering to introduce other British MEPs so they could be bribed.
Voloshyn was picked up by the authorities on a trip to the US in 2021, which enabled the FBI to discover his end of the conversation.
He is now believed to be in Russia, but has been sanctioned by the UK government over allegations of trying to destabilise Ukraine.
Nathan Gill pleaded guilty to eight counts of bribery over pro-Russian statements. Including to media outlet 112 Ukraine. Pic: Met Police
He remains wanted in both Britain and Ukraine.
A Reform UK spokesman said: “Mr Gill’s actions were reprehensible, treasonous and unforgivable.
“We are glad that justice has been served and fully welcome the sentence Nathan Gill has received.”
Mr Farage, the Reform UK leader, said: “An investigation into Russian and Chinese influence over British politics would be welcome.”
The MP for Clacton previously described his former colleague as a “bad apple” and said he was “shocked” after Gill pleaded guilty to eight counts of bribery.
He said: “Any political party can find in their midst all sorts of terrible people.
“You can never, ever guarantee 100% that everyone you meet in your life, you shake hands with in the pub, is a good person.”
-
Sports2 years agoStory injured on diving stop, exits Red Sox game
-
Sports3 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports2 years agoGame 1 of WS least-watched in recorded history
-
Sports3 years agoButton battles heat exhaustion in NASCAR debut
-
Sports3 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Environment3 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment1 year agoHere are the best electric bikes you can buy at every price level in October 2024