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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 + Brendan Chesterton whose daughter Emily died in November 2022 after suffering a pulmonary embolism
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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
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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.”

Marion + Brendan Chesterton whose daughter Emily died in November 2022 after suffering a pulmonary embolism, missed by a physician associate

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”.

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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 whose daughter Emily died in November 2022 after suffering a pulmonary embolism which was missed by a physician associate
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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).

British Medical Association (BMA) deputy chair Dr Emma Runswick
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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, general secretary of UMAPs trade union
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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, said: “We’re accepting all of the recommendations of the Leng review, which will provide clarity for the public and make sure we’ve got the right staff, in the right place, doing the right thing. Patients can be confident that those who treat them are qualified to do so.

“Physician Assistants, as they will now be known, will continue to play an important role in the NHS. They should assist doctors, but they should never be used to replace doctors.

“Our Plan for Change will build on its findings and we will work to implement these findings in the interests of staff and patients alike.”

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Babies born with DNA from three people in the UK – to prevent ‘devastating’ illness with no cure

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Babies born with DNA from three people in the UK - to prevent 'devastating' illness with no cure

Eight babies have been born in the UK with DNA from three people following a procedure to eliminate an incurable inherited disease.

It is a major advance for the technique, called mitochondrial donation therapy, designed to prevent a life-limiting, often fatal illness caused by genetic mutations in the structures that generate energy in all our cells.

It is also a test of the UK’s permissive but highly regulated stance on human embryo research that allowed a technique once criticised for creating “three-parent babies” to proceed.

Screen grab taken from handout video of a diagram showing the embryo replacement procedure.
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This image shows the embryo replacement procedure. Pic: PA

The babies, four girls and four boys – two of them identical twins – were all born in the last five years and are healthy, according to research published in the New England Journal of Medicine.

“It’s a great success for these families,” said Sir Doug Turnbull, emeritus professor at the University of Newcastle who helped pioneer the treatment.

“This is a devastating disease with no cure and without this technique, they would not feel that their families were free of mitochondrial disease. This gives them that opportunity.”

Mitochondrial disease affects around one in 5,000 babies born in the UK.

Depending on the number and type of mutations in their mitochondria, the severity and type of disease can vary, but includes neurological, metabolic and developmental disorders.

Only women at high risk of passing on severe disease qualify for the procedure, provided though a specialist facility at Newcastle upon Tyne Hospitals NHS Foundation Trust.

The identities of the seven families and their babies are being withheld, but a mother of one of the baby boys speaking anonymously said: “The emotional burden of mitochondrial disease has been lifted, and in its place is hope, joy, and deep gratitude.”

A diagram showing an embryo o created by mitochondrial donation. Pic: PA
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Pic: PA

How does the technique work?

The procedure involves removing the genetic information from an affected mother’s fertilised embryo before inserting it into one from a healthy female donor, from which the genetic information has been removed.

Crucially, the hundreds of thousands of diseased mitochondria are left behind, leaving the new embryo with healthy ones present in the donor embryo.

Mitochondria contain a tiny amount of their own unique genetic code, so the resulting babies carry DNA from three different people.

But because it represents just 0.02% of our total DNA and has no bearing on genetic traits we inherit from our parents, researchers behind the technique, have never liked the “three-parent” moniker.

However, the technique – whatever you choose to call it – isn’t perfect.

A total of 22 women underwent the procedure but only seven became pregnant, resulting in eight births – a 36% success rate.

Five of the eight babies were born with no trace of disease.

But tests on the other three revealed a small percentage of mutated mitochondria had been carried over during the procedure.

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While they are at levels too low to cause mitochondrial disease, the babies will require careful follow-ups to ensure they continue to develop normally.

“We have designed a study specifically for that purpose,” said Professor Bobby McFarland, who leads the service in Newcastle.

“That’s what is unique about us offering this in Newcastle because there isn’t anywhere else in the world that’s doing this in a regulated way.”

While there’s good reason to expect the children will develop normally, the procedure does take medicine into new territory.

Because mitochondria contain their own genetic code, girls born via the technique – carrying those from the healthy donor – will pass that on to any children they may have in future.

Changing the “germ-line” in such a way has raised ethical concerns.

But for seven new families, and more to follow, the procedure promises to cure a disease that has affected their families for generations.

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Acid attacks rise in UK – with 25% of them in an area that’s home to just 2% of the population

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Acid attacks rise in UK - with 25% of them in an area that's home to just 2% of the population

The number of acid attacks has risen 10% in a year, according to a Freedom of Information request to UK police forces.

Acid Survivors Trust International (ASTI) said its analysis shows 498 physical attacks involving corrosive substances were recorded in 2024 – compared with 454 in the previous year.

According to the charity, the real figure is likely to be even higher because of under-reporting by victims.

In 2023, both Northumbria Police and the Metropolitan Police recorded the highest number of physical attacks – 18% and 16% respectively.

But figures in 2024 showed a significant fall in attacks in London, dropping by 78%, while cases in Northumbria rose substantially.

ASTI executive director Jaf Shah told Sky News that attacks in Northumbria account for almost 25% of the nationwide total – despite making up just 2% of the population.

He explained: “Historically, London has always seen the highest number attacks, which is unsurprising because of the population. But what we’ve seen in the 2024 data is a massive drop in the number of attacks in London to just 16.

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“Whereas in Northumbria we’ve seen a 49% increase to 121 attacks, so there’s a massive disparity in terms of numbers, especially relative to population figures for each of those corresponding areas. So this is obviously a very worrying trend.”

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In July 2024, four men were handed life sentences for ammonia murders

Mr Shah added there was supporting evidence about the type of attacks taking place in the Northumbria force area.

“Professor Francisco Figueiredo, who is head of ophthalmology at Newcastle University … certainly picked up on an increase of young men receiving treatment with corrosive injuries in the eye.

“A lot of the injuries he’s treated are related to the use of ammonia … that’s quite different to some of the attacks we’ve seen in other parts of the UK where sulphuric acid is commonly used.”

West Midlands Police also recorded a significant increase in attacks – rising 82% between 2023 and 2024 – and making up 12% of the UK total.

ASTI states the FOI data reveals acid attacks in the UK are historically associated with male-on-male violence and often linked to gang activity.

Of the 224 physical attacks where gender data was recorded, a third of victims were female, reflecting the increasing use of acid as a weapon of violence against women and girls.

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How Clapham chemical attack in January 2024 unfolded

ASTI also commissioned research, conducted by Frontier Economics, which concluded that the financial impact of all acid attacks in 2024 was more than £31m.

The study estimated that a single attack costs £63,000, consisting of the medical and psychological support victims require and paying for the criminal justice system to deal with perpetrators.

ASTI also told Sky News it was recommending reforms to tackle the “lack of robust checks on sales of corrosives”, especially via online retailers.

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Acid attack ‘devastates lives’

Commander Stephen Clayman, National Police Chiefs’ Council lead for corrosive substances, said an attack “devastates lives and causes physical and psychological damage to victims that can last a lifetime” and officers were committed “to tackle this appalling crime”.

In a statement, he added: “Many corrosive substances are available over the counter at supermarkets and DIY stores.

“It is important that law enforcement and government work closely with retailers themselves, to enhance our intelligence picture, and determine the best ways to keep these products from falling into the hands of people who intend to use them to cause harm.

“Serious crimes such as this should not go unreported and we want victims to feel able to come forward and report these matters to us.”

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Red House: 62 people now say they experienced abuse at children’s home run by a ‘cult’

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Red House: 62 people now say they experienced abuse at children's home run by a 'cult'

“It was like hell on Earth.”

Warning: This article includes references to sexual abuse and suicide that some readers may find distressing.

Colin (not his real name) is one of 19 alleged abuse victims who has come forward following a Sky News investigation into a closed children’s home in Norfolk.

The total number is now 62.

Red House

Numerous people have told us that they experienced physical, emotional and sexual abuse at The Small School at Red House run by a Danish organisation called Tvind, which has been described as a cult.

Colin was taken into care after being a victim of sexual exploitation, but when he arrived at The Red House at 15, his personal, painful history was used against him.

“A couple of the lads grabbed hold of me,” he said. “They’d been told that I was a rent boy before I got there, they wanted to knock me into shape. I contemplated killing myself. I’d never experienced that humiliation.”

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Children were sent to The Red House from all over the country. Some have told Sky News that violent staff broke their fingers, threw them down the stairs and even locked them in rooms with Alsatians.

Red House

Sadly for Colin, his experience of sexual exploitation continued at the home.

“They put these three lads in my room, they squeezed me round my neck and I passed out,” he said. “When I came round they were sexually abusing me. I was screaming and screaming. The next day I ran and I never went back there.”

The home was run by the Tvind School Cooperative of Denmark. A controversial group founded in the late 1960s, they opened around 30 radical schools in Denmark, mostly for disadvantaged children, and two in England. Many have since closed.

Tvind

Inspections by regulatory bodies reveal growing concerns about The Red House. In 1990, the Social Services Inspectorate wrote to directors of local authorities warning them against sending children to the home.

An inspection report made by Norfolk County Council in 1994 shows they were aware of alleged “sexual abuse” and “physical abuse” involving 20 children.

Yet the home continued to operate and three years after that inspection report, Norfolk County Council sent a teenage boy to the Red House.

Red House

“Red House was this black hole where they could just dump people and not worry about them,” he says.

“Whilst I was there I can’t even think of one instance when my social worker turned up to come and check on me.”

He is one of the many alleged victims in the process of suing Norfolk County Council and the local authorities which sent children to the home.

Read more:
The Red House: The children’s home run like a cult
The Danish group behind a children’s home run like a cult

Sky's Alice Porter with Colin

Daniel Lemberger Cooper is representing victims on behalf of Imran Khan and Partners.

“[We] urge Norfolk Council, who are the centre of this and whose geographic area Red House was based, to tell the truth. They were aware very early on … about abuse and allegations of abuse and they failed to act.”

Victims are also being supported by the Shirley Oaks Survivors Association who are urging any more people to come forward.

The home was shut down in 1998. Norfolk Police have done two investigations into allegations of abuse but no one has been charged.

The Red House in Norfolk

Those still working for Tvind in Denmark say they are not associated with the former cooperative.

Norfolk County Council says: “We continue to investigate and respond to those private claims through the appropriate legal channels.

“Our thoughts are with all survivors of abuse but, as there is an ongoing legal claim relating to Red House, we cannot comment further at this time.”

People can contact the Shirley Oaks Survivors Association by visiting: www.smallschoolredhouse.co.uk.

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

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