A former NHS GP has uncovered data showing that two doctor shifts at the Royal Berkshire NHS Foundation Trust were allocated to trainees between last December and April.

Dr Sandeep Bansal trained to become a GP in Oxford before going on to found the company Medic Creations and the Medic Beep app, which allows hospital and community staff to share real-time updates and information about patients.

As a result, the National Health Service and especially its trusts based in the Southeast bear particular importance to him and his medical background has been the basis for a near-18-month effort to expose issues linked to underfunding through Freedom of Information requests.

His latest data deep-dive included something that caught even him by surprise, however – the indication that trainee physician associates (PAs) had acted as substitutes for doctors at the Royal Berkshire NHS Foundation Trust on two separate occasions between December 2023 and April.

PAs are medically trained and work alongside nurses and doctors to provide care, but don’t have the same level of training as doctors and can’t act as direct replacements. General understanding states that they can access, diagnose and treat patients alongside doctors in a supplementary capacity.

While the PAs would not have been the only person working on shift, Dr Bansal said their presumed substitution for FHOs (doctors in their first year of foundation training) is an “astonishing” finding.

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He said: “I know about issues with doctors and GPs being out of work and floods of PA roles created by the NHS, but I was surprised by the trainees being on shift. I’ve never seen that before.

“As qualified as PAs are, they just haven’t gone through medical school and done the basic foundational training. The analogy I give is that if you want to build a skyscraper, you have to get the foundations right. 

“That involves a knowledge of the foundational sciences – the anatomy and physiology – all of that understanding that is critical to providing the services that doctors do. I’m worried that this is a trend which signals a massive deskilling of the entire workforce.”

Emily Chesterton, 30, from Salford, died in November 2022 after she saw a PA who she thought was a GP and who failed to diagnose a blood clot which ultimately travelled to her lungs.

The British Medical Association has since highlighted a “dangerous blurring of the lines” for patients between doctor and assistant roles.

A spokesperson for NHS England told the PA News Agency this week that guidance published online laid out expectations for trusts to follow regarding “the deployment of medical associate professionals” and “safety, accountability and transparency”.

A Department of Health and Social Care spokesperson added: “Physician associates have played an important role in the NHS for over two decades, but we are clear they should be supporting, not replacing doctors and receive the appropriate level of supervision by healthcare organisations.”

The Royal Berkshire NHS Foundation Trust has been contacted for comment.