Physician associates (PAs) should not be carrying out medical examinations of children who have reported abuse or who are at risk of abuse and should not produce evidence for courts, forensic doctors have said in guidance.
The advice from the Faculty of Forensic and Legal Medicine of the Royal College of Physicians was issued shortly after it came to light that an NHS trust had for four years employed a PA to do safeguarding work, instead of a paediatrician.1
Alder Hey Children’s NHS Foundation Trust said that it employed a PA within its safeguarding team between May 2019 and March 2024. The PA undertook child sexual abuse medicals up until October 2023, under the supervision of a safeguarding consultant. An audit carried out by the Royal College of Paediatrics and Child Health between March and July 2023 found that the PA was a member of the specialist safeguarding team and shared the on-call rota.2 But the arrangement could have prevented successful future prosecutions because PAs are not recognised as professional legal witnesses, according to the trust’s own risk register.3
The faculty’s guidance, issued on 1 October, makes the requirements clear. It states, “A PA should not be undertaking the examination of children …
