Pamela Marking, 77, who died in February 2024, had been suffering from severe abdominal problems but was disagnosed as having suffered a nosebleed by a PA.

The inquest heard Marking had to be re-admitted to East Surrey Hospital after having been discharged without a 'medical review or direct medical supervision', the MailOnline reported.

She underwent surgery but died within 48 hours following issues with her anaesthetic.

Coroner Dr Karen Henderson warned the unfettered use of PAs could lead to more deaths, adding: ‘This blurring of roles without public knowledge and understanding of the role of a physician associate has the potential to devalue and undermine public confidence in the medical profession.'

A Department of Health and Social Care spokesperson said: ‘This is a tragic case and our deepest sympathies are with Pamela Marking's family and friends. 

‘The secretary of state has launched an independent review into physician and anaesthesia associate professions to establish the facts and make sure we get the right people in the right places providing the right care.

‘Regulation of PAs and AAs by the General Medical Council began in December to ensure patient safety and professional accountability.'

An NHS spokesperson said: ‘NHS England extends its deepest sympathies to the family and friends of Pamela Marking - we are carefully considering the Prevention of Future Deaths Report sent to us by HM Coroner and will respond in due course.

‘The NHS has always been clear that physician associates are not replacements for doctors and should only practice with appropriate medical supervision, but there remain legitimate concerns about the roles and so the Leng Review will gather insight from across the NHS to ensure they are being used appropriately to deliver safe care for patients.'

Surrey and Sussex Healthcare NHS Trust offered its ‘deepest sympathies' to Marking's family and pledged to learn lessons from the case, adding: ‘Our Emergency Department follows Royal College of Emergency Medicine guidelines and operates a multidisciplinary rota, which includes Tier 2 clinicians such as resident doctors, advanced care practitioners (ACP), and physician associates (PA). Physician associates follow a nationally recognised programme of training and work within a very specific scope of practice under the direct supervision of a consultant, as was the case here. All of our physician associates wear designated scrubs with their job title, physician associate lanyards, and use the recommended introduction of their role when meeting patients. We have also introduced a visual guide clearly illustrating the different uniforms, roles and responsibilities within our Emergency Department.'