Failures in girl's care add to fears over GP associates

A five-year-old was left traumatised, bleeding and in severe pain after a physician associate wrongly prescribed her a vaginal pessary, according to a damning report by the health ombudsman.

- Anna Bawden

The Parliamentary and Health Service Ombudsman said there were “multiple failures” in the care of the girl, who saw a physician associate (PA) at a GP practice in the East Midlands after complaining of itching and vaginal discharge.

The PA suspected thrush and recommended a vaginal pessary and cream. The five-year-old’s mother, who believed her daughter was being seen by a GP, questioned the treatment and the size of the pessary, but was reassured that it was appropriate.

PAs do not have prescribing rights and their work must be supervised by a doctor. But the ombudsman found that there was no discussion between the PA and GP before the GP authorised the prescription, even though vaginal pessaries are not suitable for prepubescent children and the girl’s symptoms were consistent with vulvovaginitis, not thrush. Also the prescription was not questioned by the pharmacy that dispensed it.