Health secretary Wes Streeting has launched an independent review into the role of physician associates (PAs) to assess the safety of the role and how it supports wider health teams.
The review, which will also look at anaesthesia associates, will seek evidence from employers, patients, professional bodies and academics. It will look into recruitment and training, scope of practice, supervision and regulation.
Led by Professor Gillian Leng, president of the Royal Society of Medicine and a former consultant in public health medicine and chief executive of NICE, the review will be published in the Spring and will assess ‘how effectively these roles are deployed in the NHS’ and offer recommendations on how new roles will work in future.
Currently there are over 3,500 PAs working in the NHS, according to the Department of Health and Social Care (DHSC), with over one third of those employed through primary care networks (PCNs).
PAs have been around since 2003, however NHS England committed to increasing the number of PAs in the NHS to 10,000 by 2036/36, with training places for the role set to rise to over 1,500 by 2031.
But there has been controversy surrounding the role, which caught public and the profession’s attention after a handful of high-profile tragic cases, including Emily Chesterton, a 30-year-old patient who died at the end of 2022 after a pulmonary embolism. The coroner in the case concluded that the poor quality of care provided by the PA she saw contributed to her death.
In June, the RCGP urged that PCNs halt the recruitment of PAs, while in the same week, the BMA launched legal action over the regulation of the profession, which is set to begin on 13 December.
In October, the RCGP set out a scope of practice for PAs which limited their current practice. It suggested that they should not see patients who have not been triaged by a GP, nor patients who present for a second time with an unresolved issue.
However, the unofficial body representing PAs, the United Medical Associate Professionals (UMAPs), prepared to take legal action as a result of this at the end of October, as it said this scope had caused ‘harm’ and had adversely affected the careers of PAs.
Mr Streeting, said: ‘Many physician associates are providing great care and freeing up doctors to do the things only doctors can do.
‘But there are legitimate concerns over transparency for patients, scope of practice, and the substituting of doctors. These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised.
‘This independent review, led by one of the UK’s most experienced healthcare leaders will establish the facts, take the heat out of the issue, and make sure that we get the right people, in the right place, doing the right thing.’
Professor Leng added: ‘To promote patient safety and strengthen the NHS workforce, it’s crucial that we have a comprehensive review of the role of PAs and AAs. This will cover recruitment and training, scope of practice, supervision and professional regulation.
‘As I conduct this review, I am looking forward to speaking to a broad range of stakeholders and to gathering evidence from the UK and abroad so that we can reach a shared understanding of these roles and their place in wider healthcare teams.’
Amanda Pritchard, chief executive of NHS England, said PAs are ‘important members of NHS staff’ who come to work to help care for patients.
‘They deserve to be treated with the same respect as anyone else coming to work in the NHS,’ she said.
‘While we have always been clear that they are not replacements for doctors, there are clear and ongoing concerns which we are listening to carefully and taking action to address – this independent review marks our pledge, together with the government, to getting this right.’
It comes as the Labour government has committed to developing a new long-term workforce plan for the NHS that will be published next summer.
