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Calls mount for independent review into physician associates

LEADING medics demanded an independent review into physician associates (PAs) and anaesthesia associates (AAs) to investigate concerns around patient safety today.

Plans have been outlined to expand the number of PAs and AAs across the NHS to 10,000 by 2037. 

Unlike doctors, who study medicine for five years and undertake two years of placements, medical associates qualify from a two-year master’s degree. 

The roles have faced backlash over concerns that they will replace trained doctors.

This intensified after a 29-year-old woman died in 2022 after being misdiagnosed twice by a PA she thought was a GP. 

The Academy of Medical Royal Colleges has written to Health Secretary Wes Streeting and NHS chief Amanda Pritchard to call for a rapid review to “clarify claims around their safety and usefulness in patient-facing roles” and examine if the roles are cost effective, efficient and safe for patients.

Dr Jeanette Dickson, chairwoman of the Academy, said: “The expansion of PA/AAs is causing an increasing amount of disquiet, upset and confusion across different parts of the NHS and is damaging working relationships in hospitals particularly in multi-disciplinary teams that have traditionally worked well together.

“We want an independent, evidence-based, rapid review to help us make a decision about how best to delineate their roles and where they might best fit into the system.”

The British Medical Association (BMA) has warned that plans for the associates to be regulated by the General Medical Council in December risks “blurring lines” between doctors and associates, and has launched legal action against the regulator.

Commenting on the Academy’s letter, BMA council chairman Professor Philip Banfield said: “The Academy has finally acknowledged the mounting worries of the medical profession about the expansion of the role of PAs and AAs, who cannot and should never replace the role of a fully qualified doctor.

“In survey after survey, thousands of doctors tell us of severe worries about the use of lesser-qualified staff in place of appropriately trained medical professionals. What is troubling is that it has taken so long for it to acknowledge that concern.”

“Until we get a commitment of a full and frank investigation, and NHS England can ensure that PAs are working to a strict scope of practice such as the one BMA has produced, we need the recruitment and expansion of PAs to be paused.”

A Department of Health and Social Care spokesperson said: “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 should receive the appropriate level of supervision by healthcare organisations.”

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