Leading medics call for independent review into physician associates

Leading medics have called for an independent review into medical associates.

The Academy of Medical Royal Colleges said there should be a review into physician associates (PAs) and anaesthesia associates (AAs) to “clarify claims around their safety and usefulness in patient-facing roles”.

It comes amid an ongoing debate about the use of such roles.

Concerns have been raised about the prospect of PAs and AAs performing tasks outside their capabilities.

The Academy, which represents 24 medical royal colleges in the UK and Ireland, highlighted how there has been an “increasingly acrimonious and destructive debate about their expansion”.

Much of the adverse commentary is “driven by information circulating across social media”, the Academy said in a letter to Health Secretary Wes Streeting and NHS England chief executive Amanda Pritchard.

But much of the debate is “devoid of factual information”, the group added, as it called for a rapid review to examine if the roles are cost effective, their efficiency and whether they are safe for patients.

PAs are graduates – usually with a health or life sciences degree – who have undertaken two years of postgraduate training.

Their role is to “support doctors in the diagnosis and management of patients” and they can deployed across GP surgeries and hospitals.

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.

“What’s important is that we can objectively assess the data around safety, efficiency and cost effectiveness and make a judgment about what precise roles in healthcare may be suitable for them and what levels of responsibility they might be safely given based on the actual evidence.”

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.

“The NHS has issued clear guidance on the deployment of PAs in the NHS and we expect trusts to follow this.”

An NHS England spokesperson said: “The NHS has always been clear about the role medical associates play in supporting clinical teams to provide high-quality care for patients – they are not replacements for doctors but support teams with specific tasks they are trained to do, under supervision.

“We know that the confidence of the public and the medical community is absolutely essential as we develop an NHS workforce that is fit for the future, which is why the NHS has issued updated guidance on the appropriate deployment of these roles, and will continue to work together with government and medical and patient groups to provide clarity on these roles for patients and the public, ahead of the GMC regulation coming into effect at the end of the year.”

Earlier this week the parents of Emily Chesterton, who died after being misdiagnosed twice by a PA, said they do not want another family to “go through this hell” as they backed a legal campaign calling for more clarity about the use of medical associates.

Miss Chesterton died in 2022 at the age of 30 after she had a pulmonary embolism.