Government Orders Review of Physician and Anaesthesia Associates in NHS
The UK government has initiated a comprehensive review of physician associates (PAs) and anaesthesia associates (AAs) in the NHS following growing concerns about their expanding roles and potential patient safety issues.
Health Secretary Wes Streeting announced the review, acknowledging legitimate concerns while also criticizing the “toxic nature of the debate” surrounding these healthcare professionals. The review will examine how PAs and AAs are deployed and what safeguards are needed to ensure patient safety and clear professional boundaries.
Currently, the NHS workforce plan aims to dramatically increase the number of PAs and AAs from just over 3,000 to 12,000 by 2036. PAs can work in GP surgeries and hospitals, performing tasks such as taking medical histories, conducting physical examinations, and ordering some scans. However, they are not authorized to prescribe medication. AAs, who support surgical teams, are much smaller in number, with only about 100 currently in the NHS.
The review was prompted by several significant concerns, including a recent high-profile case involving the death of 77-year-old Susan Pollitt at Royal Oldham Hospital. An inquest into her death highlighted potential risks associated with PA involvement in medical procedures.
North Manchester coroner Joanne Kearsley raised critical issues about PAs, including:
– Lack of a comprehensive national regulatory framework
– Insufficient training and supervision guidelines
– Limited understanding of their role among patients and NHS staff
– Potential confusion due to the title “physician” and lack of distinct uniforms
The British Medical Association has voiced concerns that PAs are increasingly being asked to perform tasks beyond their intended scope, blurring the lines with doctors’ responsibilities.
Positive aspects of the review include:
– The General Medical Council will begin regulating PAs and AAs next month
– Healthwatch England has reported some patients have had positive interactions with PAs
– The goal is to clarify roles and improve patient care
Streeting hopes the review will “take the heat out of the issue” and ensure the right professionals are performing appropriate tasks. The review will be led by Prof Gillian Leng, a former chief executive of the National Institute for Health and Care Excellence, and is expected to report back early next year.
The Academy of Medical Royal Colleges has supported the review while criticizing the increasingly acrimonious debate, which they believe is damaging healthcare teamwork.
Key concerns remain about patient transparency, with Healthwatch England noting that patients are not always informed when they are being seen by a PA instead of a doctor.
The review aims to address these complex issues and provide clear guidance for the future integration of PAs and AAs in the NHS workforce.
