Call for halt on physician associate recruitment

As reported by GP Online, GP leaders raise concerns over the increasing use of physician associates, calling for an immediate recruitment freeze until safe regulatory processes are established in English general practice

A motion passed by the BMA England GP committee this week expressed concern over the increasing use of physician associates, warning they are not a safe or appropriate substitute for a GP.

The committee demanded an ‘immediate pause on all recruitment of PAs’ across PCNs and in general practice in England until safe regulatory processes and mechanisms are in place.

GP leaders voted in favour of a statement warning that it was ‘entirely inappropriate and unsafe’ for GP registrars to be supervised or debriefed by PAs – and reminding registrars that they could refuse to sign prescriptions or order tests on behalf of staff in these roles.

The motion also rejects plans for PAs to be regulated by the same regulator as doctors, warning that they should be ‘appropriately and safely regulated by a body other than the GMC’.

Warnings over the use of PAs in general practice have intensified in recent weeks and months. Thousands of doctors signed a Doctors Association UK letter this week warning that plans for the GMC to regulate PAs were ‘unsafe’.

The letter came just days after the RCGP set out ‘red lines for the use of PAs in general practice, warning that these roles must always be supervised and never be expected to perform the full range of work a doctor carries out. The BMA also published a position statement opposing expansion of PA roles in September.

Commenting on the motion passed this week, BMA England GP committee chair Dr Katie Bramall-Stainer said it was ‘about finding ways to protect patients by ensuring appropriate processes and regulations are in place’.

She said: ‘The BMA recognises the vital role that multidisciplinary teams play in the NHS. In general practice, patients have long benefited from having access to a wide variety of healthcare professionals that can input into their care, from physiotherapists to diabetes nurses.

‘Patients need to know and understand what each healthcare professional can & cannot do, & where their expertise is relevant. This is crucial in helping patients understand the care they’re being given.

‘Recently, we have seen some examples in the media that suggest there is a potential blurring of the line between doctors and non-medically qualified professionals, leading patients to think they’ve seen a GP or other medically-qualified team member when they haven’t.

‘GPs are expert medical generalists with the experience and medical knowledge to diagnose, treat and manage multiple and complex conditions. PAs are not doctors – they are not regulated and they cannot prescribe. At best this is confusing, at worst, it can threaten patient safety.’