As reported in The Herald, physician associates (PAs) should be barred from treating patients who haven’t first been assessed by a doctor, according to a government-commissioned review
The report, led by Professor Gillian Leng, president of the Royal Society of Medicine, recommends a major overhaul of the PA role within the NHS, amid growing concern that PAs are being used as substitutes for doctors despite having considerably less training.
Currently, more than 3,500 physician associates and 100 anaesthesia associates (AAs) are working in the NHS. However, increasing opposition from within the medical profession – coupled with several high-profile patient deaths involving misdiagnosis by PAs – prompted Health Secretary Wes Streeting to commission a formal review.
Presenting her findings, Prof Leng stated: “Crucially, I’m recommending that PAs should not see undifferentiated or untriaged patients.” She added that when patients have been properly triaged, PAs could see adults with minor ailments, provided this is in accordance with guidance from the Royal College of General Practitioners.
To clarify the purpose of these roles, the report recommends renaming physician associates as “physician assistants” to reflect their intended position as a supportive, complementary part of the medical team. Likewise, anaesthesia associates would be renamed “physician assistants in anaesthesia.”
The review also calls for newly qualified PAs to complete at least two years of hospital experience before being permitted to work in GP surgeries or mental health settings.
Although studies suggest that patient satisfaction with PAs is generally high, the report found that many patients were unaware they were not being seen by a doctor. Additionally, a significant number of doctors expressed concern over the level of supervision PAs and AAs require, and the lack of formal training for those expected to supervise them.
A survey included in the review revealed limited confidence in the diagnostic capabilities of PAs. Only 29% of primary care doctors working alongside PAs felt it was appropriate for them to diagnose illness, a figure that dropped to just 14% in secondary care.
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