BMA says that physician associates are creating more work for doctors

The British Medical Association (BMA) is calling for an immediate halt to the recruitment of Medical Associate Professionals (MAPs) in the UK, including Physician Associates (PAs) and Anaesthesia Associates (AAs) on the grounds of patient safety.

The call follows a survey of almost 19,0000 doctors by the BMA that found 55% of doctors are finding that working with PAs and AAs are increasing their workloads rather than decreasing them.
Only 21% of respondents reported a decreased workload since the employment of MAPs.

As a result, the BMA wants the long-term expansion plans for the roles to be paused and titles reverted to physician assistant and​ physician assistant (anaesthesia)​​/anaesthesia assistant to avoid public confusion. In addition, it says that the scope of the roles should be​ strictly​ limited to ​the​​​ original intention of supporting doctors with administration tasks and​ a defined range of low-risk​ clinical​ tasks​​.

Physician associates (PAs) are healthcare professionals with a generalist medical education who work alongside doctors and surgeons providing medical care as part of the multidisciplinary team. PAs work under the supervision of a named senior doctor (such as a named General Medical Council registered Consultant or GP) but can work autonomously with appropriate support.

Although the physician associate profession is still considered relatively ‘new’ in the UK, the first physician associates were formally introduced in 2003. The role of physician assistant first developed in the US in the 1960s, and equivalent or similar roles exist in many healthcare systems around the world.

The role of PAs in the NHS is becoming a divisive issue as many doctors have told Pavilion Health Today that they find working with PAs very useful and think they are the subject of too much bad press at the moment.

Doctors say physician associates drain their time and energy

The BMA, however, say that too many doctors are telling them that working with PAs is draining their time and energy. This is due to the responsibility for signing off prescriptions and ensuring the PAs are working within their proper scope of practice, which falls on the supervising doctor.

Prof Phil Banfield, BMA chair of council, added: “The House of Lords will soon have a chance to oppose damaging legislation that aids that blurring of lines by regulating PAs under the GMC, the doctors’ regulator rather than the more appropriate Health and Care Professions Council.

“The Government and NHSE should be instead ensuring that PAs return to their original purpose of supporting, not replacing doctors, so that doctors can get on with utilising the diagnostic and treatment skills they have spent so long at medical school gaining their expertise in.  Their scope should be strictly defined and, to ensure patients are not confused, the title returned to the more accurate “physician assistant” – then they can play their valuable role in supporting the delivery of NHS care safely.”

The BMA added that MAPs should not be utilised on any level of doctor rota ​or​​ perform, train in, or consent ​to​​​ invasive or life-threatening procedures. They should not be receiving any specialty referrals ​or​​ be in roles​ requiring them to give specialty advice. They should not make ​unsupervised ​treatment decisions or management plans. They must work under direct on-site supervision ​​at a level commensurate with their qualification and not​ be​ ​using​​ ​ on-the-job experience​ to work beyond their formal level of qualification.