Pavilion Publishing and Media Ltd
Blue Sky Offices Shoreham, 25 Cecil Pashley Way, Shoreham-by-Sea, West Sussex, BN43 5FF, UNITED KINGDOM
Tel: +44 (0)1273 434 943
Email: [email protected]
The government has announced that it will lay legislation this week to begin the process of regulating physician associates (PAs) and anaesthesia associates (AAs) through the General Medical Council (GMC).
The Anaesthesia Associates and Physician Associates Order (AAPAO) is due to be laid in Westminster and the Scottish Parliament on Wednesday 13 December.
The GMC will set standards of practice, education and training, and operate fitness-to-practise procedures, ensuring that PAs and AAs have the same levels of regulatory oversight and accountability as doctors and other regulated healthcare professionals. The regulations will come into force at the end of 2024.
Physician associates and anaesthesia associates are healthcare professionals, trained to the medical model. They have been practising in the NHS since 2002 and 2004, respectively.
PAs work alongside doctors providing medical care as an integral part of the multi-disciplinary team. They can work autonomously, but always under the supervision of a fully trained and experienced doctor. Staff working in the role are also trained to do clinical duties such as taking medical histories, carrying out physical examinations, and developing and delivering treatment and management plans.
There are currently around 1,500 PAs working in hospitals and 1,700 in primary care settings. There are approximately 320 AAs. The Long Term Workforce Plan sets out plans to increase the PA workforce to 10,000 by 2036 to 2037 and the AA workforce to 2,000 over the same period.
BMA says GMC regulation will encourage a false impression
The move, however, has been condemned by the British Medical Association (BMA) for encouraging a false representation that could make patients think they are receiving a doctor’s standard of care.
It said that by giving the impression that PAs can do everything doctors can do, the government is opening the way to more patient safety incidents along the tragic lines already seen.
Prof Philip Banfield, BMA chair of council, said: “For the government to call this move a “boost” to patient safety, it will feel like another slap in the face for undervalued UK doctors who have spent years patiently explaining why it is exactly the opposite.
“At every stage we have been clear that the GMC is the wrong regulator for medical associate professionals: it is the body for regulating doctors, which these professionals simply are not. For the government to press on despite the overwhelming opposition of the medical profession and opposition from patients shows they are failing to take seriously the safety concerns that have been raised about the choice of regulator.”
A UK-wide BMA survey also found that doctors are reporting overwhelming concern about patient safety in the NHS due to the current ways of employing physician associates and anaesthesia associates.
87% of doctors who took part said the way AAs and PAs currently work in the NHS was always or sometimes a risk to patient safety.
In addition, 86% reported that they felt patients were not aware of the difference between these roles and those of doctors, showing the immense scope for patient confusion about the level of care they are receiving. In a separate survey of the public, 29% of patients said they did not know whether or not they had been seen by a PA.
Physician Associates have important role
The government, however, hopes regulation and growth of these roles will support plans to reduce pressure on frontline services and improve access for patients.
It said that regulation will give the GMC responsibility and oversight of doctors, PAs and AAs, allowing it to take a holistic approach to the education, training and standards of the roles. This will enable a more co-ordinated approach to regulation and, by making it easier for employers, patients and the public to understand the relationship between these roles and doctors, help to embed them in the workforce.
Charlie Massey, Chief Executive of the General Medical Council, said: “This is a welcome and significant milestone towards bringing PAs and AAs into regulation.
“We’re pleased to support the development of these valuable professionals recognising the important role they play in the medical workforce. Regulation will help increase the contribution PAs and AAs can make to UK healthcare while keeping patients safe.
“We are working hard to design and deliver detailed regulatory processes for registration, education, standards and fitness to practise for both profession.”