The role of physician associate (PA) ‘remains viable’ after the Leng review, PCN leaders have said.
The review, which recommended a change in name to physician assistant, suggested clearer governance, supervision and training of the role. But said it would be a ‘significant, unprecedented intervention’ to abolish the role fully, adding that the role did not need to be scrapped.
The Government yesterday accepted all the recommendations of the report.
PCN leaders have welcomed the review, with one saying there were ‘sensible and pragmatic recommendations’.
Dr Sarit Ghosh, clinical director at Enfield Unity PCN in north London, said the role would still be ‘viable’ in primary care.
He said: ‘Across the RCGP and Leng guidance, it appears a front end GP triage model with supervision and debrief time would still mean the role is viable in primary care especially as PA competency and scope increase with training.’
But he added that there were areas that needed development, for example around children.
He said: ‘I do question why children are excluded from the RCGP scope and Leng job description, especially when they are able to be seen in the Pharmacy First scheme (without GP supervision) for defined conditions such as earache and sore throat. Stable, low risk mental health presentations also seem an area where the added time and good PA communication skills described in the Leng review would be suited and patients could benefit.’
He added there was also uncertainty around the recommendation of two years in secondary care for newly qualified PAs and how that could apply to the existing workforce in primary care.
Dr Beth Lynch, clinical director at Brownlow Health PCN in Liverpool, added that the outcome ‘seems to support their potential contribution within the NHS workforce’, but also recognised the need for ‘much clearer governance, supervision and training protocols to ensure patient safety remains priority’.
She added that the review did not change her PCN’s attitude towards hiring PAs.
‘At Brownlow, we have taken the decision to not to embed PAs in our clinical workforce, instead focusing on developing and investing in roles that closely align with our clinical model and the needs of our patient population,’ she said. ‘The outcome of the Leng report will not change this for us.’
The RCGP however said that their position opposing the role in general practice remained.
Professor Kamila Hawthorne, chair of the RCGP, said: ‘Our position is that the College opposes a role for PAs in general practice.
‘We’ll be considering the Leng Review's findings and recommendations but any change to our position would need to be agreed by College Council.’
The GMC, which now regulates the profession, said the review brings ‘much-needed clarity’ and offers an opportunity to ‘reset across healthcare’.
‘As the regulator for PAs and AAs we work with them to ensure good, safe patient care,’ said Charlie Massey, chief executive and registrar of the GMC.
‘Our regulation has been helping provide assurance to patients, employers - and doctors that PAs and AAs have the right level of education and training, meet the standards that we expect, and that they can be held to account if serious concerns are raised.
‘The findings of the Review will be pivotal to how we work with others and continue to improve our regulatory practices. We look forward to working on the aspects of the report that relate to the GMC and with others where there is a shared responsibility to deliver change.
'As always, patient safety remains our absolute focus and priority.'
In May, the GMC approved 33 PA courses after it became the regulator for the profession.
It comes as the decline in the number of PAs has slowed, according to the most recent monthly workforce statistics.