The safety of using more, less qualified staff has caused major contention. Here, much of the debate has focused on the role of physician associates (PAs).
Recently the RCGP has said there is ‘no role’ for physician associates (PAs) in general practice, in its evidence to the independent review launched by Wes Streeting into the safety of the roles.
RCGP chair Professor Kamila Hawthorne said that this position was reached after GPs reported ‘specific’ examples of patient safety ‘being compromised by the work of PAs’.
In a letter to Professor Gillian Leng, president of the Royal Society of Medicine and former chief executive of NICE, who is leading the review, she set out the college’s position on the roles.
Professor Hawthorne said: ‘I am writing in relation to the independent review you are leading of physician associate (PA) and anaesthesia associate (AA) professions, to set out the college’s position that there is no role for PAs in general practice.
‘Our position was reached through a vote at our UK Council in September 2024, following a member survey that found 50% of all respondents reporting being aware of specific examples of patient safety being compromised by the work of PAs.
‘Common themes from responses to our survey included misdiagnosis and diagnostic errors by PAs, inappropriate prescribing and management, and lack of communication to patients and GPs.’
It comes after the college voted to oppose the role of PAs in general practice last year, and went on to set out a clear scope for the 2,000 PAs who currently work in practices, which severely limited their roles.
The NHS workforce plan commits to expanding their number to 10,000 by 2036 without saying how many will be in general practice.
Regulation by the General Medical Council officially began in December with around 5,000 PAs across the UK now set to be regulated.
There have been reports of redundancies, and the numbers of PAs hired under ARRS continues to a steady decline. The recent monthly primary care workforce figures showed that the number of full-time equivalent (FTE) PAs has decreased by 37 to 1,147, from 1,184 in July.
As sister title Pulse’s report on the issue concludes – ‘Between [an ongoing] legal case and the Leng review, spring 2025 will hopefully bring clearer directions from central bodies on how PAs should be deployed.’