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Independents' Day

GMC ready to regulate physician associates to ‘bolster workforce’

The GMC has said that it is ‘best placed’ to take on the role of regulator for physician associates, but called for government funding to set up the regulation.

In its response to the Department of Health consultation on Regulation of Medical Associate Professions in the UK, the GMC argued that its ‘current regulatory work and remit in relation to doctors, and discussions with key stakeholders, have led us to conclude that there is a compelling case that can be made for the GMC to regulate physician associates’.

It added that regulation could ’dramatically strengthen health services while ensuring patient safety’.

The GMC said it would be prepared to take on the role of regulator, but stressed that it is ‘clear that doctors should not subsidise the costs of set up or the ongoing regulation.’

It called for the Government to provide transitional funding to cover setting-up costs, and said that ongoing costs would be borne by the GMC as an ‘independent regulator’, through collection of an annual retention fee from the physician associates.

The DH consultation, launched in early October, proposed statutory regulation for physician associates after a risk assessment found there was a potentially high risk of harm to patients based on the responsibilities of the role and their high level of interaction with patients. 

The GMC went further by recommending that physician associates should have prescribing rights in due course.

Its consultation response said: ‘This would alleviate pressures on doctors and other professionals with prescribing rights, so that an individual professional’s skill sets are best utilised.

‘It would enable doctors to focus on more complex, higher-risk patient needs.’

Charlie Massey, GMC chief executive, said: ‘Our health services must be dynamic to meet the changing needs of patients and we believe a range of new professionals with varied skillsets must be part of the solution.

‘It’s down to the four UK governments to decide which of these roles should be regulated and by whom.

‘However, as physician associates work closely with doctors, we believe there is a strong argument that we should accept responsibility for them. We are in a good place to do this, providing the Government gives us funding and the underlying legislation is fit enough for modern healthcare.’

He added that the GMC would stay ’focused on its reforms aimed at improving doctors’ professional lives and keeping the cost of registration as low as possible’.

Jeannie Watkins, president of the Faculty of Physician Associates at the Royal College of Physicians, which currently oversees and administers the Physician Associate Managed Voluntary Register, welcomed the GMC response.

She said: ‘The GMC has a long history and wealth of experience in regulating doctors, and understands the standards required both educationally and professionally to deliver safe, competent high-quality medical care to patients.

‘Regulation from the GMC would help provide professional credibility and inspire confidence in both our healthcare colleagues and most importantly patients.’

BMA chair Dr Chaand Nagpaul said the BMA supports the need for statutory regulation of physician associates to ensure there is the ‘necessary competence, accountability and safety of care’ provided by these healthcare professionals.

He added: ‘We believe, however, that that the regulation of doctors should be separate from that of other healthcare workers and providers.

'This is to ensure that the complexities of the medical profession, which has different training structures, career routes and responsibilities to other professions are adequately recognised and taken into account.’

The Health and Care Professions Council in its response to the consultation expressed support for statutory regulation of physician associates and said that ’as a multi-professional regulator we would be willing to act as regulator if asked’.

The Government has committed to recruit 1,000 physician associates to general practice by 2020. Pulse reported that Health Education England is recruiting physician ‘GP ambassadors’ to promote and develop their role in practices, in line with the GP Forward View.

The Department of Health is expected to report on the outcome of its consultation in 2018. Interested parties have until Friday 22 December 2017 to respond.




Readers' comments (10)

  • Strangely caring comment from GMC????
    'Doctors already pay for their own execution rope/bullet so we propose getting the tax-payer to fund the actual on-site gallows/yard executioners. It will be cost-neutral for doctors and agreeable to our business planners and other staff.' 😇
    P.s. Nobody whatsoever will be hurt or injured in this process (and if they are, it will be their own fault for not reflecting where they are and shifting their ass/arse pronto).

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  • End of the line?

    Whats the difference between a nurse practitioner and a physician associate??
    So long as each member pays their own indemnity
    and the physicians indemnity does not rise due to their being ... ahem .. associates associated involuntarily...

    If these physician associates are not skilled nurses then where else will they be coming from .. pharmacists ??

    GMC Monopoly.. who else can or will be allowed to provide the role
    of course they are interested in extra revenue

    Change word "regulate" to
    persecute with little evidence

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  • If physician associates are employed by practices I suspect that market forces will dictate that the cost of indemnity is borne by the employer. many of us already pay indemnity fees for salaried GPs. Make no mistake one way or another it is practices who will end up paying unless this is directly funded by the Government.

    Either practices will be left to pay the the indemnity cost or physician associates will demand higher salaries to account for the cost.

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  • National Hopeless Service

    Bolster = patch up

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  • Desperate times for the NHS.Doctors are neglected ,training numbers are reduced and more quacks are allowed in the profession.

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  • Why have physician associates. I can see no benefit whotsoever. The risk/cost will go to the GP's.

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  • LetsCutTheCrap

    So now the "gatekeeper" role can be handed over to physician associates (PA's).
    They can assess, prescribe, share management with Nurse Practitioners, and then perhaps refer onward and upward to a medically trained doctor, here is an idea, the GP!
    Which automatically gives the GP the mantle of primary physician, and should now be included in the Specialty Register.
    If anything goes t!ts up in primary care, let the PA's have it.
    Also we can now delegate all the rubbish tasks to them.
    So far I see no downsides ;-)

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  • We’re getting increasingly desperate letters asking us if we want to offer a training placement for PAs. No chance!!!!!

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  • AlanAlmond

    Our practice trains PAs. They go straight in and are given a list of patients who come to see them as if they were a Dr. When I’ve seen people after them the patients mostly think they saw a Dr and have great difficulty understanding the difference. To be honest most often they do a supprisngly good job but once in a while they really miss the point and get in no end of bother. It’s pretty easy to guess what kind of atypical, complex stuff causes them difficulty. The thing is you can’t triage in advance for this stuff...the PAs will end up seeing it and they will end up over complicating and miss diagnosing stuff on a regular basis. It’s when stuff is atypical or complex ..or actually nothing parading as something when mistakes take place. I see little to suggest this won’t be inevitable with the wide spread introduction of PAs. and with the current trend towards a fully salaried GP work force with insufficient numbers of medics willing to go through medical school at great expense just to become a part time dogs body ...I cannt see anything else but a primary care service staffed almost entirely by cheep semi Dr PAs supervised by hospital based primary care consultants run by hospital trusts. With all the money and power there is in cash guzzling secondary care...why would it be surprising that we end up with a primary care sevice designed and run by hospitals, with little regard for the lost value of GPs. Any one remember previous comments from Prof M Thomas of the Chelsea and Westminster saying we dont need Drs in primary care, we can all be replaced by paramedics? This idiocy is what is going to happen. That’s what you get when tertiary care surgeons get a say in designing a primary care service. Despite all the fluf and hot air from various prominent GPs, slowly but surely this is what we are getting - whilst nobody is putting this forward as the official plan please someone show me this is not self evidently happening.

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