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GMC calls for physician associates to be regulated

Exclusive The GMC has called for physician associates to be regulated ahead of a major rollout of the new grade across general practice, in opposition to the Government’s position that they should be subject to voluntary registration. 

GMC chief executive Niall Dickson told Pulse that the regulator believed that the grade should be subject to statutory regulation, and that the GMC was exploring how it would regulate them if it was asked to do so.

However, GMC board papers claim that the Department of Health’s position is for there to be no statutory regulation, with PAs to continue to be voluntarily registered.

The Government has pushed for PAs to fill gaps in the GP workforce, with a committment from health secretary Jeremy Hunt to recruit 1,000 PAs to work in UK general practice by 2020.

There is currently a voluntary register for PAs operated by the Royal College of Physicians (RCP), and the Professional Standards Authority in turn regulates organisations holding such voluntary registers.

But Mr Dickson told Pulse that the regulator itself believes that an statutory element should be brought in.

He said: ‘Physician associates look set to play an increasingly important role in supporting the delivery of safe medical care. 

‘We have received a number of approaches about taking on regulation of physician associates in the last few years. We would give the matter serious consideration if the four governments of the UK and the profession felt we should take on this role.

‘Even if the GMC were not considered the right regulator, we do believe that physician associates should be subject to statutory regulation.’

However, the regulator also claims that this is not the position of the UK Government.

GMC minutes from its 30 September meeting stated: ‘The most recent UK Government position has been to prefer an expansion of voluntary regulation under the Professional Standards Authority… the Scottish Government, the Academy of Royal Colleges and PAs themselves are pushing for statutory regulation under the GMC.’

They added: ‘We are beginning to explore the arguments and possible models for regulation of PAs so that we are in a position to offer a considered response if invited to do so…’

The GMC said work included ‘examining the case for statutory regulation of PAs, and the resource implications and start-up costs in the event that we were to take on this role’.

As revealed by Pulse last month, a new NHS scheme is offering £50,000 annual salaries in a bid to double the number of UK PAs by attracting 200 trained in the US between now and 2017, when UK university training courses should begin to produce their own.

According to the RCP’s Faculty of Physician Associates, the universities of Aberdeen, Birmingham, Plymouth, St Georges, Worcester and Wolverhampton have all been running active PA courses since January 2015.

The DH defines a PA as ‘a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision’.

A DH spokesperson said: ‘We are working with NHS England and Health Education England to deliver 1,000 physician associates by September 2020. As part of this we will consider how best they should be regulated.’

Should I employ a physician associate?

 This article was edited on 22 October to correct Mr Dickson’s title, he was previously reported as Professor Dickson.

Readers' comments (19)

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  • At St George's, University of London, we are in our 8th year of successfully educating physician associates. We have a strict selection process which involves Values Based Recruitment. Our students are not medical school rejects and have included those already holding MSc or even PhD degrees. The vast majority of applicants already hold an undergraduate life science degree and receive an intense medical education, which emphasises the importance of evidence-based decision making.

    If readers are interested in learning the facts about PAs, visit the Faculty of Physician Associates website:

    Karen Roberts, MSc, PA-C/R
    Course Director, Physician Associate Studies
    St George's, University of London

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  • First GMC 'regulates' PAs at £420 pa, then BMA entices them skimming £400 pa and finally Indemnity Provider swats them for 10k :)Can see the perplexed look on the Employer's physiognomy.
    Jus' luv it !

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  • Karen - In fairness I don't think there's really be any criticism of PAs (in this thread, the £50k salary thread was always going to be a bloodbath).

    But the fact of the matter is the more qualified they are, the more responsibility they take on, then the more importance that regulation becomes.
    You can train them as well as you would like, the point who keeps an eye once they are out in the wide world.

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  • It may be easier to work as a PA than as a gp! No revalidation, lower indemnity etc...
    If PAs are deeemed safe to work with patients without revalidation and the insane amount of experience and qualifications and paperwork that doctors now need, why are doctors being so victimised for their greater level of training?
    Surely we should have lower indemnity fees not higher.

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  • Well as a quick look at the Pulse Q&A will show (see : the 50k issue is a bit of a red herring, as it is a very temporary measure to bring very experienced US PAs here. There is good UK evidence that PAs can help us GPs (and yes, I'm a GP), and yes regulation would be very appropriate. Many of us are working with GMC and others to move this forward. Meanwhile 10 universities are currently training PAs (including Birmingham where I work and where we started training PAs in January 2008). By 2020 there could be 3,000 or so. NB most work in hospitals; this is NOT a threat to GP.

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  • Dear Dr Parle, while I understand where you are coming from when you say that PAs are not a threat to GPs.
    On a wider issue, the fact that there are some 'alternative' doctors availible may have helped emboldened the government/GMC etc.. to be too rigid and unrealistic in their demands and requirements for doctors revalidation. Consequently myself and many many others (so the officer from GMC alrady told me) have not been able to revalidate and so we have all already been shafted by this situation and been forced to leave medicine since as academics working outside the NHS without responsible officers etc.. it was impossible for us all to revalidate.
    While PAs should theoretically not be a threat to GPs, I do hope for your and others sake this remains the case.

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  • why laugh at asia that they have quacks working as doctors there. Welcome to first world NHS with "qualified qucks with extensive 2yr training"

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  • I'm a 5 session salaried GP, doing a 10-11 hour day, and still struggling to "keep on top " of things, for 50k. Maybe I'll down grade for better pay, respect and QoL as a PA?

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