The BMA’s GP Committee for England has called for an immediate pause on all recruitment of physician associates across general practice and PCNs.
During a meeting yesterday, the committee passed an emergency motion ‘expressing concerns over the increasing trend of PAs being used to substitute GPs’, and calling on practices and PCNs to stop PA recruitment ‘until appropriately safe regulatory processes and structures are in place’.
The motion also reminded GPs and GP registrars that they may refuse to automatically sign prescriptions or request investigations on behalf of a PA.
GPC England chair Dr Katie Bramall-Stainer said that the motion is ‘about finding ways to protect patients’ by ensuring appropriate processes and regulations are in place.
She said: ‘The BMA recognises the vital role that multidisciplinary teams play in the NHS. In general practice, patients have long benefited from having access to a wide variety of healthcare professionals that can input into their care, from physiotherapists to diabetes nurses.
‘Patients need to know and understand what each healthcare professional can and cannot do, and where their expertise is relevant.
‘This is crucial in helping patients understand the care they’re being given. Recently, we have seen some examples in the media that suggest there is a potential blurring of the line between doctors and non-medically qualified professionals, leading patients to think they’ve seen a GP or other medically-qualified team member – when they haven’t.
‘GPs are expert medical generalists with the experience and medical knowledge to diagnose, treat and manage multiple and complex conditions.
‘PAs are not doctors; they are not regulated; and they cannot prescribe. At best this is confusing – at worst, it can threaten patient safety.’
She said that this distinction must be protected, and PAs ‘cannot be used as a substitute for GPs’, or in place of a GP when supervising GPs in training.
Dr Bramall-Stainer added: ‘The GP workforce crisis is a result of the failure of Government to plan for the recruitment and retention of GPs.
‘Only by valuing and investing in the recruitment and retention of GPs will the experience and care of patients improve.
‘While PAs may help reduce general practice workload in some cases, it should not come at the expense of patient safety.’
The Department of Health and Social Care (DHSC) is currently preparing legislation for the regulation of both PAs and anaesthetic associates (AAs), after closing a long-awaited consultation which suggested PAs could get prescribing rights in order to relieve pressure on GPs.
This legislation is due to be laid before Parliament by the end of this year, with GMC regulation expected to begin by the end of 2024.
Last week, the GMC asked NHS England to address the perception that there is a ‘plan for health services to replace doctors with physician associates’, in a letter which said discussions around PAs have escalated in recent weeks.
The motion in full:
That GPC England fully endorses the recent statement by UEMO expressing concern over the increasing trend of “Physician Assistants/Associates” (PAs) being used to substitute GPs in English General Practice, and:
i) asserts that PAs are neither a safe nor an appropriate substitute for a GP
ii) calls for an immediate pause on all recruitment of PAs across PCNs and General Practice until appropriately safe regulatory processes and structures are in place
iii) reminds GPs and GP registrars that they may refuse to automatically sign prescriptions or request investigations including ionising radiation on behalf of a PA
iv) asserts that it is entirely inappropriate and unsafe for GP Registrars to be supervised or debriefed by PAs
v) demands that PAs be appropriately and safely regulated by a body other than the GMC
Dr Samuel Parker
Dr Matt Mayer and Dr Ian Hume