Over 2,000 doctors have expressed ‘grave concerns’ about the upcoming regulation of physician associates (PAs) in an open letter to the GMC.
Published yesterday by the Doctors’ Association UK (DAUK), the letter calls on the GMC to address inconsistencies between the ‘stringent’ requirements for doctors and the proposed transition for PAs.
The doctors make specific recommendations to address growing concern among the medical profession, saying the current proposals are ‘unsafe, premature, and lacking the necessary safeguards’.
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.
In their open letter, DAUK co-chairs Dr Matt Kneale and Ms Helen Fernandes said: ‘While we recognise the necessity of robust regulation for these roles, we find that the current approach aggravates existing tensions between doctors, regulatory bodies, and the government, and falls short in multiple crucial aspects.’
According to the letter, the plan to introduce a seven-digit registration number for PAs and AAs, like the numbers issued to registered doctors, would introduce ‘unnecessary confusion’ – it called for ‘distinct GMC numbers’ to be given to these groups.
Currently, PAs can join a voluntary register with the Royal College of Physicians, and DAUK has said the plan to transition these registrants to the GMC will forgo checks which are ‘equally rigorous’ to those faced by doctors.
The letter also demands the GMC formulate a ‘clearly defined scope of practice’ for PAs and AAs in order to avoid local variation which could lead to ‘further confusion and possible exploitation of both doctors and PAs’.
- The GMC should immediately inform the Government about the growing discontent and advocate for reopening the consultation process with the Department of Health and Social Care.
- If the regulation of PAs by the GMC goes ahead, distinct GMC numbers should be allocated to PAs to distinguish them from medical doctors.
- All PAs transferring from the voluntary Royal College of Physicians register to the GMC’s statutory register must undergo thorough verification and checks, especially with regard to Fitness to Practise procedures.
- The GMC must establish a clearly defined scope of practice for PAs and AAs, eliminating the option for these to be set locally.
A GMC spokesperson said: ‘We’re pleased to support the development of regulation for these valuable professionals, recognising the important role they can play in the medical workforce.
‘Regulation will help to increase the contribution PAs and AAs can make to UK healthcare, while keeping patients safe.’
‘We have already completed a significant amount of work in preparation for regulation. In particular, we have been working to develop policies and processes to support oversight of PAs and AAs education, the introduction of pre-registration assessments, as well as looking at the standards they will need to meet and the actions we will need to take following any serious breaches of those standards,’ they added.
Controversy surrounding the PA and AA roles has grown this year, particularly following an incident of ‘poor quality’ care at a GP practice which led to a patient’s death.
The BMA recently laid down its position on PAs, highlighting concerns around ‘patient confusion’ and an ‘unjust’ pay differential, and the RCGP has also updated its guidance, pointing out that PAs have ‘an enabling role to play for general practice’ but they ‘must not and do not replace GPs’.
Physician associates are part of ARRS and can perform diagnostic and therapeutic procedures and develop treatment management plans, under the supervision of doctors.
According to the Faculty of Physician Associates estimates, there are currently around 3,000 qualified PAs working in the UK.