The GMC has asked NHS England to address the perception that there is ‘a plan for health services to replace doctors with physician associates (PAs)’, amid an ongoing controversy around their roles.
GMC chief executive Charlie Massey wrote to NHS England’s Dr Navina Evans, chief workforce, training and education officer, and national director Professor Sir Stephen Powis pointing out that discussions around PAs ‘have escalated and grown more intense in recent weeks’.
He said that this is having an impact on PAs and anaesthetic associates (AAs) already in the workforce and on students who are in training to take up these roles, and that organisations are being challenged to consider their positions on the development and deployment of these professions.
The letter, first reported by HSJ, said: ‘As we’ve developed the regulatory model for PAs and AAs, we’ve spoken with a range of individuals and organisations across the four countries of the UK.
‘Through this work we’ve identified several issues which it would be helpful for NHS England, the Department of Health (Northern Ireland), and the NHS in Scotland and Wales to collectively address.’
These included ‘directly tackling’ the perception that there is a plan for the health services to ‘replace’ doctors with PAs or AAs ‘by convening and leading a system-wide discussion on an agreed vision for these roles’.
Mr Massey added: ‘This should include how PAs and AAs fit into multi-disciplinary teams alongside other professions (especially doctors and advanced clinical practitioners), the frameworks needed for them to work safely, and a balanced position on PA and AA scope of practice.
‘We believe governments should also consider what they can say about future training numbers to make it clear that their workforce plans envisage significant growth in doctor numbers, as well as amongst PAs and AAs.’
The GMC also said that there is a need to be ‘more explicit about commitments to safeguard postgraduate medical training’ as the PA and AA workforce increases.
Mr Massey said: ‘Our approval of training is on the basis that training organisations can deliver the opportunities for trainees to achieve their curricular requirements and thus meet in full the requirements of promoting excellence.’
It comes as the Department of Health and Social Care is preparing legislation for the regulation of PAs and AAs, after closing a long-awaited consultation which suggested PAs could get prescribing rights in order to relieve pressure on GPs.
The GMC’s letter also mentions that legislation needed for the GMC to be the regulator of PAs and AAs will be laid before Parliament before the end of the year and that following that, the GMC will hold a public consultation on the regulation at the end of 2024.
Professor Stephen Powis, NHS England’s national medical director, said: ‘There is emphatically no plan to replace doctors in the NHS, with the NHS Long Term Workforce Plan setting out a doubling in the number of medical degree school places to 15,000 by 2031, compared to 1,500 physician associate places – this in turn will mean a major expansion of specialty training which we are committed to working with the Royal Colleges on.
‘Physician associates are highly trained practitioners that support and work under the supervision of a GP after having significant clinical experience during their training.
‘The NHS has been working closely with the GMC on the development and regulation of this role for many years and we are pleased to see their commitment to ensuring regulation is agreed as a matter of urgency.’
Meanwhile, NHS England has just launched a national NHS campaign aimed at increasing patients’ confidence in the triage process and ‘non-GP’ roles used by practices.