Doctors who have worked with physician associates (PAs) have been asked to share their experiences with the Doctors’ Association, following controversies around their role.
It comes as the Department of Health and Social Care (DHSC) is preparing legislation for the regulation of 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.
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’.
Now the Doctors’ Association has asked doctors who are currently working with PAs, or have worked with them in the past, to submit their experiences as part of a survey.
The Doctors’ Association said: ‘In light of numerous recent concerns, we are collating issues at a local level from doctors who are working with physician associates.
‘We will maintain strict confidentiality and privacy for all submissions, and will ensure all identifiable details are removed unless we have your express permission for use.’
PAs are part of ARRS and can perform diagnostic and therapeutic procedures and develop treatment management plans, under the supervision of doctors.
Regulation is expected to begin ‘in the second half of 2024 at the earliest’, according to the GMC.
During the RCGP annual conference last week, GMC’s chair of council Professor Dame Carrie MacEwen discussed the role of PAs in reducing GP workload with RCGP chair Professor Kamila Hawthorne.
Professor MacEwen told the conference: ‘One of the things that we did point out was how the team can work and how general practice can be supported by other professions, nurses, physios, pharmacists and so on – and maybe by other doctors.
‘I know [the role of Pas] has been very controversial and we are going to be regulating PAs, we know that, and I think it’s really important that we have all these ways of delivering care.’
Professor Hawthorne said: ‘These professionals should not be working unsupervised in primary care, and should be supervised by qualified GPs.
‘And secondly, they are not replacements for GPs and we wish to make that absolutely clear to Government and NHS England and I’m not sure how clear it has been to them.’
Articles like this give me colicky abdominal pain.
I’ve never worked with a PA, but I did see one as a patient at my practice. It was enough put me off wanting to employ one. It was not their fault, they just simply are not doctors and are being asked to pretend they are providing first contact care.
It seems that employing organisations, whether GP partnerships. ICBs, and also Acute Trusts, are ignoring the risks of allowing PAs to see patients presenting acutely in Primary Care or A&E. Even with extremely tight supervision, the risk is that patients with atypical symptoms and signs will suffer adverse outcomes. The subtleties of history taking and clinical examination, and a genuine understanding of potential differential diagnoses cannot be acquired in the fairly brief and superficial training that PAs undertake.
You cannot replace an A scoring student with an E student. The exam has sorted it out.
i am not perfect. i sometimes get it wrong. but if i – with over 40 years on my working clock – gets it wrong, how can you possibly imagine a PA is going to get it right all the time ?
A few years our local University was starting a course for PAs. I looked at a clinical teaching role but the course content lacked depth and detail. I declined to get involved.