NHS Boss Says Physician Associates Are “Having A Really Hard Time”

Trade Unionists and doctors protested against the use of PAs outside Parliament earlier this year (Alamy)

3 min read04 December

Amanda Pritchard, Chief Executive of NHS England, told PoliticsHome the Government decision to hold a review into PAs was “absolutely the right decision”.

An ongoing row is dividing NHS staff members over the increasing use of physician associates (PAs) and anaesthesia associates across the health service.

PAs are healthcare professionals who work under the supervision of senior doctors to assess, diagnose, and treat patients, needing only around two years of training compared to four to seven years for doctors at medical school. 

With plans to increase the number of PAs in the NHS from around 4,000 to 10,000 by 2036/37, doctors and trade unions have expressed concerns that the lines between professions in the NHS are getting increasingly blurred and that PAs could be used to plug the gap when there is a shortage of doctors.

Pritchard said she was concerned that PAs are “having a really hard time in lots of places at the moment”.

“There’s a lot of strong feeling about this, and some of the social media debate in particular has spilled over into, for some colleagues, their working environment being very difficult,” she said.

“I’m certainly aware of a number of places that are having to provide quite a lot of mental health support, as well as professional support, for people in those roles.”

The British Medical Association and Royal College of GPs have called for a halt to the recruitment of PAs. Meanwhile, Health Secretary Wes Streeting has announced a review that will consider how they are being deployed and what safeguards are needed to protect patients, citing “legitimate concerns over transparency for patients, scope of practice and the substituting of doctors”.

Pritchard said the NHS was “clear” that PAs were “not replacements for doctors”, but said an “independent” review was “absolutely the right decision” as “good multi-disciplinary team working” is key to the NHS running smoothly.

“We’ve got really legitimate concerns being expressed from doctors and others,” she said. 

“So having a proper evidence-based review with an independent person who can talk to lots of different people, gather evidence and give us some genuinely independent advice on the best way forward is absolutely right.”

However, she added that “it is worth us remembering these are not new roles”.

“These have been around for a very long time, both in this country and internationally. There was a plan, still is a plan, to regulate those roles. That was always going to be critical because that helps to really codify the Code of Practice.”

She added that it was important that work on regulating the roles “continues”.

The review, which was launched on 20 November and will be led by Professor Gillian Leng CBE, will gather evidence from patients, staff, employers, professional bodies, and academics.

The full interview with Pritchard will be published this weekend.

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