There is ‘no role’ for physician associates (PAs) in general practice, the RCGP has said in its evidence to the independent review into the safety of the roles.
RCGP chair Professor Kamila Hawthorne said that this position was reached after GPs reported ‘specific’ examples of patient safety ‘being compromised by the work of PAs’.
In a letter to Professor Gillian Leng, president of the Royal Society of Medicine and former chief executive of NICE, who is leading the review, she set out the college’s position on the roles.
It comes after the college voted to oppose the role of PAs in general practice last year, and went on to set out a clear scope for the 2,000 PAs who currently work in practices, which severely limited their roles.
Professor Hawthorne said: ‘I am writing in relation to the independent review you are leading of physician associate (PA) and anaesthesia associate (AA) professions, to set out the college’s position that there is no role for PAs in general practice.
‘Our position was reached through a vote at our UK Council in September 2024, following a member survey that found 50% of all respondents reporting being aware of specific examples of patient safety being compromised by the work of PAs.
‘Common themes from responses to our survey included misdiagnosis and diagnostic errors by PAs, inappropriate prescribing and management, and lack of communication to patients and GPs.’
The independent review was launched last year by health secretary Wes Streeting in order to ‘establish the facts’ and ‘take the heat out of the issue’.
It will not cover a detailed scope of practice by setting, but will look at if and when an ‘enhanced’ scope of practice may be necessary, and it will also cover cost-effectiveness of the roles and supervision.
In her evidence, Professor Hawthorne also included some ‘key factors’ underlying the decision to ‘oppose’ a role for PAs in general practice including concerns that the red lines for the PA role in general practice were ‘in many cases not being adhered to’.
‘It is important to emphasise that the RCGP position is that at a time of significant GP workforce challenges, funding allocations, resources and learning opportunities within general practice must be prioritised for the training and retention of GPs,’ she added.
Pulse has recently looked in detail at conflicting views and advice on the scope of practice for PAs.
Doctors leaders have continued to raise safety concerns as regulation officially began in December.
Around 5,000 PAs across the UK will now be regulated by the GMC, as registration opened mid-December.
However, PAs have been given until December 2026 to register, after which it will become ‘an offence to practise as a PA’ or an anaesthesia associate (AA) in the UK without registration.
Last month, the GMC released a long-awaited report on findings from its consultation on the roles, which launched in March, with only minor tweaks made to its plans for PA regulation.
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Monopolists seek to protect their monopoly shock.
Also, of course, the mainly-NHSE monopoly health service and British government, W Streeting MP and K Stammer PM, seek to do health and General Practice ‘on the cheap’, underfund, so they will want to promote and protect the use of PAs
who cost less than GPs and what is more, aided and abetted by some GPs who employ them; furthermore, it is not very good, is it, to have unemployed real GPs because the money is going to PAs. The relentless direction of travel by the NHS monopoly is “reduce the number of self-employed GPs” and opposing this ethos seems to be so very ineffective, late and weak.
RCGP are completely out of touch with the reality of life for our patients. Most mistakes are made by doctors not PAs or nurse practitioners, receptionists or other staff- so we should cancel doctors first! The Leng review is hopefully a scientific review of evidence not reports from vested interests scapegoating others in a system struggling to see our elderly or care for them when they die. I expected better from this representative body but it is not fit for purpose, apart from a coffee waiting for a train at Euston.
Seems daft, I think PA’s can have a role in General Practice. However it needs to be a well defined one and likely limited to specific things – they could be trained up in long term condition management for example or skilled up in palliative care and work within care homes.
However the issue is essentially pay – their pay rates are over and above what the above roles are worth and they constant need for supervision and debriefing creates a lot of work for GP’s. If their pay was lower with more scope to slowly increase to a more sensible top banding they can have a role. However there’s no way that financially they are a sensible use of resources compared with say a pharmacist, practice nurse, ANP or salaried GP.
I agree. Either you know how to fly the plane or you don’t. You can’t be the pilot but delegate the responsibility if things go wrong to someone else.
It is not right to replace doctors with those who have less training and that includes pharmacists who now see patients with minor illnesses. I see patients suffering harm. The problem is the training and not who does the job. With proper training, anyone can do our job.
Ironic – from a man who’s own daughter is a physician associate and has actively hired PAs and replaced GPs where he works locally – I think you should declare your conflicts of interest every time you open your mouth and reflect on the ladders you pull up.
RCGP * Its too little and too late*. Now we will wait for future survey comparing UK Primary care service quality with Europe’s ones and see.
GPs soon will have no role in General Practice.
Just to remind everyone, membership of this organisation is entirely optional. They are not your friends.