Almost 14k doctors urge political leaders to address PA ‘scandal’

Almost 14,000 doctors have signed a BMA letter to the major political party leaders urging action on physician associates. 

The letter, sent ahead of Thursday’s general election, expressed ‘grave concern’ about the deployment of associate professionals, and warned that PAs are working ‘in practical terms, as GPs’. 

It called for the next government to take action by implementing a ‘national safe scope of practice’ and an bringing an ‘end to widespread doctor replacement and unemployment’, while arguing that so far politicians have been ‘asleep at the helm’.

The letter was sent to Labour’s Sir Keir Starmer, the Conservatives’ Rishi Sunak and the Liberal Democrats’ Sir Ed Davey. 

The BMA claimed that the ‘worrying trend in general practice funding’ has led to ‘role substitution’, with GPs effectively replaced by physician associates.

It blamed the additional roles reimbursement scheme (ARRS) which has ‘incentivised’ practices to employ PAs while ‘denying the use of these funds to employ actual doctors’.

‘The contractual expectation is that physician associates will see undifferentiated patients and act as a first point of contact. In reality this permits physician associates to, in effect, work as a GP,’ the letter said. 

Party leaders were also warned of unemployment concerns among GPs, with many struggling to find work – a fact which even NHS England has acknowledged. 

On patient safety, the union said it has received ‘hundreds of individual reports’ of issues, such as PAs and other associates ‘failing’ to clarify their role to patients, and some ‘performing procedures beyond their level of training’.

BMA council chair Professor Phil Banfield said doctors are ‘demanding’ that political party leaders take action on the ‘patient safety scandal threatening to engulf the NHS’. 

He continued: ‘Policymakers have been asleep at the helm for years, letting us drift directly into a dangerous situation where the skills of doctors are being demeaned, devalued and even replaced. We will not let the new government formed on Friday say it was not warned.’

Professor Banfield said the letter on PAs gives politicians a ‘very clear’ way to ‘reassure the public that the NHS is safe in their hands’, given that the state of the NHS has ‘dominated’ the election campaign.

The letter also highlighted the inefficiency of using PAs, since doctors have to take on ‘additional responsibility’ for supervising them, which is an issue Pulse explored in its recent investigation.

This is ‘contrary to the promise’ that physician associates would ‘free up doctors’ time’ by taking on simpler tasks, leaving doctors with more time for complex work, according to the BMA.

Last month, the RCGP urged GP practices across the UK to ‘halt’ recruitment of PAs until the profession is regulated by the GMC later this year.

This was based on ‘concerning findings’ from the college’s recent consultation, which found that 80% of GPs believe the use of PAs in general practices has a negative impact on patient safety.