PCNs urged to halt PA hiring as union launches legal action

PCNs and practices have been urged to halt the recruitment of physician associates (PAs) by the RCGP this week, while the BMA has launched legal action over the regulation of the profession.

The RCGP urged its members on Thursday to ‘halt’ recruitment of PAs until they are regulated later this year after ‘concerning findings’ from the RCGP’s recent consultation. This surveyed over 5,000 GPs and found that over 80% believe the use of PAs in general practices has a negative impact on patient safety.

Yesterday, the BMA then announced it was launching legal action against the GMC over the way it plans to regulate the profession.

The union said plans would mean ‘dangerous blurring of lines’ for patients between ‘highly skilled and experienced’ doctors and assistant roles.

It added that the GMC has been using the term ‘medical professionals’ in its materials to ‘describe all of its future registrants’, including both doctors and associates. The BMA is launching a judicial review claim against the GMC over its use of this term, which it said ‘should only ever be used to refer to qualified doctors’ (see box for details of the claim).

Around one third of PAs are currently hired through PCNs, according to NHS workforce data.

For those already employing PAs, the RCGP has advised practices to ensure they do not see undifferentiated patients and that daily supervision time is built into timetables.

The college is now working on guidance for GP practices, including a PA scope of practice and induction and supervision materials.

In the update, the RCGP said: ‘After consideration of the survey results […] we are recommending to our members that they review their recruitment plans and halt the recruitment and deployment of additional PAs into general practice across the UK until PAs are regulated and practices are in a position to implement the RCGP’s forthcoming guidance.’

The ‘disturbing’ survey results showed that half of responding RCGP members reported ‘being aware of specific examples of patient safety being compromised by the work of PAs’, including instances of misdiagnosis and inappropriate prescribing.

According to the college’s initial analysis, the consultation also highlighted ‘wide variability’ in the way PAs are utilised and supervised in general practice, and respondents called for ‘greater clarity’ on what activities PAs should carry out.

College chair Professor Kamila Hawthorne said the ‘fundamental issue’ around PAs is ‘patient safety’, and recognised that the survey results ‘will be of concern’ to patients, GPs and PAs themselves.

She said: ‘Our intention is not to disparage the individuals who are working as PAs in general practice or their profession, but to address and act on the concerns that more and more of our GP members have been raising.

‘It is not the case that we heard nothing positive about PAs working in general practice – there are reports from our survey of where the role has been working well. But it is clear that there is not a sufficiently robust framework for supervision and scope of role in place in GP practices, and this is having implications for patient safety.’