There should be board level individuals responsible for PAs, says GMC

Employers should identify individuals at ‘board level’ who are responsible for physician associates (PAs), according to GMC guidance.

In an update letter to system leaders on preparing for the regulation of PAs and anaesthesia associates (AAs), the regulator said that policies and processes required for regulation are being finalised, and outlined how PAs should be supervised within the primary care context.

It said that there should be effective clinical governance systems in place to ensure that PAs are ‘properly and safely deployed’, including that PAs must always work under supervision. But also, that appropriate governance structures ‘must be in place’ and agreed at a local level.

It recommended that organisations identify ‘an individual at board level who is responsible for PAs’.

On further clarification to Pulse PCN on which organisation should identify this board level individual, the GMC said that the guidance was applicable to ‘healthcare organisations of different size and scope’, and it was ‘not appropriate to prescribe in that level of detail’.

It added: ‘It would be for each organisation who employs doctors, PAs and AAs, to determine the most appropriate level of clinical governance for the different roles and responsibilities.

The guidance itself said there was not a ‘one-size fits all approach’ to supervision, as individuals who are being supervised develop skills, competence and experience over time.

It said: ‘This means that named supervisors should agree a level of supervision appropriate to each individual’s skill level, competence, experience, and role, and the nature of the task.’

It added that doctors themselves were ‘not accountable’ for the actions and decisions of PAs they supervise. 

Around one third of PAs are hired by PCNs through ARRS funding, with the role being the sixth most popular in the scheme after pharmacists, care coordinators, social prescribing link workers, pharmacy technicians and physiotherapists.