Deputy editor Sofia Lind on the need for statutory guidance for physician associates in general practice
After a brief month or two of respite for physician associates (PAs), this week the controversial profession is front and centre of headlines again.
Somewhat remarkably, the RCGP decidedly put its foot down determining that PAs have no role to play in general practice – at all. It did however acknowledge that there are already 2,000 PAs working in general practice and said it will still set out guidance on their scope of practice.
However, as it stands, this upcoming scope-of-practice guidance – like that already set out by the BMA– is not expected to have any statutory relation to the long-awaited GMC regulation of PAs.
In the same week, the Doctors Association UK (DAUK) decided to donate £30,000 towards an ongoing legal challenge against the GMC regarding the regulation of medical associate professionals. And the families of two victims of where PA involvement in the NHS has gone wrong also joined the same legal claim.
The claim, being brought by Anaesthetists United, wants the GMC to set out a scope of practice for PAs and anaesthesia associates (AAs); and to drop the ‘misleading’ term ‘medical professionals’ when referring to them. They also want a separate Good Medical Practice guide to be drawn up for PAs and AAs.
This does not seem to be asking for too much.
While the GMC will begin to regulate AAs and PAs later this year, it has been clear it is not intending to set out a scope of practice. In defence of that position, it argued it also does not set out a scope of practice for doctors.
But the case for PAs is vastly different, as the definition of a scope of practice is to set a limitation, which is not required for doctors who are fully qualified medical professionals.
Without this regulated – statutory – scope of practice, it begs the question how any PA can be held to account without their error ultimately being a doctor’s fault.
I feel for the poor 2,000 PAs already working in general practice. It must be horrendous to be doing your best to help patients and reducing GP workload while constantly being scapegoated. However, the lack of a statutory scope of practice is not the fault of individual PAs.
It’s time this debate, which is harmful to all parties, is put to bed with statutory guidance, which does not leave GPs in the firing line.
Sofia Lind is deputy editor of Pulse. Follow her on Twitter at @sofialind_Pulse or email her at [email protected]
37,000 GPs, 24,000 practice nurses doing their longstanding defined, statutory and historic roles in this broken NHS – and yet 2,000 PAs has created so much chatter/debate and shifted the Overton Window. Our energies could be better spent.
As the role of PAs has become so politicised and weaponised and is driving a wedge between GPs, then retiring that role should also be considered by the new Labour Govt and retraining/compensation offered to the 2,000 PAs. I have total sympathy with those practising as PAs – shameless successive Govts have used them and are still selling them out. Only a trained Dr can do a Dr’s job.
Seems sensible and essential, but would need to deal with the problem that there may have been some common modules to the training schemes, but only in basic initial training, and after that, there would be almost as many different training experiences and skills competencies as there are PAs, because training is individualised to the supervising and employing Practice. It would be easier to restrict them all back to the competencies gained from basic training – having checked for what all course providers included, but this would appear overly restrictive on those with better training.
It is going to be a massive amount of work for someone.
It would be almost easier to allow them to go to medical school to complete their training as doctors, but probaby not alll would want that, as many have done subspecialty training for individual tasks now.