Dr Steve Taylor on the need for a distinct body for PA regulation
There has been increasing debate about the role of the General Medical Council (GMC) in regard to the regulation of physician associates and anaethesia associates; in particular, the role the GMC has in setting standards and scope. Doctors have been particularly vocal about the failure to release information from the survey carried out, and there have been concerns expressed around blurring of lines between doctors and PA/AAs.
The RCGP guidance has clearly added to the pressure on the GMC. This was needed before PAs were advised to see undifferentiated patients under the ARRS scheme. It’s important we get this right for patients, PAs/AAs and doctors alike. Even these documents fail to fully address the role of supervision and training of supervisors. GP trainers go through extensive training to supervise GPSTs and students. Not all doctors have had training.
We have got here following a request from the Government in 2019 for the GMC, the independent regulator of doctors, to take on regulation of PAs and AAs. This followed a 2017 consultation with 3066 responses about regulation, with the GMC being regarded as one of the best options.
There were concerns expressed early in this process that the GMC might not be best placed to provide regulatory oversight but this was the path taken by the then UK Government, with support of the devolved Governments.
As this became known more widely, with the expansion of the roles, doctors and the public became more aware of some of the potential problems. It also became clear that more and more doctors were against the idea of GMC being the regulator. Concerns about blurring of the lines, lack of clearly defined scope, with this being made worse with PAs and AAs receiving a GMC registration number. The GMC made it clear that the new numbers would be made different to doctors but concern has continued.
I believe that the GMC should never have become the regulator of PAs/AAs, as it has a large number of other doctors. That said, the GMC has now done a huge amount of work to ensure that a register is properly regulated, collated and maintained. There have been many meetings and there are many documents, that have established frameworks for this regulation. There is still some way to go in terms of scope of practice, as demonstrated by the concerns expressed by Anaesthetists United, DAUK and more recently the BMA, but a significant amount of work has already been done.
A simple question: why don’t we have a separate body responsible for regulation of PAs/AAs? The GMC could be involved in using the same documentation, back room team and information gathered. It could be called ‘General Physicians Associate Council’ or any other name. The process to form a new charity/organisation is not complex and this could be done whilst addressing all the other issues and challenges.
The GMC has always been the independent regulator of doctors. It’s charitable aims are the regulation of doctors for the public’s safety. By clearly separating doctors from PAs/AAs there would be no need to continue to state, PAs/AAs are not here to replace doctors, and are a vital support to doctors and the multi-disciplinary team. It would be clear and the concerns over blurring of lines would be addressed.
It is not too late for Wes Streeting and the Government to fix this problem and the mess it has created. Without doing so, it will continue to mean confusion, discussions and ultimately will create further divisions in the health service.
Dr Steve Taylor is a GP and spokesperson for DAUK
There is no need for a ‘General Physicians Associate Council’, as there is already an appropriate body for this role: the Health and Care Professions Council (HCPC)