New draft national guidance is set to be shared on safe and effective practice for physician associates (PAs) by the Royal College of Physicians (RCP), as it also announces the establishment of a new oversight group for its work related to PAs.
The new draft guidance will be shared with more than 20 national stakeholders this week — the consultation will include the UK and devolved governments, the NHS, the British Medical Association, the General Medical Council (GMC), and the Academy of Medical Royal Colleges.
The guidance covers good practice for employing and supervising PAs, while reiterating the RCP’s position that they are not doctors, should not replace doctors on rotas, and any prescribing matter should be referred to a fully registered prescriber.
The newly established RCP oversight group for PAs will be chaired by vice president for Wales Dr Hilary Williams, with its first meeting set for today. The group will focus on:
- ensuring the RCP deploys a consistent approach to all PA-related work;
- overseeing the delivery of the short life working group’s (SLWG) recommendations on PAs;
- kickstarting the process of developing specialty-specific guidance for PAs; and
- advising on the future of the Faculty of PAs.
The SLWG was established in April and shortly after published a series of recommendations to the RCP Council on the role of PAs.
The council accepted all but one of the 16 recommendations — the idea that the RCP should close the PA Managed Voluntary Register (PAMVR) to new entrants was rejected following a vote. However, the royal college has since announced the PAMVR will close to all PAs this December once the GMC becomes the regulatory body for medical associate professionals.
Dr Williams, who was also chair of the SLWG, said: “As I said in May when we published our report, we cannot allow patient safety to be risked by anyone in the multidisciplinary team working outside of their clinical scope of practice or without appropriate supervision.
“The publication of this new draft guidance on safe and effective practice for PAs is a positive and very welcome step forward. Now it is time to work with the specialist societies to consider what role PAs can safely play in clinical practice.”
The RCP has called for a limit to the expansion of PAs until issues around scope and regulation are addressed. It has also urged NHS England to review its growth projections for the PA workforce. The RCP says that doctors are concerned about the:
- risk of role confusion;
- potential for a negative impact on postgraduate doctor training;
- patient safety; and
- lack of national guidance on supervising and scope of competence.
“We are also writing this week to the GMC as the regulatory body for PAs from December 2024 with questions about their future role on scope of practice and the rules around prescribing,” said Dr Williams.
She added: “I’m also delighted to say that this autumn, we will launch a new programme of work focused on our early career doctors — putting our trainees, locally employed and specialty doctor colleagues at the heart of the college.
“Led by senior censor and vice president for education and training Dr Mumtaz Patel, who is currently acting as RCP president, this work will bring together fellows and members from across career grades and specialties to consider the design and delivery of medical training and what needs to change.”
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