Health secretary Wes Streeting has launched a review into physician associates (PAs) and anaesthesia associates (AAs) in a bid from government to ensure patient safety and improve transparency.
Streeting has described discussions around the professions as having devolved into a toxic debate – primarily because legitimate concerns have been left unaddressed for too long. These concerns include:
- Transparency for patients
- Scope of practice
- The substituting of doctors
The review is expected to be published in the spring, along with what the government’s next steps on the matter will be.
Independent leadership
The review will be led by Professor Gillian Leng CBE – former NICE CEO and current president at the Royal Society of Medicine – who the health secretary believes can “take the heat out of the issue”.
Prof Leng will seek the views of a variety of stakeholders, including patients, NHS employers, professional bodies, and academics.
Streeting said: “This independent review, led by one of the UK’s most experienced healthcare leaders will establish the facts, take the heat out of the issue, and make sure that we get the right people, in the right place, doing the right thing.”
Prof Leng is also expected to gather evidence from abroad to properly establish how PAs and AAs can fit into wider healthcare teams.
Review terms
The review will fundamentally consider the scope of the roles, with separate focuses on:
- the safety of PAs and AAs;
- how they support other staff;
- their place in delivering quality and efficient care; and
- how effectively they are deployed within the health service.
The review will also explore what measures can be taken to better signpost PAs and AAs – i.e., ensure patients know they are dealing with a PA or AA.
“This [review] will cover recruitment and training, scope of practice, supervision and professional regulation,” said Prof Leng.
Wider reaction
The news has been welcomed by the NHS, royal colleges and trade unions, after months of campaigning. More recently, the Academy of Medical Royal Colleges wrote a letter to Wes Streeting and NHS England’s CEO, Amanda Pritchard, calling for this very review.
The Royal College of General Practitioners also voted against incorporating PAs into general practice over the autumn.
“We recognise that this has been a challenging situation for all involved,” said the RCGP’s chair, Kamila Hawthorne in response to today’s news. “This is why it is vital to have a transparent and thorough review, which must focus on the best interests of patients and their safety, and draw on the experiences of GPs, and other doctors working across the health service.”
The Royal College of Physicians, meanwhile, has been calling for a pause to the expansion of PAs since the March of this year.
Current NHS Long Term Workforce Plan aims are for there to be more than 10,000 PAs by 2036/37 – there are around 3,500 at present working within England’s health service.
“Patient safety is our absolute priority,” said recently appointed acting president at the RCP, Dr Mumtaz Patel.
“Many of our members have significant concerns about the safe deployment of PAs which is why we’ve called on system leaders to lead work to develop a national scope of practice, with input from royal colleges and specialist societies. It is good to see finally that PA scope of practice is going to have some focus.”
The British Medical Association has called for immediate safety measures to be taken by NHSE, while the review is being carried out.
Image credit: iStock
