Physician associates ‘mustn’t damage juniors training’

PLANS to rapidly increase the number of physician associates in the NHS must not damage junior doctors’ training, the BMA has said.

The Department of Health has announced a recruitment drive to hire more physician associates (PAs) in a bid to ease the strain on NHS resources. They plan to more than double the number of training places across the UK from 105 to 225.

The news has been welcomed by some healthcare leaders but concerns have been raised over the potential impact on junior doctors’ training and that associates could be used as “doctors on the cheap”.

PAs typically have a science degree or healthcare background and undergo two years intensive training. They work under the close supervision of a doctor and can take medical histories and diagnose illnesses. They are not allowed to carry out more complex tasks such as prescribing medications or ordering X-rays.

Chair of the British Medical Association council Dr Mark Porter said: “Physician assistants can be a valued part of the NHS and, as long as the scope of what they do is clear, they can provide an intermediate level of care and help reduce workload pressures.

"Only doctors can provide certain types of care so the government needs to ensure that standards won't be affected by these changes."

He added that it was also important that the new posts "did not erode training opportunities for junior doctors or medical students, or undermine the vital role they played in delivering care."

PAs were first introduced into the NHS 10 years ago. There are currently just over 200 working in the UK with feedback said to be positive.

A Department of Health spokesman said PAs would support busy doctors, allowing them to spend more time with patients, “not replace them.”

He added: “They can carry out clearly defined duties, but have to be under strict supervision of a doctor at all times.”

The Royal College of Physicians and the UK Association for Physician Associates welcomed the plans, but called for statutory regulation to be introduced to allow them to work more effectively and to better protect the public.

In a statement the RCP said both organisations were “fully in support” of the increase in PA numbers, adding: “There is an expanding patient population and the NHS needs to be creative about how it is going to continue to deliver high quality care.”

But Roger Goss, a co-director of Patient Concern, warned they could “end up being doctors on the cheap”.

“We can be certain that some people in management will introduce the system as intended but you can guarantee that others will see this as a glorious opportunity to cut costs,” he said.

The DoH said numbers could be further increased next year, making the NHS more like the US where there are currently more than 80,000 physician associates.