As consultants go on strike for the first time in over a decade, how will this affect physician associates? As the British Medical Association (BMA) continues to argue for improved salary and working conditions, consultants are now following their junior doctor colleagues in taking industrial action with a strike for 48 hours from 7am today (July 20th)
So, what does this mean for physician associates, who must work in collaboration with, and under the supervision of, a named consultant?
Well, the strikes will likely cause thousands of appointments and procedures to be cancelled, causing delays for PAs and their patients. It is anticipated that during the consultants’ strike, the medical cover provided at hospitals will be comparable to “Christmas Day cover”. This should mean that emergency care will still be given, but that non-emergency or elective care may be cancelled.
Christmas Day Cover should mean that a consultant is present to provide emergency care, and therefore a PA who is working on a day when consultants are taking industrial action must confirm which consultant will be available on-call, and how to contact them, before beginning their shift.
Although physician associates (PAs) are not directly involved in the industrial action and disputes, many PAs will continue to support their junior doctor and consultant colleagues. However, during the strikes, there are concerns that student PAs and qualified physician associates may be called upon to take on additional roles and responsibilities outside of their normal scope of practice.
What does the FPARCP say about the strikes?
The Faculty of Physician Associates at the Royal College of Physicians (FPARCP) have published guidance for PAs during the strike action. All PAs registered on the Managed Voluntary Register (PAMVR) agree to abide by the Code of Conduct for Physician Associates, which states: ‘You must recognise and work within the limits of your competence.’
As healthcare professionals, PAs are accountable for the care they provide to patients, including acts and omissions in care.
The FPARCP also states that PAs should make sure they only work within their agreed-upon area of clinical practise and competence on days when there is industrial action. No positions, responsibilities, or tasks that are outside the scope of that competence may be taken on by PAs. This might entail, for instance, refraining from holding bleeps that they do not feel confident handling.
Any time a student PA is directly interacting with or providing care for a patient while on clinical placement, they are always held personally accountable for their actions. Student PAs shouldn’t take on positions, obligations, or duties that conflict with their established educational plan. Student PAs are super-numerary, and are present in an educational capacity, there to learn, not to provide cover or work in place of qualified staff. Any PA students who are unsure about their placements and how to act during the strikes, should seek further direction from their university faculty and course leaders.
How might future strikes affect PAs?
The importance of PAs to the NHS has been brought to light by the recent junior doctor strikes. Patients have already received care from PAs during the previous junior doctor strikes. And, inevitably, when the NHS encounters further difficulties in the future, physician associates are likely to play an even bigger role, which has sparked worries from some about the future of PAs in the NHS.
It is still too early to predict how the strikes will affect PAs in the long run. However, it is certain that any PAs working over the next 48 hours will need to work with their junior doctor colleagues, and wider team in the hospitals, to continue providing excellent patient care.
In the coming weeks and months, the strikes might bring PAs into the conversation over the NHS’s future. If the NHS is to continue offering patients high-quality care, PAs, doctors, nurses and all other healthcare professionals and NHS staff must be fairly valued and supported.