The government has ordered a review of physician associates (PAs) and anaesthesia associates (AAs) in England amid concerns about their expanding role in the NHS.
The review will be led by Prof Gillian Leng, and will assess how PAs and AAs are deployed and what safeguards are needed. It will report back early next year to inform the government’s 10-year NHS plan.
Professor Leng is the former Chief Executive of the National Institute for Health and Care Excellence (NICE), where she was responsible for several programmes and guidelines including the guidelines on COVID-19. In 2024 she became president of the Royal Society of Medicine (RSM).
The review was expected to be announced, following a recent Channel 4 news article that highlighted physician associates in the NHS.
PAs and AAs are seen as crucial to the NHS long-term workforce plan, but concerns have been raised about PA regulation, substitution for doctors, and the potential for confusion among patients.
The British Medical Association has raised concerns about PAs being asked to do tasks beyond their scope.
Announcing the review, Health Secretary Wes Streeting said there were legitimate concerns that needed looking at but he also criticised the “toxic nature of the debate”, saying it had left PAs feeling demoralised.
Streeting said: “Many physician associates are providing great care and freeing up doctors to do the things only doctors can do.
“But there are legitimate concerns over transparency for patients, scope of practice, and the substituting of doctors.
“These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised.”
He said he hoped the review would “take the heat out of the issue” and make sure “we get the right people, in the right place, doing the right thing”.
Stephen Nash, from the United Medical Associate Professionals group which represents PAs, told BBC news that the review would be a chance to “shine a real light” on physician associates and anaesthesia associates.
Louise Ansari from Healthwatch England is also quoted on BBC News having said patients had reported “very positive” interactions with PAs, but she had particular concerns about the fact patients were not always told or made aware they were being seen by a PA.
The General Medical Council will start regulating PAs and AAs next month.