Inappropriate Scope of Practice published by the BMA

The British Medical Association (BMA), a union for doctors, has published its version of guidelines for how physician associates (PAs) should work in general practice surgeries and hospitals.

The BMA says that PAs are a safety risk and that PAs should never see undifferentiated patients on their own. This guidance ignores the established training and competencies of physician associates, who are educated to use clinical reasoning skills to examine and diagnose patients.

According to the BMA, PAs should only help doctors with routine tasks and pre-booked appointments, such as annual health checks- which severely undermines the training and education PAs complete to become highly skilled professionals. The BMA further describes that PAs should not make important decisions about a patient’s care on their own, and they must always be clear with patients that they are not doctors. They also believe some PAs are taking on work that should only be done by a doctor.

These guidelines come after continued controversy about the role of PAs on social media, radio, podcasts and newspapers.

It has been commented on that the BMA’s document was written without collaboration with any PA professional body, and is aimed at limiting the capacity of PAs to work and care for patients by proposing significant changes to PA job descriptions. It is a poorly researched article and has provided no clarity on engagement from stakeholders. NHS E, the FPA, and the PA Schools Council all released statements about the document as highlight its urgent need of engaging relevant stakeholders.

Not only this, the BMA is a Union, and are describing a scope of practice for a group of professionals whom they do not represent. There is no legal requirement for employers to follow the BMAs supposed “guidance” on PA scope of practice.

Commenting on the publication of the British Medical Association’s (BMA) Safe Scope of Practice report on the role of Medical Associate Professionals (MAPs), Danny Mortimer, chief executive of NHS Employers, said:

“It is to be hoped that further BMA contributions to this important discussion are now carried out differently, and employers across the NHS and MAPs themselves would appreciate the opportunity to play a part in this.”

PAs have been around in the UK since 2003 (see our Feature article on Edition 2), with the role expanding over recent years. Last year NHS England committed to increasing PA training places to over 1,500 by 2031, bringing the workforce to 10,000 by 2036.

Legislation bringing the PA role under GMC regulation has recently passed through Parliament and will come into force at the end of this year. This will hopefully allow appropriate bodies, such as the FPA, to help define a suitable and reflective scope of practice for Physician Associate around the UK, allowing us to practice safely, competently and most importantly, in line with what is expected from a Physician Associate.