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Employing physician associates (PAs) ‘does not mitigate the need for more GPs’ and other practice staff’ Health Minister Andrew Stephenson explained, during a debate in the House of Commons on Wednesday 7th February.

MP Stephenson further explained that the role of physician associates ‘is in no way a replacement for that of any other member of the general practice team’.

‘Roles such as physician associates, who remain supervised by doctors, play an important part in NHS provision, and it is therefore right that we include a range of roles and skills in our multi-disciplinary teams that can offer personalised, responsive care to patients,’ Mr Stephenson said.

‘Physician associates can help to broaden the capacity and skills mix within a practice team by helping to address the needs of patients in response to the growing and ageing population, but let me be clear that the employment of PAs does not mitigate the need for more GPs, nor does it remove the need for other practice staff.’

The Rt Hon Andrew Stephenson CBE MP – Minister of State in the Department of Health and Social Care 

The debate in the House of Commons on 7th February was tabled by Conservative MP for Central Suffolk and North Ipswich Dr Daniel Poulter, who is also an NHS consultant psychiatrist. Dr Poulter told MPs that while he worked alongside ‘some very competent’ PAs, there is a high degree of variability in their training and skills’.

Dr Poulter highlighted some concerns around patient safety raised by the BMA and told the chamber the PAs have been employed in the NHS in roles ‘that stretch far beyond that original remit’ and in many cases ‘they appear to be working well beyond their competence’.

Dr Poulter also told MPs of an incident where he was ‘forced to directly intervene to prevent patient harm’ in the presence of a PA.

He said: ‘Only last year, I was forced to directly intervene to prevent patient harm following a paracetamol overdose by a patient who attended A&E.

‘The physician associate incorrectly informed me that they did not require N-acetylcysteine treatment because their liver function test was normal, even though they were over the treatment line as a result of their paracetamol overdose. Of course, at that time, the patient’s liver function tests were normal, but they would not have been for very long. The consequences of that diagnostic decision by the physician associate could have been fatal.’

Dr Poulter added that the ‘key issue’ is that many PAs ‘do not know or have the self-awareness’ to understand the limits of their knowledge and practice. ‘But this is perhaps understandable in a health system that fails to adequately regulate and indeed define its scope of practice.’ Dr Poulter said.

NHS England reiterated its position on employing PAs, confirming ‘PAs are not a substitute for doctors; they are trained to work collaboratively with other health professionals as supplementary members of a multidisciplinary team.

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