PCN DES contract suggests PAs can see undifferentiated patients in primary care
The recent discussion about the role of Physician Associates (PAs) in seeing undifferentiated patients within the NHS has become a divisive topic in the medical field.
While the BMA’s March guidance raised concerns about Physician Associates seeing undifferentiated patients, I’m happy to report that the NHS PCN DES 2024/25 guidance (the primary care contract between GP practices and NHS) has clarified things significantly.
The previous 2023/24 DES clearly stated that PCNs should utilize PAs recruited through ARRS to see patients with undifferentiated conditions. This focus on patient access aligns perfectly with our training, capabilities and expected job descriptions as PAs.
The updated DES for 2024/25 provides even more clarity, emphasizing the importance of supervision from a named GP, and importantly, maintaining the description that Physician Associates can, and do see undifferentiated patients. This collaborative approach ensures optimal patient care whilst leveraging a PA’s skills and experience.
It’s important to remember that PAs are valuable members of the healthcare team, complementing, not replacing, GPs. NHS England’s collaboration with various organizations to develop comprehensive PA training and supervision guidelines further strengthens our role within the NHS.
The new PCN DES contract, released on March 28, emphasises the GP’s role as PA supervisor.
It states: ‘Where their named GP supervisor is satisfied that adequate supervision, supporting governance and systems are in place’, [physician associates] provide first point of contact care for patients presenting with undifferentiated, undiagnosed problems.
It adds: ‘The GP supervisor must take into account a physician associate’s knowledge, skills and experience gained through their training and development.’
A PA working in primary care said: “The recent news regarding clear advice on PA roles is encouraging. I’m confident that with ongoing collaboration and clear guidelines, PAs can continue to play a vital role in ensuring efficient and accessible care for NHS patients.”
This is some much-needed reprieve after a flurry of reports reporting that some PA Employers have been restricting their PA’s practicing privileges to align with the BMAs scope of practice document. The DES Contract clarification will hopefully pave the way for more robust and clear guidance around the use of PAs in the workplace, putting the BMA’s farcical scope document into further disrepute.