The Royal College of GPs’ is calling for a halt in physician associate recruitment, following a survey of its members.
The consultation was conducted by independent polling company, Research by Design (RbD). More than 5,000 members of the Royal College of GP’s – including more than 1,600 GP registrars – completed the survey, making it one of the most widely engaged with in recent College history. However, according to BMA data there are over 37,476 individual GP’s in the UK as of April 2024, so the RCGP survey seems to represent about 13% of the total GP workforce.
The survey asked questions in four categories, covering experiences members have had with PAs in general practice, how members think PAs should work in general practice, and more generally what members consider the benefits and risks of PAs working in general practice.
The RCGP is calling for practices across the UK to review their recruitment plans and halt the additional recruitment and deployment of PAs into general practice until PAs are regulated and practices are in a position to implement the RCGP’s forthcoming guidance on scope of practice, induction and supervision, work on which has already begun and will be informed by the consultation results.
Recognising that some GP practices will already be working with PAs, the College is recommending that, as well as adhering to its ‘red lines’ on PAs working in general practice, that there is appropriate time for supervision is included within GPs’ and PAs’ daily timetables.
The RCGP also recommended that processes of triage, induction and supervision are reviewed to ensure they are robust and safe for patients;
The RCGP is recommending that PAs do not see patients who have not been triaged by a GP and should only undertake work delegated to them by and agreed with their GP supervisor, in line with the agreed scope of role for that PA in the practice.
The RCGP is calling for transparent and accurate methods of introduction of all members of the multi-disciplinary team seeing patients are visible to patients, including on the practice website, on consulting room doors, on name badges and when appointments are booked.
The RCGP is also calling that patients who have already consulted a PA for a problem, and who re-present again with the same problem which has not been diagnosed and resolved, should not re-consult a PA, but should see a GP.
As well as a halt to recruitment of PAs in general practice, the College is also calling for governments across the UK to:
- take urgent action to grow the GP workforce and ensure that PAs are not used as substitutes for GPs or a means of mitigating the need to address the chronic shortage of GPs;
- commission an urgent review of the ways in which PAs work in the NHS; and
- ensure appropriate resources are provided to support multidisciplinary team (MDT) professionals working within general practice, including appropriate induction, supervision, and teamworking support.
The RCGP work is likely to be seen as guidance of best practice, but many GP’s are not members of the RCGP. Each GP practice is run as an independent business and can choose to follow any guidance it wishes. It is important to note that both NHS England and the Care Quality Commission recently updated their position of physician associates working in the NHS.
Both Labour and the Conservatives have pledged to deliver the NHS long term workforce plan, which looks to recruit up to 10,000 PAs in the workforce, with considerable emphasis of PAs working in primary care.
There will be a meeting of the RGP UK Council on 22 June, where the results are expected to be discussed. Using insight gathered from the survey results, as well as further external stakeholder and member engagement, the RCGP will develop UK wide guidance on scope of practice, induction and supervision of PAs in general practice. This will be brought to the meeting of RCGP UK Council in September 2024 for approval prior to publication.