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The Royal College of Physicians (RCP) have published the results following the recent extraordinary general meeting about physician associates.

The extraordinary general meeting (EGM) was called to debate the issue of physician associates and their role, scope of practice, and supervision, as well as regulation, expansion of the PA profession and other matters.

At the EGM, the RCP presented data from a membership survey which had gathered views on the role, scope and supervision of PAs, as well as any impact on doctors’ training. However, there was controversy over the way data from a membership survey was presented at the EGM, which caused several resignations from the Royal College of Physicians in response.

Following the EGM, Fellows of the RCP were given a week to vote on five motions related to PAs. The results have been published tonight, ahead of schedule – it was expected that the results would not be published until next week.

The vote had a turnout of 31.9% of eligible RCP Fellows.

The Faculty of Physician Associates at the Royal College of Physicians (FPARCP) is the professional membership body for physician associates (PAs) in the United Kingdom. Established in 2015, it is responsible for setting PA standards, running the national examinations, management of the Physician Associate Managed Voluntary Register (PAMVR) and is a faculty of the RCP.

The FPARCP provided evidence to the RCP ahead of the EGM. The FPARCP supported the first four of the five motions. The motions, and the results of each, are covered below:

  • 1. Scope of practice – PASSED with 96.9%
  • Physician associates are not doctors. They should not be regarded as replacements for doctors, and they should never replace a doctor on a rota. They are valued healthcare professionals who participate in patient care in addition to the rest of the wider multi-disciplinary team.  

    2. Accountability – PASSED with 95.6%
  • This EGM notes the current legal restrictions on who can prescribe medication or request ionising radiation and reminds all medically qualified membership categories of the College that they remain responsible for any such decisions by others that they may be asked to endorse.

  • 3. Evaluation – PASSED with 96.1%
  • This EGM calls on the RCP to contribute actively to generating an evidence base and evaluation framework around the introduction of PAs, addressing (for example) clinical outcomes, cost effectiveness, safety, the patient experience, staff wellbeing and interrelationships, and implications for the healthcare workforce.

  • 4. Training opportunities – PASSED with 95.9%
  • This EGM calls on the RCP to explore, document and address the impact on training opportunities of doctors resulting from the introduction of PAs.

    5. Caution in pace and scale of roll-out – PASSED with 78.7%
  • In the initial request for this EGM, Fellows called on the RCP to pause the roll-out of PA roles. A pause was felt not to be feasible given recent NHS workforce long term plans. This EGM therefore called on the RCP to call for caution in the pace and scale of the roll-out of physician associates until the medicolegal issues of regulation, standards and scope of practice are addressed.

Conclusion

The RCP have said they will need time consider the results. RCP president Dr Sarah Clarke said in a statement prior to the announcement of the results : “We will honour the outcome of the vote and our next steps will be decided by RCP Council and the RCP Board of Trustees.”

It is unsure what meaningful impact, if any, this will have on the professional lives of physician associates or PA students.

Keep checking the PA+PER regularly for up to date news and analysis on this breaking story.

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