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The Royal College of General Practitioners (RCGP) has updated its stance on Physician Associates (PAs) working in general practice. The College recognises the potential of PAs to support GPs but highlights several key points for their successful integration.

The RCGP published “red line” guidance on the use of PAs in General Practice, outlining their opinion on how PAs should be utilised in the workplace.

The initial publication consisted of the following recommendations:

  • PAs working in general practice must always work under the supervision of qualified GPs.
  • PAs must be considered additional members of the team, rather than substitutes for GPs.
  • PAs do not replace GPs or mitigate the need to urgently address the shortage of GPs.
  • PAs must be regulated as soon as possible.
  • Public awareness and understanding of the PA role must be improved.
  • Training, induction and supervision of PAs within general practice must be properly designed and resourced.

Following on from an RCGP UK governing council meeting, they voted to add two additional “red lines” for PAs in GP Land. They state:

  • At a time of significant GP workforce challenges, funding allocations, resources and learning opportunities within general practice must be prioritised for the training and retention of GPs.
  • The significant responsibility and skills required for supervision must be recognised and resourced, with GPs able to choose whether or not they are willing to undertake supervision of PAs. PAs should not be employed unless sufficient supervision can be provided.

They go on to further acknowledge the urgent need for PA regulation, but also express concerns about the General Medical Council (GMC) taking on this role. They believe it could lead to patient confusion regarding the differences between doctors and PAs. The College proposes a different regulatory body and emphasizes that any associated costs should not fall on GPs.

The RCGP will consult with members on the PA role, including their scope of practice and supervision. This will inform future College guidance for incorporating PAs effectively.

The guidance also stresses several other key points:

  • The importance of clear guidelines to ensure patient safety and a sustainable healthcare system.
  • The need for proper resources and funding for PA supervision.
  • The vital role of GPs in general practice, emphasises they cannot be replaced by PAs.

The FPA has released guidance on the appropriate use of PAs, a suitable introduction for PAs and clearly explains that PAs always introduce themselves appropriately to patients to ensure there is no confusion around the role.

A PA told The PA+PER “I always introduce myself as a Physician Associate to the patient, following recommended guidance. My practice always has a supervising doctor for my shift. I think the RCGP “Red Lines” help provide some clarity to Doctors on the PA role, but hope that any further discussions also include the FPA so PAs themselves can have a say in their guidance”.

The College’s position acknowledges the potential benefits of PAs but emphasizes the need for PA integration to be done thoughtfully, prioritising patient care and a sustainable future for general practice.

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