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The government has finally released the long-awaited NHS workforce plan. The release comes at a time when public dissatisfaction with NHS services is at an all-time high, with the highest recorded NHS waiting lists ever, and the threat of more strike action from both junior doctors and their consultant colleagues.

With rising anti-physician associate sentiment on social media, fuelled primarily by anonymous accounts (purporting to be doctors), any efforts to expand the PA workforce are expected to face severe scrutiny from all sides. So, what exactly does the NHS long term workforce report say…

The first thing that caught my eye about physician associates on reading the 150-page document was the plan to increase PA numbers to 10,000 by 2036-37.

This sounded low to me; given that we already have about 4,000 PAs registered on the PAMVR, and graduate almost 1,000 new PAs each year, we may reach 10,000 PAs much sooner than 2036. But let’s go a little deeper…

The plan states the government want to increase PA training numbers to over 1,500 annually by 2031/32. This will be done in stages, starting with 1,000 or more student physician associates in 2023/24 and gradually expanding to over 1,400 a year in 2027/28 and 2028/29.

Number of projected PAs in the workforce

If we accept that there are roughly 3,500 to 4,000 PAs currently listed on the PAMVR, we can also presume that there are a limited number of eligible PAs who are not on the PAMVR. To continue working as a physician associate, they will need to register with the GMC once statutory regulation is in place, thus that figure may go up slightly in the future years.

And we know that not every student who enrols in a PA programme will complete it and graduate, and attrition rates can be difficult to forecast. Approximately 800 to 1,000 PA students graduate and pass national exams each year, which will increase with the extra training slots offered, as long as the RCP exams unit can accommodate that level of students coming through.

We also know that the PA apprenticeship route will be launched soon, which will likely start modest but has the potential to significantly increase the PA profession in the following decades.

There is also the possibility that qualified PAs will choose not to continue working as PAs. The junior doctors and consultants’ strike demonstrates how difficult a career in healthcare can be, with many opting to emigrate and work elsewhere, accept non-clinical positions, or leave the industry entirely. The same strains and stressors will affect PAs in the workforce, and some of our colleagues will leave the PA profession, making an accurate workforce projection challenging.

Other PAs may go on to become doctors by attending medical school or through the medical apprenticeship method.

In conclusion

So, a figure of 10,000 PAs by 2036 still seems off to me, and I expect we’ll get there sooner, but it’s tough to be too specific. Check back again later as we continue to delve into the NHS workforce plan and what it might mean for physician associates in the future.

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