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To: Wes Streeting - Secretary of State for Health and Social Care
Review the use of Physician Associates in the NHS
Physician Associates (PAs) are not substitutes for doctors; their 2 years of training is inadequate to enable them to work with patients without full supervision. Yet they are promoted as ‘medical professionals’ in roles and settings where their lack of expertise is a danger to patients. Please commission a full review of the impact of the use of PAs with a view to appropriate regulation.
Why is this important?
Two years of training is insufficient for Physician Associates (PAs) to diagnose or treat patients effectively. The promotion of PAs in medical settings has several drawbacks, both for the PAs who are being parachuted into jobs they aren't prepared for and set up to fail, and for doctors who must supervise them and are held accountable for their mistakes.
PAs lack the medical expertise that comes with specialised training, unlike nurses or paramedics, and their role does not complement but, rather, attempts to mimic that of doctors. Their courses are unaccredited, and they miss crucial training in ethics, communication, and basic medical knowledge. Consequently, PAs often fail to diagnose or treat conditions correctly, burdening already overstretched doctors with the responsibility for these errors.
PAs also dilute the educational opportunities available to student doctors and, unlike other health professionals, PAs lack a regulatory body to ensure safety and accountability.
Employing PAs over doctors in GP practices, where they often work unsupervised, is financially incentivised. However, it can lead to increased net costs due to the need for supervision. In GP practices and across NHS Trusts, patients are frequently seen by PAs without realising they are not doctors, undermining the extensive training that doctors undergo. This practice devalues doctors, creates friction within the NHS, and contributes to the unemployment of qualified GPs.
The introduction of underqualified PAs, who often receive better pay and conditions than more medically competent doctors or nurses, is seen by many as a move to undermine the NHS and erode public trust and the morale of healthcare professionals.
How it will be delivered
Online
