NHS Employers clarifies guidance on physician associates

NHS Employers has released a statement outlining its current position on Medical Associate Professions (MAPs), including physician associates.

NHS Employers is an organisation which acts on behalf of NHS trusts in the National Health Service in England and Wales. It was formed in 2004, is part of the NHS Confederation, and negotiates contracts with healthcare staff on behalf of the government.

NHS Employers state that physician associates have been working safely for many years, above the level set out in recent scope of practice documents released by other organisations such as the BMA.

NHS Employers recognise that roles such as physician associates 'are poorly understood by the public and many stakeholders' and equally confirms that 'no PA or anaesthesia associate (AA) should be appointed in place of a doctor.'

NHS Employers state that there is no single widely agreed scope of practice for physician associates, yet several organisations have worked or are working on scope of practice documents for PAs - including many medical royal colleges.

NHS Employers state that there are minimum standards for physician associates, that have been long established by the Faculty of Physician Associates, and accepted by the GMC, which will be enforced by law when regulation is in place at the end of 2024.

NHS Employers clarifies that the British Medical Association's recently released document on PAs diverges from these guidelines in certain areas, and that a significant number of physician associates have been working safely for many years, above the level set out in the recent BMA document. The BMA is a trade union and professional body that represents and advocates for doctors and medical students in the UK

NHS Employers have held extensive discussions over the past six months, which involved a wide range of stakeholders from the NHS, including professional bodies, patient representatives, and those concerned about the expansion of these new roles. It says that PAs should introduce themselves as ”Hello, my name is XX and I am a physician associate working for YY. I work alongside doctors, but I am not a doctor.”

Many PAs working in primary or secondary care have been safely practicing beyond the scope outlined in the BMA document for years. This discrepancy has led to questions about the consistency and clarity of the guidance available to PAs.

NHS Employers also point out that part of a doctor's role is to supervise other colleagues (medical and non-medical) as an essential aspect of the unique accountability that doctors take for patient care in healthcare settings. Tasks and responsibilities can be delegated, but with this understanding of a colleague’s competence, and that this will vary over time and by their role.

The rapidly evolving landscape of MAPs in the UK - including physician associates - has made it challenging to reach consensus among all parties involved with PAs.

The statement addresses several key issues related to MAPs and will provide employers with valuable insights as they navigate the evolving healthcare landscape.