Physician associates (PAs) have become an increasingly prominent part of the UK healthcare system. Designed to support doctors in a variety of clinical settings, PAs are trained medical professionals who can diagnose illnesses, develop treatment plans, and perform procedures under the supervision of a doctor. However, their growing role has sparked considerable debate within the medical community, with concerns raised about their training, regulation, and potential impact on patient care. While there have been criticisms, many also argue that PAs are a valuable asset in an overstretched NHS.
Concerns About Physician Associates
One of the primary concerns about PAs in the UK is their level of training. Unlike doctors, who undergo five or six years of medical school followed by extensive foundation and specialist training, PAs complete a two-year postgraduate programme following an undergraduate degree in a health or science-related field. Critics argue that this difference in training could compromise patient safety, particularly when PAs take on responsibilities traditionally reserved for fully qualified doctors. This has led to the establishment of an independent review, which is due to report in Spring 2025.
A case that raised serious concerns involved a patient who tragically passed away after being sent home by a PA. According to reports, the PA failed to identify a serious underlying condition, and delays in treatment contributed to her death. This case fuelled fears that patients may not always be aware they are being seen by a PA rather than a doctor, leading to inappropriate expectations and, in some instances, misdiagnosis.
Furthermore, the British Medical Association (BMA) has voiced concerns about the description of physician associates and that patients mistakenly believe that they are being treated by a doctor as opposed to a PA. In a statement, the BMA called for stricter regulation and clearer guidelines on the scope of practice for PAs to ensure patient safety, and that PAs should be renamed to prevent patient confusion. There have also been reports of junior doctors working alongside PAs who are paid similar salaries but have significantly less training, leading to concerns about fairness and appropriate use of NHS resources.
Cases of Criticism in Patient Care
Several incidents have highlighted potential issues with PAs providing unsupervised care. A report from The Guardian detailed how a hospital relied heavily on PAs in an emergency department, leading to delays in senior medical input for critically ill patients. Concerns were raised that some PAs were working beyond their intended scope, making complex clinical decisions without sufficient oversight.
The Positive Contributions of Physician Associates
Despite these concerns, there are also strong arguments in favour of PAs. Supporters highlight that they help to fill workforce gaps in the NHS, particularly given the ongoing shortage of doctors. With increasing demand for healthcare services and difficulties in recruiting enough GPs and hospital doctors, PAs provide much-needed support by handling routine patient cases, freeing up doctors to focus on more complex conditions.
Additionally, studies have shown that when PAs work within their defined scope and receive appropriate supervision, they can contribute positively to patient care. A study published in the BMJ found that PAs in primary care settings were able to provide safe and effective consultations for common illnesses, achieving similar patient satisfaction rates to GPs.
Furthermore, some NHS trusts have reported that PAs help to improve continuity of care PAs help to improve continuity of care , as they often remain in the same role for longer than junior doctors who rotate frequently. This stability can be beneficial for both patients and healthcare teams.
Finding the Right Balance
While PAs can play a valuable role in the NHS, it is clear that their integration into the healthcare system must be carefully managed. Ensuring that patients are always aware they are seeing a PA rather than a doctor, implementing stricter regulations on their scope of practice, and maintaining proper supervision are essential steps to addressing the concerns raised.
The decision to introduce statutory regulation for PAs by the General Medical Council (GMC) in November 2024 is a step in the right direction, as it will provide clearer professional standards and accountability. However, ongoing monitoring will be crucial to ensure that patient safety remains the top priority. It will also be interesting to see the outcome of the independent review and the conclusions on the ongoing future of PAs in the NHS.
Ultimately, the debate over PAs highlights broader challenges in the NHS, including workforce shortages and resource allocation. While PAs are not a replacement for doctors, when used appropriately, they can provide valuable support in an overstretched healthcare system. Striking the right balance between their benefits and limitations will be key to their future role in UK healthcare.
Daniel Fourie, Consultant Paralegal, and Specialist Medical Negligence Consultant Paralegal from MDS states “Physician Associates can play a valuable role in easing NHS pressures, but patient safety must come first. Clear regulations, proper supervision, and transparency about their role are crucial to ensure they complement—not replace—doctors in delivering safe and effective care."
MDS is a specialist medical negligence law firm. We specialise in claims involving cancer, maternity claims, and cauda equina syndrome. Our expert solicitors represent clients all around England and Wales, and we are dedicated to helping people who have been injured by medical negligence.
Our solicitors have extensive experience of representing clients and their families whose lives have been affected by medical negligence Click here to read more about how we can help you, and here to read our client’s stories.
If you are concerned about any care that you or a member of your family has received, please contact our experienced team on 0116 254 7456 or email: enquiries@moosaduke.com. You can also enquire online by clicking here.
