Physician associates: Streeting orders review to end ‘toxic row’

The current NHS workforce plan sees PAs and AAs as a crucial part of the staffing mix in the health service.

The numbers have been gradually increasing in recent years, but the plan, published last year, called for a rapid expansion from just over 3,000 to 12,000 by 2036.

PAs can work in GP surgeries and hospitals. They are not authorised to prescribe, but they can order some scans, take medical histories and conduct physical examinations.

AAs, which support surgery teams, are a much smaller group – there are only about 100 in the NHS.

Both PAs and AAs have to complete a two-year master’s degree. They usually need a bioscience-related first degree, but that is not a prerequisite.

British Medical Association leader Dr Phil Banfield called for the rollout of new PAs to be paused while the review takes place.

And he added: “The NHS must tell us how they are going to keep patients safe while this review is carried out.

“You do not fly a plane under safety review, you ground it.”

Last week the BBC reported on the death of 77-year-old Susan Pollitt who died in 2023 at Royal Oldham Hospital after a drain was mistakenly left in her abdomen for too long.

The inquest into her death concluded it had been caused by an “unnecessary medical procedure contributed to by neglect”. She received treatment from a PA alongside other staff.

Following Mrs Pollitt’s inquest, North Manchester coroner Joanne Kearsley warned about the use of PAs.

She said there was a lack of regulation and national framework covering training, supervision and competency, and limited understanding and awareness about the role among both patients and other NHS staff.

She also said the lack of a distinct uniform and the title “physician” was giving rise to confusion as to whether the practitioner is a doctor.