Doctors want clarity on role of physician associates to avoid patient confusion

The support staff role was first introduced in 2003.

Members of the BMA want more clarity on the role of physician associates who provide support in GP surgeries and hospitals (Anthony Devlin/PA) (PA Wire)

More clarity should be provided on the role of people employed to help doctors diagnose and manage patients to avoid confusion and stop respect for clinicians being “eroded”, members of the British Medical Association (BMA) have said.

Physician associates work in GP surgeries and hospitals, carrying out tasks such as taking medical history from patients, performing examinations, diagnosing illnesses and analysing test results.

The post was first introduced in 2003 and training usually lasts for two years before staff are qualified.

However, Dr Latifa Patel, BMA representative body chair and workforce lead, has called for more to be done to ensure it is clear that physician associates “cannot replace a doctor”.

The Government and NHS England has so far provided little clarity and communication to the medical profession or to patients around the role and responsibilities of physician associates and there is a real risk of patients being confused

Dr Latifa Patel

“Doctors have been persistently devalued for too long via years of real-terms pay cuts,” she said.

“Doctors appreciate the hard work of colleagues across the health service, but as we have consistently made clear a physician associate cannot replace a doctor.

“Doctors undergo intense and demanding training to qualify, and so that they are able to take on the significant and important responsibilities that only doctors can.”

A motion was passed at the BMA’s annual representative meeting in Liverpool on Wednesday that said the post of physician associate should be renamed physician assistant, and that those in the role should never be referred to as “doctor” in medical settings.

It also called for physician associates to hold their registration through the Health Professions Council rather than the General Medical Council, and said they must “take personal responsibility for their professional actions”.

Dr Patel said the vote “speaks of the great concern from our members that their professional integrity and respect for their expertise is being eroded”.

She added: “It’s vital that the roles, remits and responsibilities of physician associates are clearly explained.

“The Government and NHS England have so far provided little clarity and communication to the medical profession or to patients around the role and responsibilities of physician associates and there is a real risk of patients being confused about the level of skill and type of treatment they will be able to provide, and that some patients and other healthcare workers may confuse them with doctors.”

A Department of Health and Social Care spokesperson said: “The NHS Long Term Workforce Plan makes clear that physician associates and other associate positions can provide vital support in providing medical care and anaesthetic services to patients and can help reduce pressure on doctors, freeing up their time to focus on tasks only they are qualified to do.

“There are record numbers of doctors working in the NHS with over 5,800 more compared to this time last year, and the NHS’ plan – backed by over £2.4 billion – will double the number of medical school places by 2031 alongside increasing the number of physician associates to 10,000 by 2037.”

Labour MP Barbara Keeley (Worsley and Eccles South) led a Commons debate on Thursday in which she called on the Government to “move quickly” to regulate physician associates.

Ms Keeley raised concerns over the role of a physician associate in the case of budding actress Emily Chesterton, who died aged 30 in November 2022 after suffering a pulmonary embolism.

The MP’s voice cracked with emotion as she read out words from Ms Chesterton’s mother, who said: “We have lost our precious, beautiful, kind, loving, talented and irreplaceable daughter and this must not be allowed to happen to any other family.”

Health minister Will Quince said the General Medical Council (GMC) is “well advanced” in developing regulatory processes for physician associates.

He said: “We intend to lay legislation at the end of this year which will allow the GMC to commence the regulation of physician associates by the end of 2024.”

On whether to change the title of physician associates, Mr Quince said he will look at the suggestion “in some detail”.

He said regardless of the title that “we need to make sure they are properly introducing themselves and their role, and making that very clear to patients”.