From the Guidelines
Physician associates (PAs) in the UK play a crucial role in the healthcare system by working alongside doctors to provide medical care, taking medical histories, performing physical examinations, diagnosing illnesses, developing treatment plans, and providing patient education, all under the supervision of a physician. They typically complete a two-year postgraduate program following a biomedical or healthcare-related undergraduate degree. Unlike physician assistants in the US, UK physician associates were previously unregulated, but as of 2023, they are now regulated by the General Medical Council (GMC) 1. This regulation standardizes their training and practice while providing greater professional recognition. PAs always work under physician supervision and cannot prescribe medications independently or order certain tests like X-rays without oversight.
Key Responsibilities and Benefits
- Trained to take medical histories, perform physical examinations, diagnose illnesses, develop treatment plans, and provide patient education
- Work under the supervision of a physician to provide medical care
- Help improve healthcare access by taking on tasks that would otherwise fall to doctors, thereby reducing wait times and allowing physicians to focus on more complex cases
- The profession is growing rapidly in the UK as part of the NHS workforce strategy to address staffing shortages in healthcare, as noted in studies discussing the role of allied healthcare professionals, including physician associates, in enhancing training and service delivery 1.
Regulation and Training
- Regulated by the General Medical Council (GMC) as of 2023
- Complete a two-year postgraduate program following a biomedical or healthcare-related undergraduate degree
- Standardized training and practice provide greater professional recognition, which is essential for their role in the NHS, as highlighted by the need for clear definitions of their roles and regulation 1.
Integration into Healthcare Teams
- Part of multidisciplinary teams that work in a systematic and structured way to advise, educate, and support patients, as seen in guidelines for hypertension management that emphasize the need for extended roles for healthcare professionals, including nurse practitioners and pharmacists 1.
- Complement the work of junior doctors and do not replace them, ensuring that surgical training is not negatively impacted, as recommended by the Association of Surgeons in Training 1.
From the Research
Role of Physician Associates in the United Kingdom
The role of Physician Associates (PAs) in the United Kingdom is a topic of ongoing discussion and development. Key aspects of their role include:
- Assisting doctors and relieving their workload 2
- Undertaking complex procedures or managing undifferentiated patients in primary care 2
- Working in secondary care teams, including inpatient wards, and undertaking direct and non-direct patient care activities 3
- Working within interprofessional teams, with line management often provided by consultants 3
Challenges and Barriers
Despite their potential to address medical workforce shortages, the introduction of PAs has not been universally welcomed. Challenges and barriers include:
- Concerns over patient safety and consent 2
- Uncertainty around their specific roles and responsibilities 4
- Potential adverse consequences for medical training 2
- Variation in ongoing supervision and support 3
Future Development
The profession is growing rapidly, with statutory regulation, protection of the title, and career progression supported by a national-level framework all in the pipeline for the near future 5. However, the experience in the UK offers cautionary lessons for other European countries contemplating similar ideas, highlighting the importance of maintaining trust, undertaking detailed systems analysis, and agreeing clear role definitions 2.