The Academy of Medical Royal Colleges has called for an independent review of physician and anaesthesia associates (PAs and AAs) in England amid a “increasingly acrimonious and destructive debate” about their role in healthcare. While the group has broadly supported the use of PAs and AAs in assisting healthcare teams, it has expressed concern over claims around safety and the impact of social media-fuelled opposition on teamwork. The British Medical Association has also criticised the blurring of lines between the roles of PAs and AAs and those of doctors.
There are currently over 3,000 PAs and AAs in England, with the NHS workforce plan aimed at increasing their number to 12,000 by 2036. PAs are not authorised to prescribe medicines, but are able to order scans, take medical histories and conduct physical examinations. Both PAs and AAs are required to complete a two-year master’s degree, although a bioscience-related first degree is not essential.
The academy, which represents 24 medical royal colleges, has called for an “independent, evidence-based, rapid review” to help clarify the roles and responsibilities of PAs and AAs, and to determine where they might best fit into the health system. Chair Dr Jeanette Dickson emphasised the need to assess safety, efficiency and cost-effectiveness of the roles objectively and to make appropriate judgements based on evidence. The review would need to be “robust and independent” in the manner of earlier reviews by Lord Ara Darzi and Dr Hilary Cass.
While the BMA has welcomed the call for a review, it has also stated that the academy has been too slow to take action. Meanwhile, NHS England has argued that updated guidance has already been provided which clarifies the roles of PAs and AAs. The NHS stated that the roles of such professionals have always been specific and supportive, and are necessary to comtest with increasing demand for medical care
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