The British medical community is divided over the role of physician associates (PAs) in the National Health Service (NHS). PAs have been in the NHS for 20 years, providing support to doctors by assessing patients and carrying out examinations. Their numbers have grown rapidly, from a few hundred three years ago to 3,500 now, as part of a government push to increase their numbers to 12,000. However, concerns have arisen that the PA role is becoming too deeply embedded in the NHS, that too much is being asked of them, and that patient safety is being compromised.
Some doctors are refusing to work with PAs and are making them increasingly uncomfortable in the workplace, putting the working relationship between the two groups under great strain. The situation has prompted the government to order a review into the PA and anaesthesia associate (AA) roles, following concerns raised by the British Medical Association (BMA) about the risk to patient safety.
The BMA has called for a halt to the rollout of PAs and AAs while the review is carried out. A survey of 18,000 BMA members last year showed that almost nine out of 10 felt that current working practices posed a risk to patient safety. The BMA has also cited two high-profile cases in which patients died following consultations with PAs.
The Union of Medical Associate Professionals, which represents PAs and AAs, said concerns about patient safety were legitimate but called for a no-blame approach, teaching lessons about what went wrong and avoiding demonising a whole profession. The Royal Society of Medicine is leading the independent review of the roles to establish the truth of the situation.
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