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The Regulation of Physician Associates

At a time when health professions are under immense pressure, the UK is exploring new ways to address the shortage of healthcare workers. One way in which this can be achieved is by expanding roles such as that of Physician Associates. 

Physician Associates are described by the Faculty of Physician Associates (FPA) as ‘medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. Physician Associates are practitioners working with a dedicated medical supervisor but are able to work autonomously with appropriate support.’  

The profession is still relatively new in the UK, having originated in the US. The GMC have now published standards for PAs. This will be translated into a formal framework to monitor students (core competencies, skills, etc), and AEIs offering the PA course will need to demonstrate how they deliver on those GMC standards. 

To become a PA in the UK, individuals must complete a postgraduate PA training programme that is accredited by the FPA. These postgraduate programmes typically take two years to complete full-time and include both academic and clinical components. After completing their training, PAs must register with the FPA and maintain their registration by completing continuing professional development (CPD) activities. The number of AEIs offering the course is increasing, and as the profession develops, so must the legislation, framework, and standards too. 

The UK government is currently seeking views on the legislation that will enable the GMC to regulate Anaesthesia Associates (AAs) and Physician Associates (PAs) in the UK. Interestingly, on the link above, the government states that: 

‘As well as bringing AAs and PAs into regulation, this consultation also paves the way for full scale reform of the regulatory frameworks of all the healthcare professional regulators. This is a rare and significant opportunity to deliver a large-scale programme of reform that will implement improvements to the system of professional regulation, to the health and care workforce and, most importantly, to patient and public safety.’ 

So, the way that the UK ends up regulating PAs will be used as a standard for all healthcare education, possibly leading to clearer standards for the Allied Health Professions. The NMC have recently updated their Standards for assessment but there is also the potential for it to impact nursing, and midwifery. The information on the government’s website goes on: 

‘One of the key elements of our reform programme will be the introduction of a modern, fit for purpose regulatory system, which we will achieve by updating the legislative framework for each of the 9 healthcare professional regulators: 

  • General Chiropractic Council (GCC) 
  • General Dental Council (GDC) 
  • General Medical Council (GMC) 
  • General Optical Council (GOC) 
  • General Osteopathic Council (GOsC) 
  • General Pharmaceutical Council (GPhC) 
  • Health and Care Professions Council (HCPC) 
  • Nursing and Midwifery Council (NMC) 
  • Pharmaceutical Society of Northern Ireland (PSNI) 

The reforms span the 4 key areas of regulation: 

  • governance and operating framework 
  • education and training 
  • registration 
  • fitness to practise’ 

The legislation will empower the GMC to regulate the professions, and the GMC have published the learning outcomes that all 37 PA programmes and 3 AA programmes that are available in the UK will have to follow. You can find the document here.

Overall, the regulation of PAs in the UK is designed to ensure that they are trained to a high standard and able to provide safe and effective care to patients under the supervision of a qualified medical practitioner. 

The FPA was established in 2015 and is part of the Royal College of Physicians (RCP). It oversees the registration, training, and continuing professional development of PAs, and has been campaigning for regulation of the profession using the hashtag #RegulatePAsNow 

The FPA has previously shared how PA regulation will allow the profession to work to its full potential, supporting to reduce waiting lists and treatment delays. 

FPA president Jamie Saunders said: “Today marks the next exciting phase in our journey to enabling our profession to work to its full potential. With the support of our members, we have already used the #RegulatePAsNow campaign to showcase how essential PAs are to the health service. We’re now ready to continue working closely with the DHSC and the GMC to enable PAs to assess, diagnose and treat patients and ultimately become regulated healthcare professionals. It is encouraging to see that the consultation documents continue to expect the GMC to be able to regulate PAs at the end of 2024. The FPA and I will continue to stress the importance of regulation being achieved in this timeline.” 

Overall, the regulation of PAs in the UK is designed to ensure that they are trained to a high standard and able to provide safe and effective care to patients under the supervision of a qualified medical practitioner. 

Increasing the number of PAs working for the NHS makes perfect sense; the role has fewer responsibilities, so staff are cheaper and faster to train, and for the PA, they can expect a better work/life balance. The only issue is that regulations fell behind, so it’s an exciting step forward that this is now being addressed. 

At MyKnowledgeMap we have experience of working with PAs at Hull York Medical School and working with translating standards into assessment documents. 

We’re interested in getting a more informed view, so if you’d like a conversation around this, please get in touch with us by email at:   

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