The Welsh Government has defended the employment of “physician associates”, despite concerns that they can pose a danger to patients.
Nation.Cymru reported that an assessment carried out by Health Education England (HEE) , and considered by all four of the UK’s health departments, concluded that patients were at high risk of harm from PAs. The health departments have therefore recommended the introduction of statutory regulation for the profession.
The relevant consultation document said:
“HEE’s assessment of risk reflects the wide ranging scope of the PA role, including the provision of direct and interventional care to patients, the environments they work in, particularly primary care and the level of direct supervision they are subject to. For example, PAs are often alone with vulnerable patients and service users, and can make autonomous diagnostic and treatment decisions without the immediate direct supervision of a doctor. In addition, the types of intervention they undertake can also be invasive, such as performing diagnostic investigations.”
Dr Iona Collins, Chair of the BMA’s Welsh Council said:
“Patients should know who is treating them and what level of care is reasonable to expect from each of those roles.
“Currently, there are reports of confusion, whereby patients do not appreciate that the person treating them is not, in fact, a medically-qualified doctor.
“In addition, doctors in training report that they are forced to compete with AAs and PAs for educational opportunities – after so many years of gruelling study and significant student debt, these doctors report feeling both demoralised and betrayed. There is insufficient time for doctors to deliver NHS care and also train two separate professions.
“We are clear that expanding the GMC’s remit to regulate PAs and AAs is inappropriate, because regulating these professionals together adds to the current confusion regarding practise scope and levels of responsibility. The BMA maintains that these new roles, which depend on doctors’ supervision to deliver safe supporting care, should be regulated by the Health and Care Professions Council (HCPC) instead, for the sake of role clarity.
“We are calling on patient safety grounds, for a change to the professional titles of PAs and AAs to physician assistant and physician assistant (anaesthesia) or anaesthetic assistant to stop ongoing confusion for the public.
“We remain very concerned regarding the planned expansion of these roles in the Welsh NHS– while doubts about scope, impact on doctor training and confusion with the public are far from resolved.
“We are asking the Welsh Government and NHS in Wales to halt the further expansion of these roles in light of the serious concerns raised by doctors in Wales and the absence of any robust evidence as to their effectiveness.”
A Welsh Government spokesperson said:
“PAs and AAs are there to support the work of doctors not replace them. While these roles can work autonomously, they must always work under the supervision of a named, fully trained and experienced doctor.
“Fifty-seven PA training places are being commissioned as part of the 2023/24 Training and Education Plan in 2023/24.”
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