I am a physician associate with six years’ experience and I am concerned about how one-sided the media coverage has been on the work we do in the NHS. I have just been made redundant, along with three other PAs at my practice. This is happening across the country. The NHS has invested in training and employing thousands of us for 20 years, only to now pull the rug out from under us and end our careers, losing skilled workers from a system that is under strain. And for what?
The cases mentioned in your editorial (21 November) where errors were made are sad, but not unique to the PA role. I was a team leader of 12 allied health professionals and worked hard to provide excellent patient care. The system has been using us as a cheaper resource because it has been able to get away with it, and then framed it that we are the problem. The emotional and financial impact of this on PAs is huge. What’s more, it will make access to primary care appointments worse.
Name and address supplied
• Physician associates can be a huge asset to the NHS if trained, regulated and supervised appropriately. In the last five years of my time as a GP, our team benefited hugely from having two full-time PAs, supervised by the GPs. They bring a high level of skill after intensive two-year, medical-based training, with supervised learning in healthcare settings, usually on top of biomedical science degrees or similar. Our patients value them.
Due to rising demands on our services and the increasing complexity of care, we have increased the size of our team, but could not afford (or find) GPs, hence the addition of other professionals trained to diagnose and manage simple problems.
We should welcome the review commissioned by Wes Streeting (Wes Streeting orders review of physician associates’ role in NHS, 20 November), but be aware that some of the antagonism from the medical establishment seems protectionist rather than in the best interests of patients.
Dr Charles Heatley
Retired GP, Sheffield
• The dispute about the role of physician associates in the NHS is rooted in dogma. Whether the person delivering treatment is a medical doctor is not the issue. What matters is that anyone delivering healthcare is trained and qualified to do so, practises within the correct guidelines and has access to support and guidance whenever a situation arises that falls outside the routine. This should apply to PAs, resident doctors and experienced consultants alike.
In cardiothoracic surgery, surgical PAs (known as surgical care practitioners) have worked alongside surgeons for two decades, with substantial evidence that they have enhanced care quality and the training of resident doctors. There is no reason why such a model cannot apply in other specialties.
Samer Nashef
Consultant cardiac surgeon, Royal Papworth hospital, Cambridge
• I am puzzled by the need for physician associates when we already have well-trained nurses in speciality roles. In the 1990s, I trained several senior nurses to become expert in gastroscopy (passing fiberoptic telescopes to examine the gullet and stomach). They would do this in a theatre adjacent to mine. I attend my local hospital twice a year to have a similar telescope passed into my bladder by a urology specialist nurse. There are others such as specialist asthma and diabetes nurses. Why duplicate professions needlessly?
Dr Giles Youngs
Retired consultant gastroenterologist, Drinkstone, Suffolk
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