Physician associates who “deliberately” mislead patients about their status could be investigated for serious misconduct under new guidelines from the medical regulator.
The General Medical Council (GMC) has published its proposed rules, standards and guidance on regulating physician associates (PAs) and anaesthesia associates (AAs) following a consultation.
Its chief executive said regulation – which will come into force on December 13 – is a “vital step towards strengthening patient safety and public trust” in the roles.
However, top GPs have said they “do not believe the GMC is the most appropriate body to do this”.
Under current plans, the number of PAs in England could increase from 3,500 to 10,000 by 2036/37, along with 2,000 more AAs.
It is the college’s position, following consultation with members and discussion amongst our governing council, to oppose a role for physician associates in a general practice setting
These staff are graduates – usually with a health or life sciences degree – who have undertaken two years of postgraduate training.
The role of a PA is to “support doctors in the diagnosis and management of patients” and they can be deployed across GP surgeries and hospitals.
AA duties include reviewing patients before surgery and taking medical history, as well as inducing, maintaining and waking up patients under supervision.
The new report by the GMC includes a number of changes to its initial proposals for PA and AA regulation, including the expansion of behaviours indicating “a high level of seriousness”.
Cases where PAs or AAs “deliberately” mislead a patient or others about their registered status will be classed as serious misconduct, the regulator said.
More case examiners will be required for fitness to practise cases involving PAs and AAs.
The process, which assesses a professional’s ability to practise safely and effectively, will now need two examiners rather than the one that was initially proposed by the GMC.
Course providers must also ensure that student PAs or AAs make it clear to patients that they are involved in their care.
Charlie Massey, GMC chief executive, said: “Regulation is a vital step towards strengthening patient safety and public trust.
“It will provide assurance to patients, employers and colleagues that physician associates and anaesthesia associates have the right level of education and training, meet the standards we expect, and can be held to account if serious concerns are raised.”
PAs have come under increased scrutiny in recent years due to patient safety concerns.
In 2022, Emily Chesterton suffered a pulmonary embolism at the age of 30 after being misdiagnosed by a PA on two occasions.
Last month, the Government launched a review into the role of PAs and AAs, led by Professor Gillian Leng, president of the Royal Society of Medicine.
It is expected to report in the spring and will recommend how new roles should work in the future.
In October, the Royal College of General Practitioners (RCGP) published guidance which said PAs should not see patients who have not been assessed by a GP first.
RCGP chairwoman Professor Kamila Hawthorne said: “It is the college’s position, following consultation with members and discussion amongst our governing council, to oppose a role for physician associates in a general practice setting.
“However, acknowledging that there are around 2,000 PAs already working in general practice, one of our red lines has always been that the profession must be regulated as soon as possible.
“We do not believe the GMC is the most appropriate body to do this but we recognise they have been given this responsibility and that regulation will commence later this month, so we will continue to work with the GMC to ensure regulation of PAs can be implemented as smoothly as possible to protect patient safety.”
