Peter Marshall was thrilled when he finally secured an appointment at his GP surgery after calling for several days. During his appointment, a young medic diagnosed him with irritable bowel syndrome (IBS) and suggested over-the-counter peppermint tablets to alleviate his stomach pain. Peter, a retired IT specialist, was relieved to finally have a diagnosis and treatment. However, he was surprised to find out that he had actually seen a physician associate (PA), a type of healthcare worker whose presence is increasing in the NHS to alleviate the workload on doctors, allowing them to focus on more complex cases.

The number of anaesthesia associates (AAs) is also increasing in the NHS. These highly trained practitioners are able to administer anesthesia under the supervision of an anaesthetist. However, concerns have been raised about the level of supervision in short-staffed hospitals, and an emergency meeting is scheduled to address these concerns.

While many may be unfamiliar with the role of associates, it is not a new concept. PAs have been working in small numbers in the NHS since 2003, and they are common in healthcare teams in other countries as well. Currently, there are approximately 2,500 PAs and 200 AAs working in the NHS across the UK, with the majority in England. The role has the support of various medical associations, including the Royal College of Physicians, the Royal College of Surgeons, the Royal College of GPs, and the Royal College of Anaesthetists.

To address the current pressures and shortage of doctors in the NHS, the Government plans to train at least 1,300 PAs each year in England, with the aim of having 10,000 PAs working in the NHS by 2036/37. The number of AA training places will also significantly increase. The Government intends for PAs to be regulated by the General Medical Council and to extend their role to include prescribing medication.

However, the increased use of PAs has sparked a debate about their level of authority and the tasks they are allowed to perform. While routine tasks such as taking blood samples are widely accepted, critics are concerned about the riskier procedures that some PAs are now conducting, such as pelvic examinations and lumbar punctures. Critics argue that two years of training may not be sufficient for PAs to have the necessary skills and knowledge to take on these responsibilities.

Ultimately, the role of a PA is meant to complement that of a doctor, not replace it. While there may be highly capable individuals who become PAs, it is crucial to ensure that they have the necessary skills and knowledge to carry out their assigned tasks. Some argue that nurses, who undergo more extensive training, already possess the skills needed for many of these tasks. The debate surrounding the use of PAs in the NHS continues, with concerns about patient safety and the appropriateness of their scope of practice.

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