BMA Scotland: Scottish doctors express “serious concerns” over deployment of Physician and Anaesthesia Associates in the NHS.

by BMA Scotland media team

Press release from BMA Scotland

Location: Scotland
Published: Wednesday 13 December 2023

A BMA survey of 1700 doctors working in the NHS in Scotland has revealed the scale of the profession’s concerns over the utilisation of Physician Associates (PAs) and Anaesthesia Associates (AAs) in Scotland’s health service – with 80.3% of those who responded saying they believe the way PAs and AAs currently work in the NHS is always, or sometimes, a risk to patient safety.

Doctors also voiced their concerns over how patients and their families perceive PAs and AAs – with 82.8% reporting that they feel patients are not aware of the difference between the roles of PAs and AAs, and the roles of doctors, showing the immense scope for patient confusion about the level of care they are receiving.

Dr Iain Kennedy, who is chair of the BMA’s Scottish Council, said: “There is absolutely no doubt that doctors across Scotland have serious concerns about the confusion, and resulting impact on patient safety, caused by the use of Physician Associates and Anaesthesia Associates in our NHS.

“We have a duty of care to our patients and their families – and they need to know who they are being treated by, and the level of their experience and skills. It is becoming worryingly clear that this isn’t always happening, and I am deeply concerned about the implications this has on the level of care that is being delivered.

“In addition to this, there is a clear impact on junior doctors, who are sometimes being placed behind AAs and PAs in the queue for access to key training opportunities. Senior doctors simply do not have the time to effectively train two separate professions and unfortunately it is often the junior doctors who are being impacted by this, which is unacceptable, since it is our younger colleagues who will one day step into our shoes – not PAs or AAs.

“This is an extremely important and urgent matter, and one that BMA Scotland has already raised with the Scottish government, including directly with the Cabinet Secretary for Health. While the Scottish government has only set out vague plans for a gradual increase in the numbers of PAs and AAs, we remain very concerned that this is not the right time – while doubts about scope, impact on doctor training and confusion with the public are far from resolved.

“In terms of regulation BMA Scotland is worried that asking the GMC – which regulates doctors across the UK – to do this will only further increase the risk of confusion around these roles. This is a devolved matter, and we understand that it will be brought to the Scottish Parliament soon – and we will be making a strong and clear case that an alternative should be sought. For the good of our profession, and our patients.”

Notes to editors

This was part of a wider BMA survey which received around 18,000 responses from doctors across the UK.

To note, today (Wednesday 13 December) the Westminster government will lay legislation to begin the process of regulating Physician Associates and Anaesthesia Associates by the General Medical Council. This legislation will be an Order in Council (the Anaesthesia Associate and Physician Associates Order (AAPAO)) amending the 1999 Health Act. This is secondary legislation which will receive far reduced parliamentary scrutiny than primary legislation. The regulations will come into force at the end of 2024.

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