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Call to define role of physician associates

The BMA has warned that physician associates must not replace doctors, as the government announces a huge expansion of their training programme.

Mark-Porter-QA-196x148The government plans to double numbers of training places for physician associates — a relatively new type of healthcare professional who, though not medically trained, works alongside doctors under medical supervision.

The Department of Health says that 15 per cent of existing physician associates work in NHS emergency departments, which have been under intense pressure recently, and it is particularly keen to increase the numbers working in emergency medicine.

BMA council chair Mark Porter (pictured above) said physician associates could be ‘a valued part of the NHS’, but said the scope of their work needed to be clear so they could best provide an intermediate level of care and reduce workload pressures.

Quality of care

Dr Porter said: ‘It is important that all healthcare professionals — including doctors — are clear about the limits on the care they are able to provide, and work within them. 

‘Only doctors can provide certain types of care so the government needs to ensure that standards will not be affected by these changes and the quality of patient care will be protected and maintained.’

Dr Porter added that it was also important that the new posts did not erode training opportunities for junior doctors or medical students, or undermine the vital role they played in delivering care.  

‘Crucially, these new posts cannot replace doctors,’ he said. 

‘While they may alleviate some pressure on the system, the government also needs to address the funding, as well as recruitment and retention, crisis which is adding to pressure on emergency medicine.’

Two-year course

Physician associate training focuses on adult medicine in hospital and general practice settings rather than on specialty care and takes place over two years with students studying 46 to 48 weeks of each year. Students have usually completed a science degree.

Presently, there are three courses in Aberdeen, Birmingham and London, accounting for about 105 training places a year. 

Between now and January, three new physician associate courses in Plymouth, Wolverhampton and Worcester will open. This will double the number of available training places to 225. Four further courses are planned by autumn 2015.

A Department of Health spokesperson said: ‘There are already physician associates in the NHS, supporting busy doctors to spend more time with patients, not replace them. They can carry out clearly defined duties, but have to be under strict supervision of a doctor at all times.

‘Many physician associates will already be trained physiotherapists, nurses or paramedics and will have two years of intensive training on top of that.’

Professional association

The Royal College of Physicians of London and the UK Association for Physician Associates are setting up a new Faculty of Physician Associates to support and develop the role. 

The two organisations support statutory regulation of the physician associate role, in line with other healthcare professions.

Physician associates take medical histories, perform examinations, develop differential diagnoses, analyse test results, develop management plans and refer patients as required.

Physician associates currently practice in the East and West Midlands, parts of London and the surrounding areas, Weston-super-Mare, Bristol, Glasgow and Edinburgh.