Health secretary Wes Streeting has launched an independent review into the coverage and safety of physician associates (PAs).

Having previously recognized doctors’ ‘legitimate concerns’, Mr Streeting has now launched a review of PAs and anesthetists (AAs) which will cover recruitment and training, scope of practice, supervision and regulation.

Mr Streeting said the review would ‘reveal the facts’ and ‘take the heat out of what has become a toxic debate’.

It will be led by NICE’s chief executive, Professor Gillian Leng, a former consultant in public health medicine and now president of the Royal Society of Medicine.

The Department of Health and Social Care (DHSC) said Professor Leng would only look at ‘how effectively these roles are being implemented in the NHS’ in England and provide recommendations to inform the Government’s future workforce plans.

This independent review and next steps will be published in spring 2025, coinciding with the expected publication date. DHSC’s 10-year plan for the NHS and plan ahead for a planned update to the NHS Long Term Workforce Plan next year.

Patients, NHS employers, professional bodies and academics will be invited to share their views on PAs, and Professor Leng said it aims to gather evidence from both the UK and abroad to ‘achieve a common understanding of these roles’.

The review will examine the safety and effectiveness of the 3,500 PAs currently working in the NHS in England, with more than half working in GP practices.

It will also seek to ‘increase transparency’ around PAs and AAs and look at measures to ensure patients know when they are interacting with these roles.

health secretary He hinted at a possible review last weekHe says he needs to ‘assess’ concerns about PAs before ‘stepping on the gas pedal’ to expand the role. And according to a report TelegramThe review will look at whether PAs should be allowed to see undifferentiated patients.

Today Mr Streeting said many PAs ‘provide great care’ and ‘save time’ for doctors but there are ‘legitimate concerns about transparency for patients, scope of practice and substitution of doctors’.

“These concerns have been ignored for too long, leading to a toxic debate in which doctors feel ignored and PAs feel demoralised,” Mr Streeting added.

He said of the review: ‘This independent review, led by one of the UK’s most experienced health leaders, will establish the facts, take the heat out of the issue and make sure we get the right people in the right place. I’m doing the right thing.”

Academy of Royal Colleges last month Urged health minister to order ‘rapid review’ He argues that the current debate around the roles is ‘almost devoid of factual information’ regarding the safety and efficiency of PAs.

Other medical organizations, e.g. RCGP And BMAThe GP Committee took a completely opposing stance to PAs working in general practice.

Responding to the launch of today’s review, Professor Leng said: ‘To promote patient safety and strengthen the NHS workforce, it is crucial that we undertake a comprehensive review of the role of PAs and AAs. This will include recruitment and training, scope of practice, supervision and professional regulation.’

NHS England chief executive Amanda Pritchard said PAs were ‘important members of NHS staff’ and they ‘deserved the same respect as anyone who comes to work in the NHS’.

He continued: ‘While we have always been clear that they cannot replace doctors, there are clear and ongoing concerns that we are listening carefully and taking action to address; This independent review is with the government, that’s right.’

The RCGP said a ‘comprehensive and evidence-based review’ of PAs was ‘necessary and welcome’, given doctors’ concerns. NHS England’s target is to increase this role to 10,000 by 2036.

College president Professor Kamila Hawthorne points to RCGP Latest coverage for PAsThis severely limits their current practice and the university recognizes ‘this is a challenging situation for everyone involved’, he said.

He continued: ‘It is therefore vital that a transparent and comprehensive review is carried out, focusing on the interests of patients and their safety, and drawing on the experience of GPs and other doctors working in healthcare. The College looks forward to benefiting from this.’

Danny Mortimer, chief executive of NHS Employers, also welcomed the review and argued that NHS leaders and medical representative bodies are ‘struggling to find constructive and consistent ways to respond to public concerns’ about PAs.

‘At times the response lacked kindness and compassion, especially for those in these professions,’ he said.

Mr Mortimer continued: ‘Professor Gillian Leng is widely respected as an evidence-based clinician and leader and her review provides an opportunity for careful examination of these roles, particularly in light of upcoming regulation by the General Medical Council.’

This week, BMA calls for ‘full transparency’ from GMC Regarding their position regarding their PA scope of practice.

There is currently no nationally agreed scope of practice for PAs, with multiple organizations including the BMA, RCGP and the Royal College of Physicians (RCP) producing their own versions.

The GMC has made clear that it will not set a scope for PAs itself once it comes into regulation next month. About the scope of practice of other organizations, GMC says Pulse PAs will require ‘individual’ scopesbut fitness to practice proceedings will ‘contain reference’ to scopes produced by the royal colleges.