The Royal College of Physicians (RCP) has published its submission to the independent review of physician associate (PA) and anaesthesia associate professions (the Leng review).
The RCP has announced that it supports a change in nomenclature for PAs. RCP Council today (19 March 2025) has agreed that the job title of a PA should be renamed to 'physician assistant'. This follows a formal recommendation from the RCP Resident Doctor Committee and the RCP PA oversight group.
The RCP submission includes interim college guidance for PAs on scope of practice, supervision and employment, and titles and introductions, as well as the Council minutes from a meeting on 19 November with NHS England (NHSE) and the General Medical Council (GMC). Other documents include a thematic analysis of responses to a stakeholder consultation on guidance for safe and effective practice for PAs, the RCP response to a Regulation 28 report to prevent future deaths (Susan Pollitt) and the full set of pre-EGM survey data from March 2024.
PAs are not doctors. They should not be regarded as replacements for doctors, and they should never replace a doctor on a rota.
In its submission to the Leng review, the RCP has recommended that NHSE and the UK government should:
- develop and enforce a nationally agreed scope and ceiling of practice for PAs
- ensure that PAs are supervised only by fully qualified consultant or autonomously practising specialist, associate specialist and specialty (SAS) doctors, and not by resident doctors
- ensure PAs clearly introduce and explain their role in all clinical settings (and the named supervisor responsible for governance so patients know who is responsible for decision making).
- ensure that the role and supervision of PAs does not have a negative impact on education and training opportunities for resident doctors. The educational supervision of resident doctors, especially those in training programmes, should be prioritised, particularly where capacity is limited.
The RCP has called on the UK government to work with NHSE to review the projections for growth in the PA role in the NHS Long Term Workforce Plan, while the devolved nations should also clarify the position of PAs in their long-term workforce planning.
RCP Council has also decided against offering PAs the option of affiliate subscriber status. The Faculty of Physician Associates was closed in December 2024 and the PA Managed Voluntary Register will not be searchable after 31 March 2025. All PAs should now register with the GMC ahead of the statutory deadline of December 2026.