The Royal College of Physicians (RCP) has closed a 6-week consultation on draft guidance on safe and effective practice for physician associates (PAs).
Written for doctors and employers, the draft guidance sets out high-level principles for employing PAs and was shared for consultation on 1 August 2024 with more than 50 external stakeholders.
The guidance was sent to government departments and NHS organisations across England, Wales, Scotland and Northern Ireland, as well as the GMC, the BMA, royal colleges, faculties and specialist societies. Before going out to consultation, the draft guidance was reviewed by RCP Council, as well as a wide variety of other RCP committees and working groups.
The RCP will also host a roundtable on next steps with physician-led organisations on 26 September, where specialist societies and royal colleges will discuss the role of PAs in the medical specialties and feedback from the consultation. The intention is to work collaboratively to reduce variation, protect patient safety and improve training for early career doctors.
The RCP announced this week that the Faculty of Physician Associates (FPA) will close in December 2024. The next iteration of the draft guidance will not be published in consultation with the FPA.
Dr Hilary Williams, vice president for Wales and chair of the RCP oversight group for activity linked to PAs, said:
‘The RCP has been clear that we need a limit to the scale and pace of the expansion of PA numbers in the UK and we will continue to call on NHS England to review the number of projected numbers for PAs in the Long Term Workforce Plan. Training the next generation of physicians to deliver high-quality patient care remains our priority.
‘I want to offer my thanks to all those stakeholders that have contributed to this consultation on draft guidance for doctors and employers.
‘The RCP remains committed to a national scope of practice for PAs. Locally set scope of practice is unacceptable and we will work with other organisations to advocate for a clear, consistent and national approach to setting scope and education standards.
‘We fully recognise that we need a clear national framework of practice and consistent training standards linked to clinical competence. Clinical scope will be discussed at our planned roundtable in September. Healthcare professionals should only practise what they are trained and competent to deliver.
‘PAs are not doctors and must not be used to replace doctors. They play no role in prescribing medications or ionising radiation, and we recommend in the draft guidance that only senior doctors (a consultant, specialist, associate specialist or a GP) should supervise PAs.
‘This debate is taking place in a very challenging landscape. The conversation about the role and responsibilities of PAs in the multidisciplinary team is, quite rightly, at the forefront of people’s minds right now. For us, this is about ensuring patient safety, high professional standards and boundaries.
‘We were very clear with stakeholders that this was a draft document. We have not published it on our website, and it was shared with stakeholders individually. This was for clinical governance reasons: the last thing we want is for NHS employing organisations to find this draft guidance online and start using a version without appropriate amends incorporated.
‘Stakeholders have worked hard to get us their feedback – now it is time for us to consider everything we’ve received and decide on next steps for this draft guidance. Whatever we publish will be signed off by RCP Council. It is important that the guidance is endorsed by those elected and appointed to lead our clinical policy work.’