Interim guidance for physician associates working in the medical specialties

Developed by the RCP oversight group for activity related to PAs (also known as the RCP PA oversight group, or PAOG), this interim guidance is approved by RCP Council and acts as a placeholder to ensure patient safety and support physicians and the wider healthcare team until the independent review of PA and anaesthesia associate professions (the Leng review) reports its findings.

The interim guidance covers scope of practice for general internal medicine, supervision and employment of PAs, and how PAs should describe their role to patients, employers, other healthcare professionals and the public. It will be reviewed in collaboration with stakeholders, including RCP fellows and members, following the publication of the report of the Leng review.

In the guidance, the RCP is clear that:

• PAs must support – not replace – doctors, have a nationally defined ceiling of practice, and have a clearly defined role in the multidisciplinary team (MDT).
• PAs must never function as a senior decision maker, nor should they decide whether a patient is admitted or discharged from hospital.
• Resident doctors are not, and must not be expected or asked to be, responsible for the clinical supervision of PAs. PAs should only be supervised by consultants, specialist or associate specialist doctors.
• PAs cannot prescribe medications regardless of any prior healthcare background while working as a PA.
• PAs must clearly explain their role to patients, their families and carers, as well as colleagues and supervisors, and provide details of their educational and clinical supervision when required.

In our submission to the Leng review, the RCP will be calling for the publication of a nationally agreed scope and ceiling of practice for PAs, a review of the projections for growth in the PA role in the NHS Long Term Workforce Plan, and a review of the way the PA role impacts training opportunities for resident doctors.