9 January 2025
Abby Wallace, a Trainee Solicitor in the Clinical Negligence department considers the upcoming review of the role of physician associates
Wes Streeting, the Secretary of State for Health and Social Care, has ordered Professor Gillian Leng, an expert in evidence-based healthcare and former chief executive of the National Institute for Health and Care Excellence (NICE), to conduct a review of the role physician associates. This has arisen as a result of concerns regarding patient safety within the NHS due to care provided.
Physician associates are clinicians who work with doctors to provide medical care. They can work in both GP surgeries and hospitals and are trained to perform a variety of clinical duties such as taking medical histories, conducting physical examinations, making diagnoses and developing treatment plans under the supervision of a doctor. They are required to undertake two years of medical training which is significantly less than a doctor. There are approximately 3,500 physician associates in England and this number is expected to triple by 2037.
Despite the role of physician associates being introduced with the purpose of freeing up doctors to carry out roles that only doctors can perform and filling clinician gaps within services, there have been growing concerns regarding the use of the role within the healthcare system. These concerns include transparency for patients, many of whom do not recognise that they are being treated by clinicians who are not doctors, the scope of their practice including supervision and the substitution of doctors.
The British Medical Association (BMA) General Practitioners Committee for the UK in October voted in favour of stopping hiring physician associates in general practice and for existing roles to be phased out as it was considered that the use of physician associates in general practice was fundamentally unsafe. The committee felt that the role of a physician associate was inadequately trained to manage patients who would present to be diagnosed for the first time.
Professor Leng aims to undertake a comprehensive review with the aim of promoting patient safety and strengthening the NHS workforce. It is currently unclear as to what the outcome of the review will be or what recommendations may be made.
It is therefore important that patients are both informed and understand when they are being treated by a physician associate. Healthcare providers must also ensure that the required supervision is in place. If the correct provisions are not in place, this may amount to a breach of duty (negligence) and provided that some harm has been suffered as a result, this may give rise to a clinical negligence claim if something goes wrong.
