3 November 2024
Open letter to the Secretary of State for Health and Social Care, UK, on the fate of Physician Associates

Dear Secretary of State,

We are writing to express our deep and increasing concern about the perception of the role of Physician Associate in the United Kingdom. The BMA’s General Practitioner Committee, as you will be aware, has recently voted to remove the role of PAs within general practice, citing inadequate training and concerns about patient safety bma.org.uk/bma-media-centre/gps-vote-in-favour-of-...

It would appear that there is a huge misunderstanding and/or lack of education within both the medical and public sphere about the role of PAs, and that many doctors now see us as a liability, rather than the asset we can be if our skills are used appropriately. We are not doctors and we do not pretend to be; however, many of us offer invaluable assistance within both primary and secondary care, we are proud to work for the NHS, are passionate about delivering good patient care, and we receive excellent feedback from the Partners at our practices and, equally importantly, from patients. We are sure this is the experience of many of our colleagues and the wider PA community.

As you will be aware, the state of primary care in the United Kingdom is dire, with many patients waiting weeks to see their general practitioner, and with a decreasing number of trained GPS available. The role of Physician Associate was in part introduced to alleviate the problems in primary care, and to enable GPs and other qualified doctors to offer increased appointments to patients whilst supervising suitably trained PAs. PAs have been active in the UK for over twenty years, following development of the role in the USA in the 1960s and with equivalent or similar roles now common in many healthcare systems around the world. The fate of PAs within general practice in the United Kingdom now seems to have been decided by a relatively small number of people, campaigning relentlessly to undermine the role and foster mistrust and malcontent with the general public.

We are being painted as unqualified and overpaid, but this ignores the fact that we study for five years, first acquiring an appropriate undergraduate degree and then moving on to a two-year Master’s degree. For most of us this has meant incurring considerable student debt, and we reach a pay ceiling very early on in our careers.

We appreciate that there are concerns around patient safety and potential lack of supervision, but we venture to say that these issues are much more complicated than simply blaming PAs, whose role by its very nature is a supervised one, and who are one part of a multi-disciplinary team. Nobody seeks to phase out doctors or nurses when things go wrong and it seems, in attempting to eliminate PAs, that the baby is being thrown out with the bath water.

We support the recent call by the AoRMC for an independent review of the PA role because

the campaign against PAs has already caused demonstrable harm, both to individuals within the profession and to the PA role as a whole. This ongoing negative narrative risks worsening the situation, dissuading skilled candidates from entering the field, and undermining the contributions that existing PAs make every day in practice. We are hearing increasing numbers of cases of PAs being targeted and harassed, with reports of property damage and threats of physical harm. It is entirely disheartening to be shouted at by some patients simply because we are PAs, when we are working hard to deliver excellent care.

There is plenty of research and evidence to suggest that PAs are of great benefit, I urge you to look at the evidence brief from health education England and the work of Professor Vari Drennan.

hee.nhs.uk/our-work/medical-associate-professions/...

bmjopen.bmj.com/content/bmjopen/10/9/e037557.full....

We urge you to investigate the reasons that have led to GPs and other doctors losing faith in our role, and to consider the fate of the many excellent PAs that are currently working in our NHS, and whose reputations, careers, and very livelihoods are now at serious risk.

We urgently need visible, positive PR and public education efforts to correct misconceptions, highlight our value, and prevent further damage.

3,413
signatures
3,003 verified
  1. Rosanna Ginger, Physician Associate, London
  2. MUNACHIMSO B ENWEREJI, Physician Associate, Lewisham & Greenwich Trust, London
  3. Dure sameen Ahmed, Physician associate, North Merton pcn, London
  4. Martins Yusuffu, Physician Associate, Beckenham PCN, Beckenham
  5. Ashraf Awaiz, Physician associate, Warwick, Birmingham
  6. Charlotte Clark, Physician Associate, Sheffield
  7. Elita Unyolo, Physician Associate, Stoke On Trent
  8. Ashani Ketheeswaran, Physician Associate, Essex
  9. PA Jennifer Johnson, Physician Associate, North West England
  10. Declan McHugh, Physician Associate, Hull
  11. Katherine Lorriman, Physician associate, DONCASTER
  12. Lauren Berry, Physician associate, Local primary Care Fedarate - PCN, Blackburn
  13. Sara Marques, Physician Associate, ELFT, Bedfordshire
  14. Thavindu Liyanage, Physician Associate, Health Alliance PCN, Harrow
  15. Masooma Hussain, Physician associate, Northamptonshire
  16. Victoria Lefeuve, Physician Associate, LGT, London
  17. Manish Kumar, Physician Associate, Leicester
  18. Jathurshika Vigneswaran, Physician associate, London
  19. Wafa Nasir, PA, Birmingham, Birmingham
  20. Jemma Hardy-Goddard, Physician associate, James Paget University Hospital, Gorleston
...
2,963 more
verified signatures
  1. Eileen, Retired, Northants
  2. Chloe Constance, Physician Associate, Gosford Hill Medical Centre, Witney
  3. Edward aitchison, Retired, Newcastle
  4. Susan Duffy, Mental Health nurse, Guisborough
  5. Andrew Thompson, Cyber Security, Warwick
  6. Anonymous
  7. Adrian Hyde, Electrician, ACH Electrical & Plumbing Ltd, Beaminster
  8. Heather Widdows, Finance Analyst, Honeywell Aerospace, Beaminster
  9. G Crasto, Civil Engineer (Retired), Northampton
  10. Kirsty Solomon, HCA, NHS, North yorkshire
  11. Thomas Day, Manager, Redcar UK
  12. Richard Akkermans, Sustainability Manager, Mondelez International, Warwick
  13. Michelle Olson, Physician Associate, Anglesea Urgent Care, New Zealand
  14. Glenn Clark, Window Cleaner, Self Employed, Fakenham
  15. Professor Philip M. Sedgwick, professor of Medical Statistics and Medical Education, City St. George's, University of London, London
  16. Sohail kareem, Physician associate, Primarycare, Manchester
  17. Justine Gadd, Physician Assistant, Health Te Aroha and Health Ngatea, Waihi, NZ
  18. Jackline M'arimi, Software Developer, Bradford
  19. Helen Self, Teacher, Bath
  20. Marzabin Ahmed, Physician Associate, London
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