Today, health and social care secretary Wes Streeting launched an independent review of Physician Associates (PAs) and Anaesthesia Associates (AA) to consider how these services can be used to deliver the highest standards of care for patients.

The review, to be published in the Spring, will look into the safety and support of these roles, and the extent to which they provide patients with good care. It will also investigate how effective these roles, including gathering medical histories, performing initial examinations and reviewing patients, are while offering recommendations on what the future of these roles could look like.

The review will draw from a pool of different voices — including patients, employers within the NHS, professional bodies, and academics.

Professor Gillian Leng CBE, an experienced leader in the UK health care system, will independently lead the review.

Health and social care secretary, Wes Streeting, said:

“Many physician associates are providing great care and freeing up doctors to do the things only doctors can do.

“But there are legitimate concerns over transparency for patients, scope of practice, and the substituting of doctors. These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised.

“This independent review, led by one of the UK’s most experienced healthcare leaders will establish the facts, take the heat out of the issue, and make sure that we get the right people, in the right people, in the right place, doing right thing.”

To increase transparency in these roles, the review will also consider measures to ensure patients know when they are interacting with PAs or AAs. This means they will be able to know what type of clinician they are seeing and for what reason.

Professor Gillian Leng CBE said:

“To promote patient safety and strengthen the NHS workforce, it’s crucial that we have a comprehensive review of the role of PAs and AAs. This will cover recruitment and training, scope of practice, supervision and professional regulation.

“As I conduct this review, I am looking forward to speaking to a broad range of stakeholders and to gathering evidence form the UK and abroad so that we can reach a shared understanding of these roles and their place in wider healthcare teams.”

Amanda Pritchard, chief executive of NHS England, said:

“Physician associates and anaesthesia associates are important members of NHS staff — they come to work every day to help care for patients and so they deserve to be treated with the same respect as anyone else coming to work in the NHS.

“While we have always been clear that they are not replacements for doctors, there are clear and ongoing concerns which we are listening to carefully and taking action to address — this independent review marks our pledge, together with the government, to getting this right.

“The review will gather insight from across the NHS, hearing from hospital teams, patients, professional bodies and academics so that we have the evidence we need to tackle this head on and find a way forward that s the right one for patients and staff.”

There are currently over 3,500 PAs and around 100 AAs working alongside over 180,000 doctors and GPs with NHS England.

NHS England has provided guidance on the roles PAs and AAs play. The General Medical Council will begin the regulation of PAs and AAs in December to make sure that all PAs and AAs meet the high standards expected in British healthcare.

Professor Sir Stephen Polis, NHS national medical director said:

“Like all healthcare professionals in the NHS, physician and anaesthesia associates come to work every day wanting to do their best for patients and I have seen how well they can work as part of clinical teams, but it is essential that they are properly supported and supervised in their roles, and where there continue to be concerns that this is not always happening, we must investigate further.

“It is absolutely right that we have the confidence of the public and the medical community as we develop the future NHS workforce, and we will collaborate fully with Professor Leng and the review team to carry out this important work over the coming months.”

Dr Navina Evans, NHS England’s chief workforce, training, and education officer, said:

“We know that having a diverse set of skills and roles within the NHS workforce helps to improve care for patients and the efficiency of our teams, including staff in associate roles who work under supervision to deliver specific tasks they are trained to do alongside a wider team.

“But we must also listen to the concerns people have about these roles and I fully support this review to ensure we get the right evidence-based answers for patients, doctors, associates and the NHS as we develop our future workforce.”