Half of people know nothing about physician associates, poll suggests

More than half of people in the UK have never heard of – or know nothing about – physician associates, a new poll has found.

However, people expressed a small preference for the idea of NHS funding being used to recruit and train these staff if it means shorter waiting times for appointments.

Leading GPs said it is important people have more information on physician associates (PAs), and stressed that it should be made clear to patients being treated by them that they are not doctors.

The British Medical Association (BMA) also warned that “efforts to cut waiting lists must not come at the cost of patient safety”.

The poll of 1,127 people over the age of 16 – conducted by Ipsos for the PA news agency – found 57% had either never heard of PAs or had heard of the role but knew nothing about it.

This is compared to 3% who said they knew a great deal about PAs while 15% said they knew a fair amount and 22% said they knew a little.

After being given a brief description of the role, 40% of people surveyed said the NHS should use funding to recruit and train more PAs to support GPs, so the wait for an appointment is shorter, even if a patient is less likely to see a family doctor.

This is compared with 30% of people who agreed with the NHS recruiting a smaller number of GPs so that patients are more likely to speak to a doctor even if they have to wait longer.

Medical associate professions (MAP) roles, which includes PAs and anaesthesia associates (AAs), were introduced to the NHS workforce in the early 2000s to bolster access to care for patients.

However, they have been under scrutiny following high-profile mistakes, including the death of 30-year-old Emily Chesterton, who was misdiagnosed by a PA twice before eventually dying of a blood clot in 2022.

The NHS’s Long Term Workforce plans sets out an ambition to establish a workforce of 10,000 PAs by 2036/37 and from December this year, both PAs and AAs will be regulated by the General Medical Council (GMC).

An NHS spokesperson said: “The NHS has always been clear about the role physician associates play in supporting clinical teams to provide high-quality care for patients – they are not replacements for doctors, but support with specific tasks they are trained to do, under supervision.”

Professor Phil Banfield, the chairman of the BMA council, added: “It is incredibly concerning, but not at all surprising that so many people know so little about physician associates, even though they are working in GP practices and hospitals across the country.

“It is unclear from this poll how much detail respondents were given about the fundamental differences between a PA and a doctor in terms of clinical training and expertise; it begs the question, were those in support of recruiting and training more PAs with a view to bringing down waiting times, aware of the limitations of a PA, how little training they have in comparison to a doctor?

“PAs are not equivalent to doctors. They must always work under close supervision from a doctor and should never be used in their place.

“NHS England has stated that doctors must not be replaced by PAs. We believe that PAs should see only those patients already triaged by a GP who has many years more training as efforts to cut waiting lists must not come at the cost of patient safety.

“It takes over 10 years of training to become a GP, PAs study for two years and although they have a role in the NHS, they must not be used as a substitute for qualified staff.”

A quarter of people surveyed said that, at every appointment in the past year, they have known the role of the healthcare professional they interacted with at their surgery, be it a GP, nurse or PA.

Some 23% said they knew the role most of the time, 19% some of the time, 11% not many times and 4% answered never.

The majority of people – 77% – said they feel it is important for them to know the role of the member of staff they are dealing with.

Dr Victoria Tzortziou-Brown, vice chairwoman of the Royal College of GPs, said: “This poll shows how important it is that more information for patients is available about this role – and that it is made very clear to any patient who is being treated by a physician associate what their role is and that they are not a doctor; this is one of the college’s red lines for PAs working in general practice.

“It is the college’s position that PAs can potentially have a helpful role in general practice – but that the profession must be regulated, must be supervised by a fully qualified GP, and must work within a clearly defined scope of practice.”

Elsewhere, 62% of those who responded to the survey said they found the availability of GP appointments for non-urgent conditions, which are usually booked in advance, to be poor.

More than half (55%) said the availability of urgent appointments was also poor.

When asked about accessibility to NHS care in general, half of those surveyed said they think it is poor, compared to 29% who said it is good.

Some 39% of people said they think the quality of NHS care is poor, while 40% said it is good.

Dr Tzortziou-Brown added: “GPs are as frustrated as our patients when they struggle to access our care and services.

“Simply recruiting other healthcare professionals, including PAs, in general practice, must not be seen as the answer.”

A Department of Health and Social Care spokesperson said: “Physician associates have an important role to play but should always work with doctors, not replace them.

“This government will fix the NHS and ensure it has the staff it needs to be there for all of us when we need it.”