Independent Review of Physician Associates and Anaesthesia Associates

In November 2024, I asked Professor Gillian Leng CBE to undertake an independent review of physician associates and anaesthesia associates in England, and to set out recommendations to ensure the safety of the roles and their contributions to multidisciplinary healthcare teams.

Today I want to update the House on next steps following the publication of the review.

Professor Leng sets out 18 recommendations that will give much-needed clarity, certainty and confidence to staff and patients. The Government are accepting these recommendations in full.

The overarching recommendations include: renaming the role of “physician associate” to “physician assistant” and “anaesthesia associate” to “physician assistant in anaesthesia” to reflect their position as a supportive, complementary member of the medical team; providing ongoing opportunities for training and career development; making it easier for others to identify these roles; establishing permanent faculties to provide professional leadership and set clear professional standards; greater clarity in the differences between the regulatory requirements of doctors and assistant roles; training in line management and leadership for doctors, with additional time allocated; redesigning models of multidisciplinary working; and improvements in safety reporting.

For physician assistants specifically, Professor Leng has recommended that their initial practice is clearly defined in line with job descriptions; they do not see undifferentiated patients (except within clear national clinical protocols); that newly qualified physician assistants should gain at least two years’ experience in secondary care, to enhance clinical skills, prior to taking a role in primary care or a mental health trust; and that they should form part of a clear team structure and have a named supervisor.

For physician assistants in anaesthesia, the review recommends full compliance with the existing Royal College of Anaesthetists scope of practice; that any further expansion of the role should be taken forward in conjunction with the Royal College of Anaesthetists; and that there should be an ongoing national audit of safety outcomes in anaesthesia, to gain assurance around the safety of the physician assistants in anaesthesia role.

Implementing the recommendations will require organisations to work together and take action. Some actions will be implemented immediately, while others will require wider input, with benefits being fully realised over time. I have asked NHS England to move with immediate effect to implement those recommendations which most directly affect patient safety, including moving to the use of physician assistants and physician assistants in anaesthesia titles and ensuring that physician assistants do not see undifferentiated patients, except within clearly defined national clinical protocols.