Controversies surrounding PA and AA roles

The roles of medical associate professions (MAPs) are once again under the spotlight. There have been a number of consultations carried out by the Department of Health and Social Care together with consequent communications and agreement with the devolved nations regarding the regulation of health and social care professions. A law was passed earlier this year identifying two specific professional groups, the Physician Associates (PAs) and the Anaesthesia Associates (AAs), citing plans for their imminent formal regulation.

Currently, they are only required to be on an appropriate voluntary register managed by the Royal College of Physicians or the Royal College of Anaesthetists respectively. This is set to change in December 2024 and the General Medical Council (GMC) will take the lead setting up a new registration process for both specialist groups, which will become mandatory after a two-year transition period. This debate and new parliamentary order have set the cat among the pigeons, although everyone seems to agree that, in the interests of patient safety, formal regulation is necessary and indeed long overdue.

The most vocal groups dissenting, have been the BMA and the Royal College of General Practitioners (RCoGP) who state that the GMC is not the appropriate body to be regulating the groups, but it should rather be the Health and Care Professions Council. The RCoGP recently raised significant concerns that Physician Associate regulation by the GMC could increase the confusion among patients about the differences between doctors and Physician Associates.¹ They also are concerned about the capacity of senior GPs to supervise the learning of new and potential Physician Associates, as well as the resources to fund their training, induction and supervision overall.