Expansion of non-doctor roles risks patient safety and undermines the profession, says DAUK chair

Co-chair Dr Matt Kneale says the Doctors’ Association UK (DAUK) will continue to oppose the expansion of non-doctor roles in the NHS.

The Government will this week lay legislation to regulate physician associates (PAs) and anaesthesia associates (AAs) under the General Medical Council (GMC).

Dr Kneale said he feared the legislation was being rushed through without proper public scrutiny, as he encouraged patients to always ask to see a doctor.

“Demand transparency in your healthcare,” he said. “Your health should not be compromised by cost-cutting measures and expedited, unscrutinised legislation. 

“This is backdoor medicine being pushed through by backdoor means, to avoid public scrutiny.

“We’ll continue to oppose the expansion of these roles in the NHS, and patients should always ask to see a doctor,” he added.

Our work to oppose the expansion of PA and AA roles has been highlighted in the media, including the BBC OnlineMail Online, and the i newspaper.

More than 650 doctors completed a DAUK survey and highlighted “alarming instances of patient harm” due to the replacement of doctors with PAs and AAs.

Dr Kneale said: “We can’t ignore these voices. The stakes are too high.

“Patients deserve to know who is treating them. This isn’t just about titles, it’s about training as well.

“Across the UK, GP practices are pushed towards employing PAs and AAs due to government funding schemes, not for better patient care but for budgetary reasons. This risks patient safety and undermines the medical profession.”

According to the Department of Health and Social Care, there are currently 1,500 PAs in hospitals and 1,700 in primary care settings. There are approximately 320 AAs.

The NHS Long Term Workforce Plan sets out plans to increase the PA workforce to 10,000 by 2036/37 and the AA workforce to 2,000 in the same period.

Legislation will be laid this week to allow the GMC to begin the process of regulating PAs and AAs.

More than 2,800 doctors signed an open letter from our co-chairs Dr Kneale and Ms Helen Fernandes to the GMC expressing concerns over such regulation.

The letter set out four recommendations:

  • The GMC should immediately inform the Government about the growing discontent and advocate for reopening the consultation process with the Department of Health and Social Care
  • If the regulation of PAs by the GMC goes ahead, distinct GMC numbers should be allocated to PAs to distinguish them from medical doctors
  • All PAs transferring from the voluntary Royal College of Physicians register to the GMC’s statutory register must undergo thorough verification and checks, especially with regard to Fitness to Practise procedures
  • The GMC must establish a clearly defined scope of practice for PAs and AAs, eliminating the option for these to be set locally.