A review from Oxford University has found there is little evidence that employing physician associates (PAs) in the NHS is safe or that they improve patient care. The study, published in the British Medical Journal, examined 29 research studies and concluded that the available evidence is 'sparse', 'outdated' and of 'variable quality'.
Researchers highlighted that no studies have examined safety incidents relating to PAs, and some evidence suggests they 'struggle' when working in GP surgeries. While some research indicated PAs could support hospital ward teams and A&E when properly deployed and supervised, the number of individuals and settings studied was small, and findings should be considered preliminary.
The review also noted concerns among NHS staff about the competence of PAs and anaesthetic associates (AAs) to manage undifferentiated, clinically complex or high-dependency patients, or to prescribe. It stated: 'No evidence was found that physician associates add value in primary care or that anaesthetic associates add value in anaesthetics; some evidence suggested that they do not.'
PAs have been linked to patient deaths, including that of Emily Chesterton, 30, who died from a pulmonary embolism in 2022 after being misdiagnosed by a PA on two occasions. Last week, a coroner criticised the care provided by a PA to Pamela Marking, who died at East Surrey Hospital, noting the PA 'had a lack of understanding of the significance of abdominal pain and vomiting'.
There are currently more than 3,500 PAs and AAs employed in the NHS, with plans to recruit more. In November, the Government launched a review of the roles led by Professor Gillian Leng, president of the Royal Society of Medicine.
