New accreditation for PAs and anaesthesia associates is ‘important milestone’ for patient assurance, regulator says

More than 1,000 physician associates (PAs) could begin their careers in the NHS every year after regulators approved dozens of courses to teach them.

The General Medical Council (GMC) said it had given 36 courses formal approval to teach PAs and anaesthesia associates (AAs).

Overall, these courses had capacity for up to 1,059 PAs and 42 AAs to qualify each year.

The GMC said approving training courses would mean that “patients, employers and colleagues can be assured that PAs and AAs have the required knowledge and skills to practise safely once they qualify”.

PAs are graduates – usually with a health or life sciences degree – who have undertaken two years of postgraduate training.

According to the NHS, PAs work under the supervision of a doctor and can diagnose people, take medical histories, perform physical examinations, see patients with long-term conditions, analyse test results and develop management plans.

There were calls for more clarity in the PA role and better patient protection after the death of Emily Chesterton, 30, in November 2022 from a pulmonary embolism.

Chesterton was misdiagnosed by a PA in London on two occasions who said her calf pain was a sprain, when she actually had a blood clot.

Most associates work in GP surgeries, acute medicine and emergency medicine while AAs work as part of the anaesthesia and wider surgical team.

The GMC, which took over the regulation of PAs and AAs in December, said it had approved 33 PA courses.

Four of these – at Bradford, Greater Manchester, Queen Mary University of London and Sheffield Hallam – had been approved with “conditions” after some concerns were identified during the approval process.

The GMC said each of these courses had a “targeted action plan” in place to address concerns.

The regulator did not approve the course at the University of East London.

There are only three courses for AAs – in Birmingham, University College London and Lancaster – that were all approved, the GMC said.

Prof Colin Melville, the GMC’s medical director and director of education and standards, said: “This is an important milestone in the regulation of PAs and AAs and will provide assurance, now and in the future, that those who qualify in these roles have the appropriate skills and knowledge that patients rightly expect and deserve.

“As a regulator, patient safety is paramount, and we have a robust quality assurance process for PA and AA courses, as we do for medical schools. We have been engaging with course providers for several years already, and we only grant approval where they meet our high standards.”

In November, Wes Streeting, the health and social care secretary, announced an independent review of the PA and AA professions led by Prof Gillian Leng, the president of the Royal Society of Medicine.

Danny Mortimer, the chief executive of NHS Employers, said: “The formal accreditation of the courses of study that PAs and AAs must complete is an essential component of regulation and public safety.

“We await the outcome of the Leng review but recognise that individual NHS organisations also have a responsibility to support PAs and AAs to both use their knowledge safely with patients, and to ensure appropriate professional development and supervision.”

Prof Phil Banfield, the council chair at the British Medical Association, said it was “difficult to understand” how the GMC could approve the courses when the Leng review into PAs and AAs has not concluded.

He added: “The medical profession has alarming worries about the quality and robustness of these courses, with reports of exams with 100% pass rates.

“We have made doctors’ concerns clear in our submission to the Leng review, which includes a call for an independent body of doctors, without links to course providers, to determine proportionate and safe expectations of what can be covered in curricula for assistant roles within a two-year training period.”

PA Media contributed to this report