The UK Government has initiated a review of physician associates (PAs) and anaesthesia associates (AAs) in England following increasing concerns about their use in the NHS.

The Royal Society of Medicine president Gillian Leng will spearhead the investigation into how these roles influence safety and their integration with broader healthcare teams, including general practitioners (GPs).

Upon completion of the review, the findings and recommendations are expected to be published in early 2025.

There are currently more than 3,500 PAs and nearly 100 AAs working alongside over 180,000 full-time equivalent doctors and GPs in the NHS.

The current strategy aims to increase the number of PAs in England to 10,000 by 2037 and to add 2,000 AAs.

This expansion plan follows the Academy of Medical Royal Colleges' appeal to Health Secretary Wes Streeting in September.

The academy urged a review due to growing apprehension among doctors regarding the potential negative impact on patient safety and the overall quality of care.

The Royal College of GPs has already set forth guidelines stipulating that PAs should not consult with patients who have not been pre-screened by a GP.

The guideline says PAs should only carry out tasks delegated by their supervising GP.

PAs, who operate under the supervision of a doctor, are trained to diagnose patients, collect medical histories, conduct physical exams, interpret test results, and formulate management plans.

Wes Streeting said: “Many physician associates are providing great care and freeing up doctors to do the things only doctors can do.

“But there are legitimate concerns over transparency for patients, scope of practice and the substituting of doctors.

“These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised.

“This independent review, led by one of the UK’s most experienced healthcare leaders, will establish the facts, take the heat out of the issue, and make sure that we get the right people, in the right place, doing the right thing.”

The review will also address the necessity for patients to be clearly informed when they are being seen by an associate and the reasons for it.

It will gather evidence from various stakeholders, including patients, NHS employers, professional bodies, and academics.

Leng said: “To promote patient safety and strengthen the NHS workforce, it’s crucial that we have a comprehensive review of the role of PAs and AAs.

“This will cover recruitment and training, scope of practice, supervision and professional regulation. As I conduct this review, I am looking forward to speaking to a broad range of stakeholders and to gathering evidence from the UK and abroad so that we can reach a shared understanding of these roles and their place in wider healthcare teams.”