Streeting orders review to end ‘toxic row’ | Global News Avenue

The government has ordered a review of physician assistants (PAs) and anesthetic assistants (AAs) in England amid growing concerns about their use in the NHS.

The number of PAs and AAs assisting physicians is expanding rapidly.

But the British Medical Association expressed concern that they were being asked to do tasks they shouldn’t be doing and that boundaries with doctors were being blurred.

Announcing the review, Health Minister Wes Streeting said there were legitimate concerns that needed to be considered, but he also criticized the “toxic nature of the debate”, saying it was demoralizing for the PA.

The review will look at how they are deployed and what safeguards are needed in the future.

“Many physician assistants are providing quality care and allowing physicians to do what only physicians can do,” Streeting said.

“But there are legitimate concerns about patient transparency, scope of practice and physician substitution.

“These concerns have been ignored for too long, resulting in a toxic debate in which physicians feel ignored and physicians feel demoralized.”

He said he hoped the review would “put the issue to rest” and ensure “we have the right people in the right place doing the right things”.

The review will be led by Professor Gillian Leng, former chief executive of the National Institute for Health and Care Excellence, the NHS drugs advisory body.

It will submit a report early next year to inform the government’s new ten-year plan for the NHS.

Current NHS workforce plans recognize PAs and AAs as important components of health service staffing.

That number has been gradually increasing in recent years, but plans unveiled last year called for a rapid expansion from more than 3,000 to 12,000 by 2036.

PAs can work in GP surgeries and hospitals. They do not have the authority to write prescriptions, but they can order some scans, take medical histories and conduct physical exams.

AAs who support surgical teams are a much smaller group – there are only around 100 people in the NHS.

Both PAs and AAs must complete a two-year master’s degree. They usually require a first degree related to a biological science, but this is not a prerequisite.

last week BBC reports on death of 77-year-old Susan Pollitt She died at the Royal Oldham Hospital in 2023 after a drainage tube was mistakenly left in her abdomen for too long.

An inquest into her death concluded it was caused by a “negligent unnecessary medical procedure”. She was treated by a personal assistant along with other staff members.

Following Mrs Pollitt’s inquest, North Manchester coroner Joanne Kearsley issued a warning about the use of PA.

She said there was a lack of regulatory and national frameworks covering training, supervision and competence, and understanding and awareness of the role among patients and other NHS staff was limited.

She also said the lack of visible uniforms and the title “doctor” led to confusion about whether practitioners were doctors.

Regulatory issues should be resolved next month when the General Medical Council begins regulating PAs and AAs.

In September, the Royal College of Physicians, who have been broadly supportive of expanding this role, In light of the concerns expressed, it is accepted that a review is required.

But the college was critical of the “increasingly heated and damaging debate”, saying unsubstantiated comments on social media were fueling it and damaging teamwork across the health service.

Louise Ansari, director of UK patient watchdog Healthwatch, said she welcomed the review.

She said patients reported “very positive” interactions with PAs, but she was particularly concerned that patients were not always informed or aware that they were being seen by PAs.