In a move to shore up public trust in the country’s healthcare system, the UK government announced that it’s changing its approach to physicians assistants. The pivot. comes after an investigation launched late last year into the roles of physician and anaesthesia associates.
Health and Social Care Secretary Wes Streeting confirmed that the government will begin immediate implementation of the reforms.
“We’re accepting all of the recommendations of the Leng Review, which will provide clarity for the public and make sure we’ve got the right staff, in the right place, doing the right thing,” he said in a statement. “Patients can be confident that those who treat them are qualified to do so. Physician assistants, as they will now be known, will continue to play an important role in the NHS. They should assist doctors, but they should never be used to replace doctors.”
Chaired by Kings College London professor Gillian Leng, CBE, the review stemmed from growing public and professional concerns about the safety, scope, and oversight of PAs and AAs.
Leng drew on input from academics, clinicians, NHS employers, patients, and international experts. She has called for a more unified approach to healthcare – driven by transparency, supervision, and an integration of clinical roles.
“I’m pleased the government is implementing the recommendations in full. My review provides the opportunity of a reset, but this must be the start of the conversation, not the end,” Leng added. “Now it’s time to focus on delivery: bringing clarity for patients, complementarity between doctors and assistant roles, collaboration across teams, focussed on ensuring safe and effective high-quality care.”
Immediate Changes
The plan is for the National Health Service to implement these new protocols immediately. As Streeting mentioned, physician associates and anaesthesia associates will be renamed “physician assistants” (PAs) and “physician assistants in anaesthesia” (PAAs), which is meant to reflect their supporting roles. In a dramatic policy shift, PAs will no longer be allowed to independently triage or treat undifferentiated patients.
The government also directed employers to tweak the relevant job descriptions to reflect these changes, especially for new hires. Those already on staff will submit to evaluations by supervising clinicians to ensure that they’re still a fit for their roles.
Other important changes include:
- New PAs should accumulate at least two years of experience in secondary care before assuming a primary care or mental health trust role.
- A named doctor should assume responsibility for each PA as their formal “manager.”
- Facilities should implement standardized measures (such as clothing, lanyards, and badges) so patients – and peers – can distinguish PAs from doctors.
- NHS should offer PAs the opportunity for ongoing training and development within a formal program.
NHS England Responds
In a letter published after the release of Leng’s report, NHS England acknowledged the challenges surrounding this growing national debate.
“We want to be clear about the culture we expect – one grounded in listening, learning, and improvement. That’s how we build a workforce fit for a future-facing NHS,” Co-National Medical Directors Dr. Claire Fuller and Professor Meghana Pandit wrote in the letter.
The letter also outlines specific actions for employers while offering pastoral support for staff affected by the transition.
NHS England officials added that longer-term reforms, such as new national standards, will take time. Lessons from the Leng Review will also drive the government’s workforce strategy moving forward.
In short, the move marks not just a seismic policy shift, but a huge cultural one, too, meant to leverage toward transparency to rebuild the public’s trust.
Further Reading
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