An independent review looking at the roles of physician associates and anaesthesia associates has been published.

Led by Professor Gillian Leng CBE and commissioned by health secretary West Streeting in November 2024, the review considered the safety and effectiveness of the roles and their contribution to multidisciplinary healthcare teams.

Physician associates (PAs) and anaesthesia associates (AAs) were introduced into
the NHS in the early 2000s, reflecting a wider trend towards the development of multidisciplinary teams and with a stated aim of allowing doctors to focus on more complex cases while expanding access to care and improving efficiency.

According to the review, the initial introduction of the roles was relatively smooth and appeared to be well received by the medical profession, but expansion in numbers over the past decade has generated some challenge from medical profession, the public and the media. This has been exacerbated by workforce pressures and reduced morale
following the pandemic, and heightened by industrial action.

Concerns have been raised about safety and a lack of clarity in the roles and about the impact of training and employment of resident doctors.

In her review, Professor Leng recommends that the role of physician associate should be renamed as ‘physician assistant’, positioning the role as a supportive, complementary member of the medical team. Physician assistants should have the opportunity for ongoing training and development in the context of a formal certification and credentialling programme and should also have the opportunity to become an ‘advanced’ physician assistant, which should be one Agenda for Change band higher.

The review also recommends that standardised measures, including national clothing, lanyards, badges and staff information, should be introduced to distinguish physician assistants from doctors.

Similar recommendations were made for anaesthesia associates. Leng recommends that Anaesthesia associates should be renamed as ‘physician assistants in anaesthesia’
or PAA and they should also have the opportunity for ongoing training and development.