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Joint surgical royal colleges’ statement on Physician Associates (PAs)

09 Oct 2023

Physician Associates (PAs) are valuable members of the surgical team who help in the delivery of acute and elective surgical care. They do not undergo the same medical training or specialist education as surgeons and should always work under the supervision of a medically qualified practitioner.

The General Medical Council (GMC) is currently designing the processes and policies needed to regulate PAs. As part of this process, the surgical royal colleges responded to a Department of Health and Social Care (DHSC) consultation on regulating PAs earlier this year. The GMC expects regulation to begin in the second half of 2024, at the earliest. 
While there are a growing number of PAs working in surgical teams there is currently no standardisation of the PA role. There is also no national guidance on the scope of practice, training standards, or assessment for the role. 
A task and finish group has been established by the Intercollegiate Extended Surgical Team Board, which includes the surgical royal colleges, to address the gap in guidance for PAs and other roles in the extended surgical team (EST). The group will determine the scope of practice, training, assessment and governance arrangements for all members of the EST, and how this relates to surgical training. 
Alongside their work on other EST roles, the group will develop and publish a clear view across all specialties of the role of PAs in surgical teams. This will include developing appropriate training pathways based on the standards set for Surgical Care Practitioners (SCPs). The aim is to ensure that all these practitioners can continue to act as valued members of the surgical team, while ensuring patient safety and enhancing the experience of surgical trainees.  
The task and finish group includes members from the surgical royal colleges, surgical specialty associations, surgical trainee associations and organisations representing the non-medical professions within the surgical team. It will aim to publish the recommendations from this work by early 2024.
Until this guidance is available, surgical departments must carefully consider the work that PAs undertake within the surgical team, both in the clinical setting and in the operating theatre.  The role of each member of the EST team should be made clear to patients, and EST roles should not compromise training opportunities for surgical trainees. 

With effective team working, PAs and other members of the EST can positively enhance operative and educational opportunities for surgical trainees and improve outcomes for patients. 

Royal College of Surgeons of Edinburgh

Royal College of Surgeons of England

Royal College of Physicians and Surgeons of Glasgow 

 The statement is available to download here

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