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RCS England statement on Physician Associates and the extended surgical care team

27 Sep 2023

To read our most recent statement on physician associates, please see here.

We are aware of the concerns expressed by our colleagues regarding the current and planned expansion of non-medically qualified roles, which will inevitably affect the surgical team. We share concerns about the activities that some members of the extended surgical team have anecdotally been allowed to undertake locally. We believe that, implemented appropriately, the introduction of roles such as Surgical Care Practitioners (SCP), Physician Associates (PA) and Advanced Nurse Practitioners (ANPs) provides an opportunity to improve patient care and enhance the training surgical trainees receive.

As surgical leaders it is our long-held view that, the roles of non-medical practitioners should be developed more strategically, valuing and supporting a diversity of roles and skills while being careful not to crudely substitute doctors in training with other staff groups.

RCS England has worked hard to ensure that the Surgical Care Practitioner (SCP) role has clear standards of practice, a training pathway and robust governance. Alongside this, we have produced a set of guidelines and tools for the extended surgical team.

However, we are aware that there remains a gap in standards for other roles working within the extended surgical care team, such as the Physician Associate (PA), and we are working with colleagues in the other surgical colleges and the surgical specialty associations to address this. We will ensure that trainee and extended surgical care team representatives are involved in this work.

The NHS is under significant pressure, and understandably, surgical teams will look for willing pairs of hands. However, such roles must be developed in line with national guidance on scope of practice and clear and robust standards for training and accreditation. This will ensure that roles and responsibilities are clear, “scope creep” is avoided, surgical trainees are not undermined, training opportunities are protected, and patients are safe.

Until full national guidance is developed, we ask that caution be exercised when deciding on the scope of activities that Physician Associates in extended surgical teams are asked to undertake.

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