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World Health Authority questions UK reliance on physician associates

2 min read

The World Health Organization (WHO) has questioned the UK’s employment of Physician Associates (PAs), as the debate over their place in the NHS continues.

Physician Associates (PAs) assist healthcare teams in conducting physical examinations, developing treatment plans and diagnosing patients. The role was introduced into the NHS in 2003 to address workforce shortages, but has recently faced scrutiny over mistakes PAs have made with patients.

In an interview with The House magazine, Europe’s regional director of the WHO Hans Kluge said that, “there is a new role of physician associates but it doesn’t solve the problem” of addressing workforce shortages, since “they can do some things but they cannot take over the role of doctors”.

Kluge said ongoing wars, infectious diseases and mental health are all contributors to a current state of “permacrisis”, but that the decline of the health workforce is the single biggest issue world health systems face.

“If you ask me what the number-one crisis in the health system is in my region, I believe it’s very clear: it’s the health workforce. There is no health without a health workforce.”

The problem is especially acute in the UK, he says, where the pandemic has amplified chronic underinvestment in the NHS.

However, he said that while the NHS was once “the crown jewel of the UK”, it “has not followed an upwards trajectory” and that “it is not sustainable to rely only on attracting a workforce from other countries”. 

In February, Conservative MP for Central Suffolk and North Ipswich Dan Poulter, a trained doctor, said he had to intervene when a PA did not properly treat a paracetamol overdose.

He said: “The physician associate incorrectly informed me that they didn’t require what is called NAC treatment because of their liver function test being normal, in spite of the fact that they were over the treatment line as a result of their paracetamol overdose.

“Of course, at that time the patient’s liver function tests were normal, they wouldn’t have been for very long, and the consequences of that diagnostic decision by the physician associate could have been fatal.”

A Department of Health and Social Care spokesperson said: “The expansion of associate roles is an important part of the NHS’s Long Term Workforce Plan. Physician associates (PA) have worked in the NHS for over two decades and free up doctors’ time to focus on the tasks only they are qualified to do. They will not replace doctors, with the Long Term Workforce Plan also doubling the number of doctors in training by 2030-31.”

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