­­­­The annual physician associate census report – 2022

Each year, the Faculty of Physician Associates (FPA) conducts the largest census survey amongst the physician associate (PA) profession, including PA students. The annual census provides a true representation of the PA profession.

As the profession continues to move closer to achieving General Medical Council (GMC) regulation, the 2022 census provides vital insight into the needs and requirements of PAs and the range of specialties PAs are working within.

The FPA 2022 census highlights that while the majority of PAs who responded continue to be satisfied with their role, over half of respondents agreed that they are working under excessive pressure. The FPA understands the growing pressures and has held a series of wellness evenings for FPA members to offer support and guidance to members experiencing concerns, and continues to encourage PAs to understand the importance of taking care of their wellbeing.

The lack of regulation remained a common theme of frustration amongst respondents, and the FPA together with the Royal College of Physicians (RCP), has continued to campaign for timely regulation. The public consultation operated by The Department of Health and Social Care (DHSC) on PA and anaesthesia associate (AA) regulation was welcomed in February 2023, and the FPA provided support to members and wider stakeholders on how to submit a response. Campaigning for regulation continues via the FPA/RCP #RegualtePAsNow campaign.

The full census 2022 report can be downloaded below and accessed on the FPA census page. 454 PAs completed the survey, a return rate of 14%. Key findings include:

• PAs continue to be satisfied with their roles. 89% of respondents say that they enjoy their job and 83% would recommend it to a friend.
• We are seeing a continued increase in workforce pressures. 53% of PAs say that they work under excessive pressure (an increase from 49% in 2021).
• The number of PAs with protected time in their contract for work other than direct clinical care has increased for the second year to 39%, and 58% of this group say they are always able to use it.
• 10% of PAs take part in on-call rotas. Those who do so work an average of 10.3 hours per week on call.
• 95% of respondents are practicing clinically as a PA with 62% being employed by an NHS trust and 35% being employed by a general practice or a primary care network.
• PAs reported working in more than 37 specialties. Most respondents remain working in general practice and there has been an increase of 3% of PAs working in emergency medicine.
• The number of respondents who have protected time for work other than direct clinical care increased from 2021 (39% vs 36%). The majority use their protected time for continued professional development.

The FPA annual 2023 census survey will soon be shared with all FPA members. The final report prior to achieving GMC regulation will be vital to ensure the FPA’s work to campaign, guide and support the profession continues.

Who are physician associates?

Physician associates (PAs) are healthcare professionals who work as part of a multidisciplinary team with supervision from a named senior doctor (GMC registered consultant or general practitioner), providing care to patients in primary, secondary and community care environments. PAs are part of the government’s medical associate professions (MAPs) grouping in the health and care workforce and have been working in the UK for 20 years.

In order to qualify as a PA in the UK, students must complete a postgraduate (level 7, ie a master’s level) degree in physician associate studies. All programmes in the UK are run in accordance with the Competency and Curriculum Framework developed by the Department of Health and Social Care (DHSC), the Royal College of Physicians (RCP) and the Royal College of General Practitioners. In line with the planned statutory regulation of PAs, a new curriculum is being implemented for all PA schools from September 2023. Once they have completed a PA degree programme, all candidates must pass the PA National Examination, which is delivered by the RCP Assessment Unit, to be able to register as a PA in the UK.

Following the DHSC and Health Education England’s (HEE’s) ambition to grow the PA role in the UK, the Faculty of Physician Associates (FPA) was established by the RCP in 2015 to give PAs a professional home, set standards, and importantly, oversee the PA managed voluntary register while lobbying of government continued for timely PA regulation.

The FPA was seen as important to support, shape and understand the needs of the PA profession and fundamentally, to provide clarity to the public on the different scope of practice of a doctor and a PA. Regulation has been slow to happen despite the RCP and FPA campaigning for many years. Following a DHSC public consultation earlier this year, this is now underway and we expect the PA profession to be regulated by the end of 2024.