The role of the Faculty of Physician Associates as a professional body

The Faculty of Physician Associates (FPA), hosted by the Royal College of Physicians (RCP), is the professional membership body for physician associates (PAs) in the UK. As the professional body, the FPA sets the professional standards for physician associates, advises and liaises with other bodies and communicates on matters affecting their work.

The responsibility for education, training and professional standards for physician associates sits with the future regulator the General Medical Council (GMC), the FPA and royal colleges. The FPA develops, owns and reviews the Physician Associate Curriculum, which guides and supports the development of higher education institutions’ physician associate programmes, and provides a standardised framework to ensure high-quality education for physician associate students in the UK. This document was developed in collaboration with the GMC and Physician Associate Schools Council (PASC).

It is important to recognise that the education and training standards for PA students will soon become the legal remit of the regulator the GMC. The GMC has published clear guidance on the pre-qualification education framework and outcomes expected of newly qualified PAs. This includes the professional behaviours and capabilities, as well as the clinical care and minimum expectations for knowledge and skills required of all PA students.

We believe recent statements and publications by the British Medical Association (BMA) are an inaccurate reflection of the PA workforce. We have serious concerns about the lack of clarity around the methodology and stakeholder involvement that guided the development of their recent report, Safe scope of practice for medical associate professionals (MAPs). There are also clear differences in the competency expectations set by the GMC as part of their regulatory responsibilities for newly qualified PAs, and the view of the BMA, which is a trade union.

FPA president Jamie Saunders said: ‘With patient safety the paramount objective for all healthcare professionals, it is particularly concerning that the recent BMA report will create further confusion and divide within the multidisciplinary healthcare workforce and “blur the lines” around who sets professional standards. This potentially creates risk for patients, employers and supervisors.

The FPA was not consulted regarding the BMA’s report. We note the statement published by NHS Employers and are concerned that the BMA does not seem to have engaged with other stakeholders. We would encourage the BMA to work collaboratively.’

The FPA has always been clear that PAs, employers and others should not use certain terms traditionally associated with doctors when referring to PAs. PAs must always work under the supervision of a named senior doctor, within their agreed scope of practice and must always fully introduce themselves in line with our guidance.

In October 2023, we launched the FPA Physician associate title and introduction guidance for PAs, supervisors, employers and organisations. This guidance document provides PAs, supervisors, employers and organisations with a structured and standardised way of using the PA title. We continue to encourage PAs, supervisors and employers to refer to this guidance to ensure that the role is explained correctly to patients – and that they understand who is assessing and treating them.

Background and key principles

Physician associates first began practising in the UK in 2003. Since then, there have been several developments, including the introduction of a standardised training curriculum in 2006, the introduction of a voluntary register in 2010, and further revisions of the training curriculum in 2012 and 2023.

The FPA, hosted by the RCP, has overseen the introduction of a national Code of conduct for physician associates, the PA Managed Voluntary Register and title and introduction guidance for physician associates, supervisors and employers. Furthermore, the RCP delivers the Physician Associate National Examination on behalf on the FPA, which is required to become a qualified PA in the UK.

Through multiprofessional collaborative work, the FPA and RCP are already engaged in developing additional supportive guidance in relation to supervision, scope of practice and career development for PAs. The FPA and RCP are aiming to publish these within the coming months.

Key principles

• Physician associates are not doctors and are designed to supplement the medical workforce in primary and secondary care, as additional members of the multidisciplinary team.
• All healthcare professionals, including physician associates, should work within their scope of practice, which describes what individuals are trained and competent to undertake in the provision of safe patient care.
• Physician associates are healthcare professionals in their own right, and support the work of doctors and the multidisciplinary team.
• Physician associates are able to assess, diagnose and treat patients, provide increased access to clinical care for patients, all under the supervision of a named senior doctor.
• Physician associates must follow the guidance of their professional body, the FPA. This includes our most recent additional guidance document Physician associate title and introduction guidance published in October 2023.
• Physician associates listed on the PA Managed Voluntary Register (PAMVR) must abide by the FPA Code of conduct and Continuing professional development (CPD) requirements. The FPA regularly writes to employers to educate on the importance of only employing physician associates who are on the PAMVR.
• The education and training standards for physician associate students sits with statutory regulators and the professional membership body for the profession.
• Through a collaborative, multiprofessional working group the FPA and RCP are already engaged in developing additional supportive guidance in relation to supervision, scope of practice and career development for physician associates.

Employers, national bodies, royal colleges and others seeking clarity should contact the Faculty of Physician Associates, hosted by the RCP, as the professional membership body for the physician associate profession.

The FPA is able to offer further support, guidance and clarity where needed. Please contact us at [email protected].

March 2024