27 September 2023

The NHS workforce is widely acknowledged to be facing a severe shortage of staff numbers. Indeed, the government has recently announced its NHS Workforce Plan to try to tackle this problem. One of the key clinical disciplines facing a really acute shortage – a discipline on whom so many other clinical colleagues depend – is haematology.

The BSH is therefore greatly encouraged to see the rising number of Physician Associate (PA) roles who are specialising in haematology and welcomes their addition to the under resourced, under pressure haematology workforce. We look forward to seeing PA roles expand still further under the government’s NHS Workforce Plan.

The PA role involves two years of training and includes many aspects of an undergraduate or postgraduate medical degree, focusing mainly on general adult medicine in hospital and general practice. With further training and experience, PAs can develop their careers further and specialise in areas such a haematology, and apply for roles in management, research, or teaching, for example. The BSH considers these to be valuable roles in the NHS workforce, where they provide vital support to more qualified, more experienced clinical and medical roles.

As has been highlighted, there are some issues of pay inequity that seem to need resolving. These include the point that a newly qualified doctor entering postgraduate training is paid £11,000 less per year than a newly qualified PA.

However, the BSH does not agree that the title of ‘Physician Associate’ should itself be changed, and effectively downgraded, to become ‘Physician Assistant.’ Apart from anything else, this does a great disservice to the current PA workforce who have worked hard to get their qualifications in order to work alongside and support other clinical colleagues.

It has been claimed there is confusion over the term ‘doctor’, ‘GP’, ‘medical consultants’ and the title of Physician Associate, and that some PAs use this confusion to claim they are more senior or qualified than they are.

If this is the case, we would argue that changing the title from ‘Physician Associate’ to ‘Physician Assistant’ is not likely to help. If patients and the public find the term confusing, the answer is better awareness raising and communication about what PAs are, and what they can do. Changing part of the role’s title will lead to more confusion, not more clarity.

At a time when the NHS workforce is under intense pressure, the BSH believes we need to welcome and support new, growing roles like the Physician Associate, rather than challenge them.


BSH statement in response to the BMA article last week which can be read here