RCGP changes position on Physician Associates working in general practice

The RCGP's governing UK Council has today voted to oppose a role for Physician Associates working in general practice.

The outcome of the vote was 61% of Council Members agreeing to oppose the role of PAs working in general practice; 31% disagreeing; and 8% abstaining.

However, recognising that there are already around 2000 PAs working in general practice, RCGP Council did approve three sets of guidance to support GP practices already employing PAs. The guidance will cover the induction and preceptorship, supervision, and scope of practice of PAs currently working in general practice. This guidance has been informed by and reflects the results of the member consultation on the use of PAs in general practice conducted by the College in April and May this year, and the ‘red lines’ affirmed by UK Council in March 2024.

Council opposed inclusion of a paragraph in the draft scope of practice guidance that where existing PAs in general practice may currently be practising beyond the scope described in our guidance, it is the responsibility of their GP Clinical Supervisor and/or their employer, to determine that they are doing so safely. This paragraph will be removed to ensure it is clear that PAs must always work within the scope of practice the RCGP will set out.

The College will now undertake further work on these documents, taking on board comments made by Council Members, and publish them as soon as possible.

Given that there are PAs currently working in general practice, the principles set out in the College’s ‘red lines’, agreed in 2017 and strengthened at its Council meeting in March 2024, still stand.

It also remains the College’s position that the regulation of PAs must proceed as soon as possible. It is the RCGP's position that a regulatory body other than the GMC would be more appropriate to take forward this crucial work - but recognising that GMC regulation is well advanced, and now in legislation, the College will continue to work with the GMC to ensure there is clarity over the differences between doctors and PAs.

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: “The role of PAs in general practice has dominated the medical agenda for well over a year now and we understand the strength of feeling amongst our members and their concerns for the safety of their patients.

“It became very clear at today’s Council discussion that we needed to speak out in opposition to the PA role within a general practice setting and I am pleased that our processes have enabled us to do this in a collegiate and democratic way.

“We recognise that this new policy position may be unsettling for Physician Associates who are already working in general practice and for their employers, and we hope that our upcoming documents to be published in the coming weeks will provide some clarity on how these roles could be managed where they are in place.”

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.