The Leng Review
The Leng Review was commissioned to address the concerns raised about the role of Physician Associates (and, solely in hospitals) Anaesthetic Associates (AAs). These concerns included the loss of confidence in the role by medical professionals particularly those in training grades and safety concerns following a number of tragic well published incidents. However, there is evidence that patients are satisfied with their consultation with Physician Associates (PAs).
The Leng Review has concluded that there is insufficient evidence to support a decision that the role should be abolished. However, it has made a series of recommendations designed to improve the ‘fit’ of PAs [and AAs] in the NHS workforce. The speed with which the DHSC has responded to the Lengs Review recommendations (by writing to NHS England the next day) suggest most of these recommendations will be in line with DHSC planning. DHSC have asked NHS organisations to immediately:
- Rename such colleagues ‘Assistants’
- Withdraw colleagues from Emergency Departments and primary care roles which involve triaging patients and seeing undifferentiated patients
- Ensure any new PAs appointed within General Practice should have a minimum of two years employment in secondary care settings
The number of PAs within General Practice peaked in the summer of 2024 and has gradually fallen since; clearly there is a challenge relating to PAs currently in post aligning their scope of practice to guidance from the Royal College of General Practitioners and the BMA. Their letter will now be updated.
Picking up one of the commonest concerns from the public – uncertainty about the role of the person they have seen – it is important that PAs are distinguished by badges, lanyards, or uniforms, particularly from GPs.
PAs [and AAs] will still be regulated by the GMC but there is now a clear recommendation that the role of PAs/AAs should be distinguished from that of doctors.