Medical Associate Professionals in the UK: In the Existential Fight over Professional Territory- there is a Missing Voice
Published 2024-03-14
Keywords
- Medical Associate Professionals,
- EGM,
- BAPIO
How to Cite
Copyright (c) 2024 Professor Indranil Chakravorty MBE PhD FRCP (Lond, Edin)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Anyone who has any connection with the world of social media will be aware of the ‘storm in a teacup’ that has been brewing in the last few months with Medical Associate / Assistant Professionals (MAPs) in the UK as Parliament debated and swiftly passed legislation1 related to their regulation by the UK General Medical Council. In its supporting statement, the UK Minister for Health2 specified,
‘Physician associates work under the supervision of doctors taking medical histories, carrying out physical examinations, performing some medical procedures and analysing test results. Anaesthesia associates review patients before surgery, initiate and manage medications, administer fluids and blood therapy during surgery, and ensure there is a plan for patients following their operation. Both roles can work autonomously, but always under the supervision of a fully trained and experienced doctor.’
The legislation was passed in the UK Parliament in Feb24 and will be in force from Dec’24.
The British Association of Physicians of Indian Origin (BAPIO) is leading a survey 17and workshop designed to have a 360-degree review of the impact of MAPs on training and career progression for all doctors, including the missing voice of several thousands of doctors who are not in formal training, are locally employed on shorter-term contracts, are considered as speciality doctors by the GMC. A vast proportion of these doctors are international medical graduates, and a significant proportion belong to cohorts who are under-represented in leadership positions (including those that were previously considered from Black or minority ethnic groups). The workshops and focus groups will include representation from all under-represented groups of doctors across the spectrum, patient representatives, nursing, and allied healthcare professionals who form an integral part of the MDT, medical leaders, higher education institutions, NHS workforce Training and Education and NHS employers. The results of the independently facilitated focus groups and survey results will be published with recommendations for all stakeholders in May 2024, and aim to provide a framework for action, reflecting consultation and views of the whole healthcare profession.
References
- Draft Anaesthesia Associates and Physician Associates - Hansard - UK Parliament. https://hansard.parliament.uk/Commons/2024-01-17/debates/bde42233-6731-4370-96db-6836666abbab/DraftAnaesthesiaAssociatesAndPhysicianAssociatesOrder2024 (2024).
- Written statements - Written questions, answers and statements - UK Parliament. https://questions-statements.parliament.uk/written-statements/detail/2023-12-11/hcws113.
- Wang, H. et al. The roles of physician associates and advanced nurse practitioners in the National Health Service in the UK: a scoping review and narrative synthesis. Hum. Resour. Health 20, 69 (2022).
- Ownership power and managing a professional workforce: General practitioners and the employment of physician associates - Krachler - 2023 - Human Resource Management Journal - Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/1748-8583.12464.
- RCP500 Charter. RCP London https://www.rcplondon.ac.uk/rcp500-charter (2017).
- Extraordinary general meeting (EGM) information pack circulated to fellows. RCP London https://www.rcplondon.ac.uk/news/extraordinary-general-meeting-egm-information-pack-circulated-fellows (2024).
- Maier, C. B. The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia. Health Policy 119, 1627–1635 (2015).
- Szalados, J. E. Regulation of Provider Practice: State Oversight, Licensing, Credentialing, Peer Review, and the National Practitioner Data Bank. in The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers (ed. Szalados, J. E.) 137–169 (Springer International Publishing, Cham, 2021). doi:10.1007/978-3-030-68570-6_6.
- Drennan, V. M. et al. What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study. BMJ Open 9, e027012 (2019).
- Drennan, V. M., Gabe, J., Halter, M., de Lusignan, S. & Levenson, R. Physician associates in primary health care in England: A challenge to professional boundaries? Soc. Sci. Med. 181, 9–16 (2017).
- Roberts, S., Howarth, S., Millott, H. & Stroud, L. Experience of the impact of physician associates on postgraduate medical training: A mixed methods exploratory study. Clin. Med. 19, 4–10 (2019).
- Ritsema, T. Barriers and Facilitating Factors to the Integration of the First UK-Trained Physician Associates onto Secondary Care Services in the British National Health Service. Theses Diss. (2019).
- PA and AA regulation. https://www.gmc-uk.org/pa-and-aa-regulation-hub.
- ATDG_statement_Physician_and_anaesthesia_associates_in_healthcare_191223.pdf.
- Re: There is a role for physician associates in the NHS. (2024).
- Kar, P. Partha Kar: Sorting out the mess around medical associate professionals. BMJ 383, p2689 (2023).
- Impact of Physician Associates on International Medical Graduates. BAPIO | British Association of Physicians of Indian Origin https://www.bapio.co.uk/impact-of-physician-associates-on-international-medical-graduates/ (2024).