Earlier in the year the Faculty of Physician Associates at the Royal College of Physicians hosted a stakeholder roundtable to discuss the current practice in relation to prescribing responsibilities by those who now work as a PA but have a previous healthcare professional background. To provide advice and guidance to PAs and employers we have produced the following consensus statement which sets out best practice:
The Physician Associate (PA) profession is growing rapidly and this is set to continue. The Department of Health and Social Care has announced its intention to bring forward statutory regulation for Physician Associates. This is subject to Parliamentary time and further consultation.
Following the introduction of statutory regulation for PAs, further consultation will be necessary before any responsibility for the supply of medicines or prescribing is added to the role. Such changes will require amendments to the Human Medicines Regulations (2012).
We believe it is important for patients, PAs, healthcare providers and GP practices that clear guidance is provided to support decision making and the development of best practice. PAs, healthcare providers and practices must be clear regarding the scope of PA practice and that governance structures are put in place locally, to review it regularly.
Physician Associates come from a variety of backgrounds, including from other statutory regulated healthcare professions. These clinicians may have previously achieved an independent and supplementary prescribing qualification which led to professional registration as a prescriber. We are aware that there is a range of practice and understanding across NHS providers about whether these healthcare professionals who are now qualified and work as PA’s can continue to use these prescribing responsibilities in their practice as a PA.
Currently the scope of practice of a PA does not include the ability to supply or prescribe medicines and there is no legal framework to support this. It is therefore best practice that people who are qualified to supply medicines or who are registered prescribers do not use these responsibilities in their PA role. It is important that PAs, healthcare providers and practices are clear regarding the scope of PA practice and that governance structures are put in place locally to review it regularly.
The Nursing and Midwifery Council (NMC) has provided further information on this in the form of frequently asked questions. The FAQs set out the NMC’s legal understanding in relation to registered nurses or midwives who are working in physician associate roles whilst still relying on their skills, knowledge and experience as a registered nurse or midwife. This includes meeting all the requirements for maintaining their registration with the NMC as a nurse or midwife.
As the number of PAs practicing grows, it is important that stakeholders work together to consider the need and appropriateness of supply of medicines and prescribing rights for the profession. We acknowledge this proposal will be subject to rigorous governance and approval processes and will not happen immediately. In the meantime, it is clear that PAs will continue to play a vital role in complementing multidisciplinary team working across the NHS.
This statement is supported by NHS England, the British Medical Association, the Royal College of Nursing, the Royal College of General Practice and NHS Providers.