Leng review of Physician Associates welcomed by RCPsych

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Today, the Government has published the findings of an independent review of Physician Associate (PA) and Anaesthesia Associate (AA) professions.  

The Leng review was commissioned by the Department of Health and Social Care to explore the safety and efficacy of these roles. It makes several recommendations aimed at supporting the development of these positions.   

Responding to the review, Professor Subodh Dave, Dean of the Royal College of Psychiatrists, said: 

“The Leng review provides some much-needed clarity and insight into the role of Physician Associates at a time when significant questions remain around their training, scope of practice and supervision. 

“As part of the College’s own review over the last year, we have made it clear that PAs are not substitutes for doctors and should not diagnose or triage people with mental illness. It is positive to see this reflected in the review, which aligns with our own recent report for employers of PAs working in psychiatry and wider mental health services. We will now reflect on the Leng review’s full findings and update the RCPsych guidance accordingly. 

 “The College has long supported calls to change the title of PAs to Physician Assistants as this would help patients to better understand their position and distinguish them from other medical staff. We will begin using the term Physician Assistant with immediate effect.  

 “The review also recognises the need for a national scope of practice which more clearly defines the role and responsibilities of PAs. This should be developed with input from the relevant medical Royal Colleges, including the Royal College of Psychiatrists, and will require national funding. A new national job description would be a positive first step towards this goal. 

“There are many other recommendations that would support PAs to work more effectively, under enhanced supervision and as part of a multidisciplinary team. For example, PAs who have two years of experience working in secondary care settings would be better prepared to work in mental health services. Our own report recommended they complete an extensive inceptorship year backed by our detailed curriculum and with close supervision.  

“The College will consider the implications of this review for our membership and how we can best support the wider mental health workforce during this transition. Psychiatrists will need to be provided with the appropriate resources, such as protected time in job plans, if they are to take on additional responsibilities as a PA supervisor.  

“We look forward to supporting a detailed implementation plan, including being involved in considerations around the potential creation of a faculty or faculties of PAs, alongside the 10 Year Health Plan.  

“The Leng review should be used with our own report to ensure the development of Physician Assistants in mental health settings delivers the best outcomes for patients, doctors and PAs themselves. 

“Ultimately, it is vital that people feel safe, have confidence in those caring for them and that staff have confidence in each other.”