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Physician associate

Find out what physician associates do and how they are trained.

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What do physician associates do?

Physician associates are a new role in the UK, introduced from the United States. Works to the medical model under the supervision of a doctor, they typically take patient histories, perform examinations, undertake diagnostic procedures, and analyse test results.

Physician associates are not autonomous, and work under the supervision of doctors. They cannot currently independently prescribe medicines. Physician associates are not able to prescribe or to request ionising radiation.

How are they trained?

Physician associate training is a two-year full-time postgraduate programme (leading to a postgraduate diploma or Master's degree) applicants should hold a relevant undergraduate degree. Over 30 universities in the UK currently offer training programmes, or are in the process of developing one.

The current funding arrangements for physician associate training are mixed - ranging from salaried training posts, tuition fees being fully funded, physician associate students self-funding.

It is understood that a level 7 (Master's level) physician associate apprenticeship route will be developed.

Are they regulated?

Physician associates are not currently subject to statutory regulation. This could make it difficult for a patient to raise a concern about an individual's fitness to practise when needed (as they can to the General Medical Council for doctors or the Health and Care Professions Council for physiotherapists).

The Faculty of Physician Associates, part of the Royal College of Physicians, operates a voluntary register for physician associates. It has called for regulation and this is being considered by the Westminster government. It's not certain yet if or when this will happen, or with which regulator physician associates would be registered. If progressed, arrangements for regulation and for physician associates to be registered would take some time to be set up and implemented.

What banding are physician associate posts?

Physician associates are employed at Agenda for Change band 6 or 7 in the NHS. This is the same banding as an experienced physiotherapist, who are likely to hold advanced practice skills, such as being able to prescribe independently or provide injection therapy.

How many physician associates are there in the workforce?

There are currently 200 physician associates employed in the UK. Most of them are working in hospitals, many working alongside CSP members as colleagues.

In England, the government has set a target for 1000 physician associates to be working in primary care by 2020. Health Education England (HEE) commissioned 657 physician associate student training places for 2016-17. The Health Foundation estimated it would take at least 20 years for physician associates to be a significant feature of the UK workforce.

In Wales, the Welsh government has funded and commissioned the training of physician associates since 2016, with 27 commissioned for the 2016 cohort and 32 for 2017.

In Northern Ireland a physician associate course at the University of Ulster started in January 2017 with 13/14 participants.

In Scotland there is one physician associate course at Aberdeen University, there are currently 46 WTE physician associates employed in NHS Scotland.

What's the CSP's view?

The CSP welcome workforce developments to meet immediate capacity issues and meet population needs.

The profession supports the development of new roles, on the basis of an evidence-based assessment of what can add the greatest value and making the best use of resources.

Part of this will be the development of new parts of the workforce, including physician associates.

However just as important is the development of the existing workforce so that all professions can work at the height of their capabilities. The new role of general practice physiotherapist is an example of this.

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