- Professor Gillian Leng's review recommended changes to
provide clarity for patients and improve quality of care
- Health and Social Care Secretary confirms he will work to
implement recommendations as quickly as possible
- PAs and AAs still have a vital role to play, and government
will provide options for career development
Patient safety will be strengthened across the country, as the
government accepts all the recommendations of an independent
review into physician associates (PAs) and anaesthesia associates
(AAs).
The review chaired by Professor Gillian Leng CBE – an experienced
leader in the UK healthcare system - has made 18 recommendations
aimed at providing clarity to patients and improving patient
safety.
Launched in November 2024, it looked into the safety of the roles
of PAs and AAs and how they support wider health teams.
Professor Leng sought evidence from a range of voices - including
patients, staff groups, employers within the NHS, professional
bodies and academics. The review's recommendations cover
recruitment and training, supervision and professional
regulation.
Health
and Social Care Secretary said:
“Patients should always know who they are being treated by
and should always receive appropriate care.
“Legitimate concerns about patient safety have been ignored for
too long - that's why I sought out the very best clinical advice
to review physician associates and anaesthesia associates' roles
in the NHS.
“I want to thank Gillian Leng, one of the UK's most experienced
healthcare leaders, for her comprehensive, thorough report.
“We're accepting all of the recommendations of the Leng review,
which will provide clarity for the public and make sure we've got
the right staff, in the right place, doing the right thing.
Patients can be confident that those who treat them are qualified
to do so.
“Physician Assistants, as they will now be known, will continue
to play an important role in the NHS. They should assist doctors,
but they should never be used to replace doctors.
“Our Plan for Change will build on its findings and we will work
to implement these findings in the interests of staff and
patients alike.”
Dr Claire Fuller, Co-National Medical Director (Primary
Care) at NHS England, said: “We welcome the publication
of this review and the clarity it provides on how these vital and
valued roles can best support high-quality care for patients as
part of multidisciplinary teams.
“Following legitimate concerns raised, it is right this review
has gathered expert insight and evidence from across the health
service and internationally and we will now work with the service
and government to fully consider and implement its
recommendations.”
Professor Gillian Leng said:
"I'm pleased the Government is implementing the recommendations
in full.
"My review provides the opportunity of a reset, but this must be
the start of the conversation, not the end.
"Now it's time to focus on delivery: bringing clarity for
patients, complementarity between doctors and assistant roles,
collaboration across teams, focussed on ensuring safe and
effective high-quality care."
Health and Social Care Secretary today confirmed he would accept all the
recommendations and begin work to bring them in as quickly as
possible, directing NHS England to write to systems leaders
setting out the immediate actions for them to take.
Resident doctors have raised concerns about the safety and lack
of clarity for PA and AA roles – and the government is listening
to them.
Implementing the review's recommendations will provide clarity
for the public and – crucially - improve patient safety and
quality of care. PAs and AAs still have a vital role to play in
wider teams and caring for patients, with many hard working PAs
and AAs making a vital contribution across the healthcare system.
These recommendations will provide certainty and options for
their career development.
At the same time, clear guidance will be offered to other
healthcare professionals and patients about the contributions and
limits of these roles.
PAs will in future be identified as physician assistants and AAs
will be renamed as physician assistants in anaesthesia,
reflecting their role as supportive members of medical teams.
They will also not be able to treat undiagnosed patients, except
within clearly defined cases.
Permanent faculties will be established to provide professional
leadership and set standards for PAs and PAAs. They will also
form part of a clear team structure – led by a senior clinicians
– where everyone is aware of their roles, responsibilities and
accountability.
Doctors will receive training in line management and leadership,
ensuring they can properly fulfil their supervisory roles.
Collaboration will be vital in the face of increasing NHS demand
and the recommendations should serve as a reset – encouraging
greater teamwork across healthcare teams. These reforms all
form part of the Plan for Change's mission to build an NHS fit
for the future, and one which works for patients and staff.
Lessons learned from the review will feed into the government's
upcoming workforce plan, ensuring the NHS has the right staff in
the right place at the right time.
The 10 Year Health Plan will also ensure that new and expanded
roles are rolled out in a way which ensures that public, patient
and professional confidence is maintained.
