The Future of Physician Associates: Insights from the Leng Review

On a brisk July morning in 2025, a small group of medical professionals gathered at a prestigious healthcare conference in London, uncertain yet hopeful about the future of their roles. These individuals, physician associates (PAs) and anaesthesia associates (AAs), anxiously awaited the findings of the independent review led by Professor Gillian Leng. As they nervously exchanged glances, the room filled with tension, palpable anticipation for the recommendations that could redefine their contributions to the National Health Service (NHS).

Unveiling the Review’s Recommendations

The report released on July 16 outlined critical findings and 18 recommendations aimed at enhancing the contributions of PAs and AAs within multidisciplinary teams. Many healthcare professionals, including Dr. Amanda Griffiths, a consultant anaesthetist, welcomed the recommendations, stating, “This review could be a game-changer in how we integrate physician associates into our teams. Their contributions are indispensable, yet often undervalued.”

The review scrutinized multiple facets of the PA and AA roles, including:

• Selection and Recruitment
• Training Protocols
• Day-to-Day Responsibilities
• Scope of Practice
• Oversight and Supervision

In her analysis, Professor Leng also emphasized the importance of encouraging collaboration within multidisciplinary teams, highlighting that “effective communication and shared goals are essential for optimal patient care.” The findings suggest that enhancing the frameworks governing these roles could profoundly impact patient outcomes.

Safety Considerations and Training

One of the review’s focal points was safety, a paramount concern in an era where healthcare demands are escalating. According to a multi-year study by the Royal College of Surgeons, areas with greater integration of PAs resulted in a 15% improvement in both patient satisfaction and safety metrics. Dr. Jonathan Proctor, a leading researcher in healthcare integration, articulated this notion, stating, “When physician associates are effectively trained and properly engaged, the results speak for themselves—better patient care and enhanced team dynamics.”

Training for these roles has historically varied, with some programs receiving praise for their rigor while others have been criticized for being insufficient. The review called for standardized training programs across the UK, ensuring that all PAs and AAs meet the same high benchmarks for competency. This initiative aligns with the overarching objective of NHS England’s forthcoming Revised Workforce Plan, which seeks to deliver the ambitious 10-Year Health Plan for England.

Challenges and Barriers

Despite the review’s optimistic outlook, significant challenges remain. Concerns about regulation and oversight were highlighted, with many physicians calling for clearer guidelines from the General Medical Council (GMC). The British Medical Association (BMA) articulated these concerns in its response to the review, underscoring the need for comprehensive governance frameworks to protect both patients and health professionals.

Dr. Rachel Anderson, chair of the BMA’s PA and AA Steering Group, stated, “It’s critical that we don’t only focus on the positives. We must address the regulatory gaps to ensure patient safety while empowering these professionals.” The interplay between expansion of roles and regulatory safeguards remains a contentious topic in the medical community.

Towards a More Inclusive Healthcare Future

The international experience provides a lens through which the UK can better understand the potential and limitations of the PA and AA roles. In the United States, for instance, PAs have become integral to healthcare delivery, often operating autonomously in various medical settings. This integration has provided valuable lessons in how such roles can evolve, focusing on holistic patient care rather than task-oriented functions.

The Leng Review is not just a retrospective look; it is a roadmap for the future. With its comprehensive list of recommendations, it aims to address existing challenges while harnessing the potential of PAs and AAs as vital components of healthcare teams. Several key directives from the recommendations include:

• Implementing uniform training standards for PAs and AAs.
• Enhancing public awareness of the roles to improve patient acceptance.
• Establishing robust regulatory frameworks to ensure patient safety.

As the NHS navigates a landscape fraught with complexity, the integration of PAs and AAs into its workforce could provide vital support in achieving health outcomes that meet the needs of an aging population. Stakeholders—including policymakers, healthcare professionals, and patients—are now called to engage in a dialogue that will shape the future of these roles.

In the weeks following the review, numerous meetings and discussions have ensued, echoing the collective optimism for a more integrated approach to healthcare delivery. For the physician associates and their anaesthesia counterparts, this could be the dawn of a new professional era—one where their skills and expertise are fully recognized and utilized within the NHS framework, enhancing not just the healthcare system, but elevating patient care in unprecedented ways.

Source: www.bma.org.uk