Government must 'sort out regulation' of physician associates, warns Wollaston

GP practices could struggle to employ physician associates unless the government tackles regulation of the role, House of Commons health select committee chair Dr Sarah Wollaston has warned.

The former GP and Conservative MP for Torbay told the House of Lords committee on NHS sustainability that the lack of regulation for physician associates was creating uncertainty on issues such as insurance for NHS organisations wanting to recruit them, and ‘letting down’ trainees.

The GP Forward View published earlier in 2016 promised Health Education England funding to support 1,000 physician associates in general practice.

The government must ‘get on and sort out regulation’, Dr Wollaston told peers, who are taking evidence on the long-term sustainability of the health service.

The Torbay MP's warning came as GPonline's latest GP Podcast explored whether skill mix can help ease the GP workforce crisis.

GP Podcast

Dr Wollaston told the Lords committee that increasing skill mix was necessary for the future of primary care.

‘What we need to do, however is train that workforce,' she said. 'And it is not only about recruiting them. It is about the ongoing continuing professional development that you give people that allows people to feel valued...within the service.'

'So I think there is a huge amount that we should be doing. And regulation of course is part of it.’

The Devon MP said it was a ‘great regret’ that draft regulations for health and care professionals had not been taken forward in the last parliament.

‘So we have a very inflexible system,' she added. 'And we are training up, for example, a number of physician associates, or physician assistants, to work in primary care. And this is an unregistered, unregulated workforce. And that makes it more difficult for them to be employed because of the issues of insurance.

GP workforce

'We may actually be letting these people down. There may be a lot of people being trained for roles in which it is very complex for people to be able to employ them. So the government absolutely has to get on and sort out regulation - rather than doing this is in a piecemeal fashion, they need to allow more flexibility for the system to adapt and respond to the new workforce.’

NHS England chief executive Simon Stevens told the Lords committee that there was 'a case for legislation to clear the path' of regulation of healthcare professionals, which former Labour health minister Lord Warner suggested may be preventing physician assistants from taking on more duties.

'I know there is a bill at some point when time permits,' added Mr Stevens. But, he said, the NHS must not use regulation obstacles as an 'excuse' for not making other workforce changes, such as recruitment of 1,500 new clinical pharmacists and 3,000 mental health therapists in practices.

'Yes, there is a regulatory element,' he said, 'but I don't believe that is the principal driver or inhibitor of change.'

Dr Wollaston’s comments came as GPonline revealed plans in east London to put 100 GP physician associates through a two-year practice-based training programme over the next seven years. Clinical commissioners have told GPonline that the 2017 first-year cohort of the programme have already been allocated practices. The programme has been oversubscribed by both applicants and practices wishing to take the trainees.

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