Physician associates in the NHS will be renamed to stop patients mistaking them for doctors after a review found that their title caused widespread confusion.
Thousands of physician associates who work in hospitals and GP surgeries across the UK take medical histories, examine patients and diagnose illnesses but are not doctors.
However, Prof Gillian Leng, whose government-ordered review is looking into whether they pose a risk to patients’ safety, has concluded that they must be given a new name, so patients they treat are not misled into thinking they have seen a doctor, according to sources with knowledge of her thinking.
Doctors who fear the term has created widespread confusion among the public and risks undermining trust in the medical profession will regard ditching it as a major victory.
Wes Streeting, the health secretary, is expected to accept Leng’s recommendation and instigate the change, which could lead to physician associates being renamed “physician assistants” or “doctors’ assistants”. She will also specify in her final report, due later this month, that those who perform those roles must make clear to patients that they are assistants, not fully qualified doctors.
Physician associates have been implicated in several high-profile patient deaths. Earlier this year, a coroner found that in February 2024 a physician associate (PA) in the A&E at East Surrey hospital had misdiagnosed 77-year-old Pamela Marking as having a nosebleed when she had a small bowel obstruction and hernia that required emergency surgery. She returned to the hospital two days later but she died soon after.
In her prevention of future deaths report the coroner, Karen Henderson, warned that the term “physician associate” was “misleading to the public” and that there was a “lack of public understanding of the role”.
PAs have been causing alarm among doctors for years. They have prompted a number of legal challenges and calls, from the British Medical Association and several medical royal colleges, for their recruitment and rollout across the health service to be paused while their implications are assessed.
The parents of 30-year-old Emily Chesterton, who died in 2022 after a PA on two occasions failed to spot that she had a blood clot, recently began a legal action at the high court in London against the General Medical Council, which regulates doctors.
There are about 3,500 PAs and 100 anaesthesia associates – their equivalents in anaesthetics – working in the NHS in England. But NHS England’s plan to treble the number of PAs to 10,000 by the mid-2030s now looks in doubt. Ministers are due to publish an updated NHS long-term workforce plan in the summer.
Evidence collected by Leng since she began her review in November has vindicated the concern shared by many medical bodies that patients often struggle to distinguish a physician associate, who has done two years of postgraduate training, from a fully trained doctor with a medical degree.
In May, Leng said she had seen evidence showing that “patients [are] likely to misconceive PAs to be a doctor”. In addition, focus groups organised by the Patients Association had found that “patients were unaware of what a PA was”.
A third research study found patients “misconceived PAs to be doctors”, while a fourth cited by Leng underlined how confused the public were about the work PAs did and limits of their roles. “Patients were not able to identify what or who a PA was,” it said.
When Streeting appointed Leng to undertake the review he said that while many PAs provided good care there were “legitimate concerns over transparency for patients, scope of practice and the substituting of doctors”.
A Department of Health and Social Care source said: “It’s clear there’s a legitimate problem of patients not knowing who they are seen by, which is their basic right. It is likely the review will make recommendations to address this problem, including changing the titles of PAs.”
“The secretary of state asked Prof Gillian Leng to produce an independent review into PAs and AAs that will provide certainty to patients and staff across the NHS.
“We will consider its findings in full once it has been completed.”
