RCPsych announcement on how Physician Associates support mental healthcare

Statement / comment
28 September 2023

Dr Lade Smith CBE, President of the Royal College of Psychiatrists has made a statement about Physician Associates:

"Physicians Associates are not medical doctors, but they can support psychiatrists to do our jobs. 

"We are currently facing a workforce crisis across the health sector, but especially in mental health. In the quarter up to June 2023, the medical vacancy rate was 15.2%. For mental health nurses, the vacancy rate remains at 19.1%. While we have been able to achieve 100 per cent recruitment in psychiatry, retention remains an ongoing challenge.

"As healthcare workers, Physician Associates (PAs) can play a valuable role supporting the mental health multidisciplinary team in healthcare delivery, in the same way as Occupational Therapists and Pharmacists. However, we must be mindful that they are not medical doctors and have not undergone the same medical training or specialist education as a psychiatrist. 

"We have around 180 physician associates working in mental healthcare, and yet we have no standardised definition for this role. The scope of practice for PAs is limited. Whilst as doctors, we can support them to develop their skills in a particular area, without formal medical training they will never have the depth and breadth of knowledge as someone who has been through medical school, Foundation Years medical training, core training and higher specialist training. Therefore, they cannot serve as a replacement for any of our doctors.

"I am pleased our Psychiatric Trainees' Committee (PTC) and others have rightly flagged their concerns about the impact of the role of PAs on trainees and other doctors with me. I have listened and understand their worries.

"The College will undertake a comprehensive review of the role of Physician Associates and the competences required for this position. I am delighted the PTC have agreed to co-lead this review, alongside the Dean, Professor Subodh Dave, with our Professional Standards Department and Dr Helen Crimlisk, the College’s Specialist Advisor for Workforce.

"The aim of this review is to create guidance on how PAs can best support the multidisciplinary team in the delivery of good quality mental healthcare to patients.

"The review will cover the scope and limitation of practice for PAs, details and responsibilities for the medical supervision of PAs, and working with the General Medical Council regarding the regulation of PAs.

"It will also include an action plan for the development of these roles."

"This important piece of work will begin by January 2024."


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