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. 2025 Nov 11;17(11):e96609.
doi: 10.7759/cureus.96609. eCollection 2025 Nov.

An Examination of the Opinions of NHS Stakeholders on the Current and Future Role of Physician Associates

Bashar M Abdeen  1 , Alice Millard  1 , Tareq Al Saoudi  1 , Alex Boddy  2 , Eyad Issa  1 , John Isherwood  1 , Ashley Dennison  1 , Guiseppe Garcea  1
Affiliations

An Examination of the Opinions of NHS Stakeholders on the Current and Future Role of Physician Associates

Bashar M Abdeen et al. Cureus. .

Abstract

Introduction Healthcare systems are experiencing problems recruiting and retaining workers and consequently are developing the role of intermediate-level practitioners including Physician Associates (PAs). However, the integration of PAs into the NHS is facing many challenges and there are no studies looking into the causes behind this. This study examines the opinions of NHS stakeholders on the current and future roles of PAs and explores strategies to improve integration. Methods This cross-sectional study at a single NHS Trust gathered views and experiences regarding PAs through a survey of consultants, resident doctors (RDs), PAs, and patients. Tailored surveys were generated by doctors and a PA, validated and pilot tested then electronically distributed. Data were analysed using Excel (Microsoft, Redmond, WA, USA) and SPSS (IBM Corp., Armonk, NY, USA) and qualitative analysis for open-ended questions. Results Half of the consultants recognised the positive contributions of PAs. However, 68.6% (n=35) felt that PA roles were unclear. The PA role was explained to 11% (n=3) of RDs, 14% (n=4) understood their role, and 75% (n=21) expressed concern that PAs might hinder their training. Amongst the PAs, 75% (n=12) felt the healthcare climate adversely affected their work and 56.3% (n=9) were considering a career change. Only 14% (n=7) of patients fully understood the PA role, but 86% (n=43) were comfortable being seen by one. Conclusion This study highlights the contributions of PAs and recognition by stakeholders. Integration, however, remains challenging with concerns regarding RDs' training, and PA career progression and satisfaction. The hurdles are compounded by gaps in understanding the role. Going forwards, clear definition of and education regarding the role of PAs is essential and is the joint responsibility of PAs, managers, consultants, the General Medical Council, and Royal Colleges.

Keywords: nhs england; nhs workforce; patient opinion; physician associates; physician shortage; quality improvement research.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. The perceived positive contribution of physician associates to patient care by consultants and resident doctors
Figure 2
Figure 2. Comparison of resident doctors’ understanding of the physician associates’ role vs. physician associates’ assumptions of resident doctors’ understanding
Figure 3
Figure 3. Comparison of Patients’ understanding of the Physician Associates' role vs. Physician Associates' assumptions of Patients’ understanding
See this image and copyright information in PMC

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