This update is for all UKKA members but is particularly relevant to Fellows of the Royal College of Physicians (RCP).

There is currently considerable discussion in the medical profession, multidisciplinary professions, and in the media about the role of physician associates (PAs) and the planned expansion of this role.

We therefore felt it timely to update you on discussions in this area to which UKKA is contributing, and on our own plans for further action on work-force development.

Background

Physician associates have been a small part of the workforce for some time but have been unregulated to date.

The Royal College of Physicians (RCP) hosts the Faculty of Physician Associates (FPA) which holds a voluntary register of PAs. The RCP also deliver the national postgraduate PA exam.

In December 2023, a process was commenced for the General Medical Council (GMC) to become the formal regulatory body for PAs, with the RCP taking on much of the oversight of this.

How the UKKA has been contributing

In the autumn of 2023, the RCP asked all specialist societies to contribute to a consultation on issues concerning PAs, such as questions about the role name, their scope of practice, their regulation and their career development. We wrote to the Renal Service clinical directors (CDs) with these questions and fed back responses to the RCP.

Following the consultation, the RCP set up a working group to look at PAs including scope of practice and career development. We sought expressions of interest for volunteers to contribute to this group and are grateful to Dr Conor Byrne (The Royal London) who is representing us in this group.

We also arranged a session at the UKKA CD forum held on 13 March. We are grateful to colleagues from the Royal London Hospital who presented their own experience of integrating PAs into their workforce since 2016 and to other CDs from various parts of the country who contributed their own experiences of employing PAs, as well as the many questions that were raised.

In the interests of transparency, we would like to let you know that renal CDs who had worked with PAs in their units were overwhelmingly positive about their experiences of incorporating these roles into their teams. All agreed that proper regulation, career progression and supervision were key to making the role a future success and were keen that renal should have a voice in influencing this work. They were clear, as are we, that the continued support and training of our medical trainees must not be compromised by the introduction of PAs and that both groups of staff must have optimal support and progression. In the midst of the extensive media discussions on PAs, it was very good to watch the quality of the discussion amongst CDs and their desire to contribute to optimising this role.

We recognise that PAs must be welcome within the UKKA and whilst their numbers remain small we are in discussion with the SpR club about them helping to host the PA group, anticipating that PAs will eventually have a separate professional group of their own within the UKKA.

The Wider Context of Workforce Challenge

We know that there has never been a time of greater stress within the NHS workforce and that no debate about PAs can be seen in isolation of this. With changing national demographics, ever-growing demand and the introduction of new therapies for complex diseases, the landscape is changing. Whilst an NHS workforce plan has been published (https://www.england.nhs.uk/long-read/nhs-long-term-workforce-plan-2/) there is much work to do in full workforce mapping and identifying how patient needs are met whilst the proposed workforce expansion takes place. To address this the UKKA is currently completing our own workforce survey across all professional groups to understand current staffing numbers and models. The UKKA is also planning a summit (for Autumn/Winter 24) to discuss challenges to the workforce and look at possible solutions across all its professional groups – we hope that many of you will contribute to the debate and to the delivery of this event.

Please contribute to the current debate

On 13 March the RCP convened an extraordinary general meeting to discuss five motions raised about PAs (https://www.rcplondon.ac.uk/news/extraordinary-general-meeting-egm-information-pack-circulated-fellows) : four of the motions are uncontested but the last motion, requesting caution in the pace and scale of the roll-out is forming the heart of discussions.

A vote on these motions is open until 7.30 pm on 20th March. It is not for UKKA to direct its members in such a vote. However, we would encourage those of you who are eligible to vote (fellows of the RCP) to read the material available on the RCP site where you can find supporting documents explaining the concerns raised for the EGM and the RCP response to, and explanation of, their ongoing work to try to optimise these roles. You can also find instructions on how to vote.

The UKKA represents the professional renal workforce and remains committed to supporting all its members in finding the best solutions to workforce challenges.

If you would like to tell us your views on Physician Associates, please could you e-mail to ukka@ukkidney.org .

As always we are extremely grateful for the phenomenal hard work that the profession shows in caring for our patients.

Paul, Clare, Katie