RCPCH calls for pause in recruitment of PAs in paediatrics

The Royal College of Paediatrics and Child Health (RCPCH) has today called for a pause in the recruitment of Physicians Associates (PAs) into paediatrics.
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This follows comprehensive consultation with paediatricians on their views and experiences of PAs working in paediatrics, culminating in an independent survey of members.

Over 2,000 paediatricians in the UK responded to the survey, and 80% of respondents agreed or strongly agreed that “PA recruitment should be halted whilst the NHS develops structures for appropriate deployment of PAs”. 94% of respondents said the NHS should centrally define a training framework and scope of practice for PAs across their specialty work areas, which is something RCPCH has called for alongside full regulation of PAs. In addition, the College supports the call for an independent, evidence-based, rapid review of PAs by national bodies. It is vital that any review conducted includes a specific focus on PAs in paediatrics.

Having a well-supported and skilled multidisciplinary team (MDT) is beneficial for children and young people and supports the robustness of the paediatric workforce. Clarity about the different roles within the MDT is important – for team members, for patients, and for PAs themselves. Clinical directors and service leads should ensure they and their paediatric teams are aware of the supervision arrangements for PAs in their teams. In addition, all health professionals should have a clear training pathway that meets a nationally led and understood scope of practice for that role, which is underpinned by professional regulation. Whilst local training structures might be in place for some PAs working in paediatrics currently, no central structures exist. 

Our call for a pause in recruitment is informed by a survey of our membership, which was conducted independently of the College by Research by Design (RbD). This response was agreed by RCPCH’s Executive Committee, and the College is now working at pace with RbD to review the findings of the consultation and publish a full and comprehensive response. We are committed to publishing the independent report (containing the full data and analysis from the survey) and our response by the end of November.  

RCPCH recognises that PAs can provide important contributions to multidisciplinary teams. However, while this work is undertaken, we would once again remind local systems that PAs must not replace the role of paediatricians in the delivery of care to children and young people. 

About the survey

  • You can find background information on our full consultation on the website here. This will be updated once we publish the full findings.  
  • On 12 August 2024, RCPCH launched a survey to eligible UK-based members on Physician Associates in paediatrics. It ran for four weeks and closed on 9 September 2024.  A link to the survey was sent to eligible members via the email address on RCPCH records.
  • We have brought in an independent, experienced research agency, Research by Design, to lead on this work, including the analysis of the survey results and subsequent report.
  • It gathered the experience of College members on PAs working in all child health settings (including primary care), as well as member views on the role of PAs in paediatrics overall. 
  • The report from RbD was received on 17 October 2024, and the initial findings were discussed by RCPCH Executive Committee on 24 October 2024. 
  • The survey was sent to eligible UK members and we received 2,285 responses – a 17.9% response rate.
  • 80% of respondents agreed or strongly agreed that “PA recruitment should be halted whilst the NHS develops structures for appropriate deployment of PAs” 
  • 94% of respondents said the NHS should centrally define a training framework and scope of practice for PAs across their specialty work areas, with 75% stating that input from specialty bodies should be required in this process. 
  • RCPCH will publish the full report from RbD and its response before the end of November 2024. 
  • We have written to the Secretary of State for Health and Social Care, copying in health service leadership across the four nations, to inform them of this call for a pause in recruitment and offered to meet with them to discuss the further work we are undertaking.