Physician Associates

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Physician Associates (PA) are medically trained, generalist healthcare professionals who work alongside doctors as an integral part of the multidisciplinary team. The role is internationally recognised and has been established within the NHS for over 20 years.

PAs based in GP settings always work under the supervision of a designated senior medical practitioner, typically a GP partner. Their scope of practice is defined by an agreement between the supervising doctor and the individual PA, taking into account the PA’s experience, post qualification training, skills and competencies. With time and experience, PAs can work more autonomously, while still having access to appropriate supervision and support.

PAs have consistently proven to be safe and effective members of clinical teams. Research and experience show that they improve patient experience, enhance team effectiveness, and help reduce workload pressures on other clinicians, contributing significantly to the overall functioning of healthcare services.

UK trained PAs undertake an intensive postgraduate programme in Physician Associate Studies. This two year course comprises at least 90 weeks (around 3,200 hours) of training, divided equally between theoretical learning and clinical placements. The curriculum follows the General Medical Council’s (GMC) shared outcomes for PAs and the assessment content map, covering areas such as medical sciences, pharmacology, clinical reasoning, and hands-on experience across a wide range of healthcare settings.

To be eligible for a PA programme, students must already hold an undergraduate degree, usually in a biomedical or health or life science field, and typically have prior experience in health or social care. On completion of their studies, they must pass the Physician Associate Registration Assessment, overseen by the GMC.

PAs are qualified to:

• Take medical histories and conduct physical examinations
• Diagnose and manage long term conditions
• Formulate differential diagnoses
• Carry out diagnostic and therapeutic procedures
• Develop and recommend treatment and management plans
• Request and interpret diagnostic tests

At present, PAs are not permitted to prescribe medication or request ionising radiation (e.g. X-rays or CT scans), though this may change in future with evolving legislation.

To further strengthen public confidence in the profession, the GMC began formally regulating PAs on 13 December 2024. Regulation ensures that PAs meet nationally recognised standards of education, training, and professional conduct. This includes setting the standards of patient care and professional behaviours, approving PA course curricula, and issuing guidance to support PAs in their roles. It provides reassurance to patients, employers and colleagues that PAs are safe, competent and accountable healthcare professionals. The GMC website can be used to search for registrants. 

All PAs working at Swiss Cottage Surgery are either already registered with the GMC or are in the process of completing their registration. We are proud to have PAs as part of our team, delivering high quality, safe and compassionate care to our patients. 

PAs are supported nationally by the Union for Medical Associate Professionals (UMAP), the government-recognised trade union for Physician Associates. UMAP has outlined a base scope of practice for PAs, which is closely aligned with the nationally agreed PA curriculum. This provides further clarity on the expectations and responsibilities of PAs working in clinical environments and reinforces the role's standardisation and safety across the NHS.

Physician Associates at Swiss Cottage Surgery

Here at Swiss Cottage Surgery, PAs have been valued and integral members of our clinical team for the past nine years. Many of our patients will already be familiar with our PAs, who always introduce themselves clearly, including their professional title and role. We are proud to have been one of the first GP surgeries in London to employ PAs, and we continue to be strong advocates for the profession.

Swiss Cottage Surgery is a long established, accredited teaching and training practice. Each year, we welcome a wide range of learners including medical, nursing, PA and pharmacy students, as well as GP trainees, independent prescribing pharmacists, and nurses training in Advanced Practice.

The majority of our GPs are experienced GP trainers with many years of expertise in education, supervision and mentoring.

Each PA at the surgery is supervised by a named GP trainer and receives extensive further training upon joining the team. They take part in our weekly clinical and educational meetings and have protected time each month for formal learning. In their first 6 to 12 months, PAs work very closely with their supervisor to build their skills and confidence. Once assessed as competent, they are able to practise more independently, with appropriate support always available.

Beyond their core responsibilities, all of our PAs receive further professional development to support one or more long term conditions and develop specialist expertise in specific areas of care. Among the areas our PAs are involved in are hypertension, anticoagulation, asthma, chronic obstructive pulmonary disease, teledermatology, geriatric medicine, cryotherapy, smoking cessation, ear canal microsuction, smear taking and spirometry.

We would like to emphasise that our PAs are never used as a substitute for GPs. They work as part of a well-established, fully staffed multidisciplinary team, under appropriate supervision. We currently have a full complement of GPs with no vacancies, and our PAs play a vital role in enhancing the care we provide, supporting both access and quality.

Their contribution helps ensure that our patients continue to benefit from timely, high standard, patient centred care — something we know is deeply valued by our community.