London: Physician associates (PAs) in the NHS will undergo a title change after a government-commissioned review concluded that their current designation causes significant confusion among patients, potentially endangering safety.
The independent review, led by Professor Gillian Leng, found that many patients mistakenly believe PAs are fully qualified doctors, even though they are not.
PAs perform tasks like taking medical histories, examining patients, and diagnosing conditions, but they do not hold medical degrees and complete only two years of postgraduate training.
Sources close to the review indicate that Leng will recommend renaming the role, with alternatives such as ‘physician assistants’ or ‘doctors’ assistants’ under consideration.
Health Secretary Wes Streeting is expected to adopt the recommendation, which will also include a requirement for PAs to communicate their assistant status to patients to prevent misunderstanding clearly.
The review, launched in November 2024, was prompted by growing concern among doctors and medical organizations, including the British Medical Association and several royal colleges.
These groups argue that the PA role has created widespread public confusion, eroding trust in the medical profession and potentially compromising care. They have called for a pause in the PA recruitment drive until their impact is fully assessed.
Public and professional anxiety about Physician associates intensified following several high-profile incidents. Currently, there are about 3,500 physician associates and 100 anesthesia associates (AAs) working across NHS England.
However, NHS England’s plan to triple the number of PAs to 10,000 by the mid-2030s is now under scrutiny, with an updated NHS long-term workforce plan due this summer.
Multiple research efforts support Professor Leng’s findings. A May 2025 statement from her noted that patients often ‘misconceive PAs to be a doctor.’ Focus groups conducted by the Patients Association and several research studies confirmed that many patients are unaware of what a Physician associate is or the limits of their practice.
When Streeting commissioned the review, he acknowledged that while many PAs deliver good care, there were valid concerns over their transparency, scope of practice, and the substitution of doctors.
A Department of Health and Social Care source confirmed that the government acknowledges the problem of patients being unclear about who is treating them a basic patient right and that the upcoming report is likely to recommend solutions, including title changes.
The final report from Professor Leng is expected later in June 2025, after which the government will review and respond to its findings in full.
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