British Society of Gastroenterology Executive position on the role of Physician Associates in Gastroenterology and Hepatology

The following statement was unanimously agreed by the BSG Executive on 22nd April 2024.

We have listened to the concerns of BSG members, particularly our trainees, about the potential expansion of the scope and number of Physicians Associates (PAs).

You may already be aware that the legislative decision for the General Medical Council to be the regulator and the title Physician Associates (PAs) to be protected have already been made in law. The proposed growth of PAs is set out in the NHS Long Term Workforce Plan.

Concerns of our members include lack of detail around (but are not restricted to) the following:

Scope of practice, regulation, training, governance and supervision of PAs.
Impact of PA training on training opportunities for medical trainees (particularly GI endoscopy), nurses and other healthcare professionals.

The focus of the BSG Executive is now on how we move forward. We cannot currently support the expansion of PAs in gastroenterology and hepatology (particularly in the field of GI endoscopy) until greater detail has been provided and these concerns have been addressed.

We acknowledge current PAs for their contribution to gastroenterology and hepatology. During discussions, we have been made aware of many instances where the role of PAs is working well and improving patient care.

We will continue to gather evidence on the impact of PAs on training opportunities for medical trainees (particularly GI endoscopy).

BSG will be contributing to the Royal College of Physicians of London Physician Associate Scope of Practice document which includes representation from the BSG Trainees section. We encourage our members to contribute to the current GMC consultation on PAs and to the proposed college consultations on PAs. We encourage these organisations to work at pace.

We acknowledge that these discussions around PAs have highlighted the broader challenges our trainees face in accessing training (particularly in GI endoscopy). We want to reassure all of our members who are experiencing these challenges that the BSG is committed to working on these solutions by:

Continuing to press the JRCPTB on limiting the impact of service provision of Acute Medicine on GI and hepatology training.
Highlighting to deaneries the importance of protected training lists in endoscopy.
Considering mechanisms for trainees to raise concerns.
Maximising training opportunities and support BSG can provide e.g., bursaries, management and leadership courses, taster visits.