Physician associates play an important role in modern healthcare | Letters

I am a junior doctor with six years’ experience and I am concerned about the one-sided media reporting of the work we do in the NHS. I was just laid off, along with three other PAs in my practice. This is happening all over the country. The NHS has invested 20 years in training and employing thousands of us, only to now pull the rug out from under us and end our careers, losing skilled workers to a system under pressure. And for what?

The cases where mistakes were made mentioned in your editorial (21 November) are sad, but not unique to the role of the PA. I was a team leader of twelve paramedics and worked hard to provide excellent patient care. The system has used us as a cheaper resource because it could get away with it, and then spotlighted us as the problem. The emotional and financial impact of this on PAs is enormous. Additionally, it will worsen access to primary care appointments.
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Physician assistants can be a huge asset to the NHS if they are properly trained, regulated and supervised. Over the last five years of my time as a GP, our team has benefited enormously from having two full-time PAs, supervised by the GPs. They bring with them a high level of skill following an intensive two-year medicine-based training, with supervised learning in a healthcare environment, usually on top of a degree in biomedical sciences or similar. Our patients appreciate them.

Due to the increasing demands on our services and the increasing complexity of care, we increased the size of our team, but were unable to afford (or find) GPs. Hence the addition of other professionals trained to diagnose and manage simple problems.

We should welcome the Wes Streeting-commissioned inquiry (Wes Streeting orders review of the role of physician associates in the NHS, November 20), but we should be aware that some of the medical establishment’s antagonism is rather protectionist appears to be in the best interest of the patients.
Dr Charles Heatley
Retired GP, Sheffield

The dispute over the role of physician assistants in the NHS is rooted in dogma. Whether the person performing the treatment is a doctor is irrelevant. What matters is that everyone who provides healthcare is trained and qualified, acts according to the correct guidelines and has access to support and guidance when a situation outside the routine arises. This should apply to PAs, GPs and experienced consultants alike.

In cardiothoracic surgery, surgical PAs (also called surgical providers) have been working with surgeons for two decades, with substantial evidence that they have improved the quality of care and training of primary care physicians. There is no reason why such a model could not be applied in other specialties.
Samer Nashef
Consultant Cardiac Surgeon, Royal Papworth Hospital, Cambridge

I am amazed at the need for physician assistants when we already have well-trained nurses in specialty positions. In the 1990s I trained several senior nurses to become experts in gastroscopy (the passing of fiber optic telescopes to examine the esophagus and stomach). They were going to do this in a theater next to mine. I go to the local hospital twice a year to have a similar telescope placed in my bladder by a urology nurse. There are others, such as specialist asthma and diabetes nurses. Why unnecessarily duplicate professions?
Dr. Giles Youngs
Retired consultant gastroenterologistDrinkstone, Suffolk