The Royal College of Anaesthetists has doubled-down on its Scope of Practice document for PAAs  (Physician Assistants in Anaesthesia, aka Anaesthesia Associates), and it has reminded Clinical Directors that it does not support or see any justification for a rapid expansion of the PAA role.

In a letter sent to Clinical Leaders across the NHS the College reiterated that:

• They expect all departments employing PAAs to implement their Scope of Practice document,
• They do not support rapid expansion of the PAA role, and emphasise that the need for any future training posts should be based on the intention and capacity to employ PAAs locally in line with this Scope
• PAA training should only be undertaken where there is training capacity and no impact on the training of anaesthetists. The key workforce priority remains sustained expansion in the ability to train more anaesthetists.

Following the EGM in October 2023 the College had called for a pause in recruitment of new student PAAs until further research had been carried out, a Scope of Practice had been developed, and regulation was in place. These conditions have now been met and the College Council recognises that there are appropriate safeguards in place.

The College has undertaken extensive consultation with members and stakeholders to develop and publish their detailed Scope of Practice which provides clear parameters for practice at qualification and sets expectations for supervision, governance and professional development as experience increases over time. It clearly demarcates appropriate limits for a PAA role – and its position remains that  PAAs can only undertake work under the direction and care of an autonomously practising medical practitioner. 

The College has also reiterated that they remain fully supportive of PAAs currently training or working in the NHS, who provide a valuable contribution to patient care. They are welcomed as affiliate members of the College.  

Anaesthetists United recognises the considerable effort that has gone into this work, which has involved many challenges and conflicting opinions. The College has listened to the views of members, and continues to do so, showing excellent leadership. We hope that the changes in the role that are proposed will lead to better and safer patient care.