The Vascular Society of Great Britain and Ireland and Rouleaux Club membership survey on the role of Physician Associates in vascular surgery

Background: The UK government’s proposed expansion of the role of Physician Associates (PAs) in the NHS is an ongoing topic of debate. This survey aimed to capture the opinion of members of the Vascular Society of Great Britain and Ireland (VSGBI) and The Rouleaux Club on the role of PAs in vascular surgery. Methods: A Qualtrics online survey tool was used to distribute a pre-piloted survey through relevant mailing lists to vascular surgeon members of the VSGBI and the Rouleaux Club. Data were captured on the current role of PAs in vascular surgery and the perceived impact of PAs on patient care, workload and training opportunities. The survey collected responses between 7th and 25th June, 2024. Results: The survey received 194 responses from 59 NHS Trusts in the UK and two vascular units in the Republic of Ireland. Most respondents were consultant vascular surgeons (98/194; 51%). Of the respondents 26.8% (52/194) worked with PAs. 69.1% (134/194) of respondents support the presence or introduction of PAs in vascular surgery. The most frequent tasks carried out by PAs included taking a medical history (42/52; 86.5%), physical examinations (40/52; 76.9%) and requesting diagnostic investigations (excluding ionising radiation) (37/52; 71.2%). Respondents felt that PAs should not be involved in performing procedures (units with PAs: 43/52, 82.7%; units without PAs: 114/142, 80.3%), prescribing (units with PAs: 33/52, 63.5%; units without PAs: 70/142, 49.3%), training resident doctors/medical students (units with PAs: 31/52, 59.6%; units without PAs: 95/142, 66.9%). Themes that arose from the free text responses included the potential positives of PAs, organisation flaws that have led to the perceived problematic introduction of PAs and the negative impact of PAs on patient safety, resident doctor training and doctors’ workload. Conclusions: Fewer than a third of the vascular surgeons who responded to this survey were supportive of the introduction of PAs into vascular surgery. This is driven by concerns for patient safety, unclear scope of practice and perceived negative impact on medical training.