Leng review offers “pragmatic solution” in attempt to heal rift between doctors and PAs

The roles of physician associate (PA) and anaesthesia associate (AA) should not be abolished but be renamed “physician assistants” and “physician assistants in anaesthesia,” Gillian Leng’s independent review has recommended.1 Leng acknowledged that her “pragmatic” solution “won’t be universally popular.” She said that she found “no convincing reasons” to abolish the roles of PAs and AAs but that changes were needed to embed the roles into the NHS workforce effectively. In autumn 2024 the government commissioned Leng, president of the Royal Society of Medicine and former chief executive of the National Institute for Health and Care Excellence, to head a rapid review into the safety and scope of the roles of PAs and AAs.2 This followed growing anger in the medical profession about the way PAs were being deployed and regulated. Leng’s 18 recommendations, based on the “best available evidence,” aim to represent a “pragmatic, sensible way forward that will provide clarity and enable effective change” (box 1). She emphasised that her report must be an opportunity “to reset the hostility” in the debate and stimulate effective collaboration for the future. Box 1 ### Leng’s key recommendationsRETURN TO TEXT