The Leng Review of Physician and Anaesthesia Associates (2025)

Summary

Physician associates were introduced to support medical teams, but their rapid expansion raised concerns among doctors and patients about role confusion, supervision and safety. The independent review led by Professor Gillian Leng did not find convincing evidence to abolish the roles but recommended significant changes. These included renaming physician associates 'physician assistants' (and anaesthesia associates 'physician assistants in anaesthesia') to make clear they are not doctors, ensuring each has a named supervising doctor, and stating they should not see undifferentiated patients — people with symptoms not yet diagnosed — except within clearly defined national protocols. It also recommended that newly qualified physician assistants spend time in secondary care before working in general practice or mental health, and called for clearer identification, standardised training and better evidence on outcomes. The government accepted the recommendations.

Key takeaways

• Recommended renaming to 'physician assistant' to avoid confusion with doctors.
• No undifferentiated patients except within national protocols.
• Named supervising doctor for each physician assistant.
• The review did not recommend abolishing the roles.

How to use it

Show balance: value of the wider team versus the importance of clear roles and supervision for patient safety. Avoid disparaging colleagues.

Questions it helps with

• If you want to care for patients, why not become a nurse or a physician assistant instead?
• There has been a lot of debate about the role of physician associates in the NHS. What do you understand about this, and what is your view?