Anaesthesia Associates

The anaesthesia associates role (also known as physician assistants in anaesthesia (PAAs) following recommendations from the Leng review) was first introduced in 2004, and is now established within many NHS hospitals. These are highly trained and skilled practitioners that work within an anaesthetic team under the direction and supervision of an autonomously practising anaesthetist, such as a consultant or specialty and specialist (SAS) doctor.

The role encompasses pre-, intra- and post-operative care. Under the direction of an autonomously practising anaesthetist, such as a consultant or SAS doctor, anaesthesia associates may participate in:

• pre-operative and post-operative assessment of patients
• anaesthesia for day case surgery
• pre-operative patient pathways
• delivery of anaesthetic or sedation
• advanced vascular access.

Currently anaesthesia associates are unable to:

• prescribe
• administer and/or supply medicines under a patient group direction:

A patient group direction (PGD) is a written instruction for the supply and/or administration of medicines to groups of individuals who may not be individually identified before presenting for treatment.  Read further information on PGDs. 

Subject to locally determined governance arrangements, a PA may administer medicines under a patient specific direction. A patient specific direction (PSD) is a written instruction, signed by an authorised prescriber, for medicine(s) to be administered to a named person after the prescriber has assessed the patient. Read further guidance on PSDs.

Qualifying as an AA requires successful completion of an AA training programme. Rather than a direct application to a university, applicants are required to obtain a student AA role within a trust which has secured training places for AAs. 

Applicants are typically required to possess a biomedical science or biological/life sciences 2:1 honour degree. Alternatively, they can be registered healthcare professionals (such as nurses or operating department practitioners) with at least three years clinical experience.

On successful application, student AAs will be assigned to a university, of which there are currently three offering AA courses, whilst continuing to work within their trust. The AA training course is two years and is designed around a curriculum developed by the Royal College of Anaesthetists in collaboration with the General Medical Council. 

Anaesthesia associates, as integrated members of multidisciplinary perioperative and anaesthesia teams, can exert a positive impact on patients and service provision, by enabling flexibility to anaesthesia teams in service delivery and enabling consultants to manage their team more effectively. As a result of the increased workforce capacity, theatre downtime can be reduced, and patient flow can be increased.