Physician assistants in anaesthesia

The physician assistants in anaesthesia (previously known as anaesthesia associate) role 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, the physician assistants in anaesthesia 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 physician assistants in anaesthesia 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 PAA requires successful completion of an PAA training programme. Rather than a direct application to a university, applicants are required to obtain a student PAA role within a Trust which has secured training places for PAAs. 

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 PAAs will be assigned to a university, of which there are currently three offering PAA courses, whilst continuing to work within their trust. The PAA 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. 

Physician assistants in anaesthesia, as supplementary 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. 

For those currently on the MVR (for PAs or PAAs) the GMC will have issued invitations to apply for registration. Individuals should have received an invitation with a link to their GMC online account which included their verified qualification and assessment details.  

This link will commence the process of registration.

PAs and PAAs not currently on the MVR will need to apply directly to the GMC. Applicants will need to complete an eligibility checker and set up a GMC online account before completing the application. 

Individual PAs and PAAs will need to have contacted the GMC themselves to commence the process.