A major government review into the role of Physicians Associates (PAs) is to report next year, following concerns from a health union over patient safety.
PAs are graduates with two years of postgraduate training, but do not have a medical degree.
They assist doctors in primary and secondary care, with duties including taking medical histories, carrying out physical examinations, analysing test results and developing management plans.
In Northern Ireland, Ulster University currently runs a two-year Masters course for PAs with 20 places.
This is subsidised at a cost of £787,000 from the Department of Health, but many graduates have said it has been difficult to secure a job.
In July, the Department of Health said PAs remain “a valued element of the workforce” after the British Medical Association claimed the role was an attempt at “eroding the medical profession”.
In September, the Academy of Medical Royal Colleges also wrote to the Health Secretary Wes Streeting over “mounting concern” from doctors.
They called for the review to determine if PAs had a negative impact on patient safety, if they really free up doctors’ time for other tasks and if they improve the overall quality of care for patients.
In recent years, there have been negative headlines about the deaths of people who were treated by PAs but did not know it, and where mistakes were made.
This includes Emily Chesterton (30), who died in 2022 from a pulmonary embolism after being misdiagnosed by a PA on two occasions when she visited her GP practice in north London.
She had believed she was a seeing a GP, but a PA failed both times to spot her leg pain and breathlessness was a blood clot which ultimately travelled to her lungs.
A coroner later found she would likely have survived if she had immediately been referred to a hospital emergency unit.
Commenting on the review, Mr Streeting said many PAs provided great care and took pressure off doctors, but agreed there were legitimate concerns of transparency for patients.
“These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised,” he said.
British Medical Council chairman Professor Phil Banfield said clearer guidelines were needed.
“By allowing a free-for-all on what PAs can and can’t do, hospitals have become a postcode lottery in which patients don’t know if they are being seen by a professional with the right skills,” he said.
“Only a clear, nationally agreed scope of practice, telling employers what PAs can and can’t do, will clear up this mess. This review must lead to one.”
In a written question to the Stormont health minister Mike Nesbitt, Alliance MLA Paula Bradshaw asked how PAs fit into the workforce planning policy “with a significant number of those qualified unable to find work in the health service.”
Mr Nesbitt said: “As qualified healthcare professionals, Physician Associates can make an important contribution within that workforce.”
He added that his department was continuing to encourage health service employers to secure posts for the Ulster University graduates despite “a very challenging financial situation.”
He also confirmed that the £787,000 in funding paid for student tuition fees and provided funding to health trusts and GPs to facilitate clinical placements.