The physician assistant: would the US model meet the needs of the NHS?

The public and the government have both identified “more staff” as a way of improving the NHS.1 Problems with recruitment and retention in nursing and allied health professions and falling numbers of applicants to primary care are potential constraints on the meeting of targets. One option is to introduce a new group of staff (box 1). 2 3 Practitioners who perform “mid-level” duties in the United States include doctors in training, nurse practitioners (including advanced practice nurses and other titles), and physician assistants. These three groups perform similar duties and, at the level of the patient, act interchangeably. The American term “physician” encompasses all doctors, and physician assistants work in all branches of medicine and surgery. Physician assistants in the United States are fully trained professionals who take on a role equivalent to that of a junior doctor for their entire career. They pride themselves on their “dependent” status, have the ability to move to and from various clinical settings, have their own recertification processes, and do not compete for senior medical posts. Higher education institutions in the United Kingdom are starting to look into the education needs of such a profession. But is the US physician assistant model the right solution for the NHS?