Physician associates and endoscopy

The British Society of Gastroenterology is a multidisciplinary membership organisation which supports, guides, and represents its members for the benefit of patients. We are contacting you to reiterate our position on Physician Associates (PAs). This is in response to the recent scope of practice document released by the British Medical Association. The BMA is a trade union for doctors and medical students and did not consult with the BSG prior to releasing this document.

The BMA document recommends severely restricting the scope of practice of PAs, including exclusion from undertaking endoscopy of any kind. The BSG does not support the BMAs opposition to PAs undertaking gastrointestinal endoscopy.

JAG accredited endoscopy training in the UK is one of the highest quality and most regulated endoscopy training programmes internationally, and post certification scrutiny and quality assurance is unmatched in the world. The BSG is committed to working alongside JAG to ensure that safe, high quality endoscopy is delivered to our patients no matter which professional group delivers that endoscopy.

As part of the multidisciplinary team, the BSG welcomes professional groups who can contribute to the huge demands facing the NHS at a time of a critical workforce crisis. In endoscopy, we have gladly included Clinical Endoscopists (almost exclusively nurses at present) into the workforce, and they have made a huge contribution to not only the delivery of high quality endoscopy to patients, but also in the training of endoscopy to all groups including doctors.

Within the BSG, we have debated at length the role of PAs in the workforce including at Trustee Board, Executive, Council, Endoscopy Committee, and crucially with our Trainees committee. A range of views were considered in these meetings with the overwhelming majority supporting the inclusion of PAs in the workforce providing that they are appointed to appropriate positions, are adequately supervised, and do not negatively impact upon the training opportunities of our specialty trainees. The consensus statement on PAs from the Academy of Royal Medical Colleges is extremely helpful, and the BSG will continue to work collaboratively with other organisations to contribute to guidance across all areas of practice related to gastroenterology, hepatology, and endoscopy.

We do understand that there are legitimate concerns as to how PAs have been deployed or supervised in some clinical areas, but we will work with our members, and with Royal Colleges and NHS agencies across the UK to ensure that PAs are incorporated safely within our specialty to enhance patient care, and absolutely not to the detriment of our trainees or other members.

Andy Veitch

President, British Society of Gastroenterology

19th March 2024

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