Advice for doctors who supervise physician associates and anaesthesia associates

Physician associates and anaesthesia associates (PAs and AAs) are clinically trained healthcare professionals, who work under supervision alongside doctors and provide medical care as an integral part of the multidisciplinary team in community, primary or secondary care. 

During and beyond qualification in their roles, PAs and AAs develop their skills through on-the-job experience under the day-to-day supervision of appropriately qualified and experienced clinicians.

As a supervising doctor, you’ll make an important contribution to the PAs and AAs that you oversee. In order to support you in your role, we have put together this advice which is drawn from key principles from our professional guidance; insights from those with experience of acting as supervisors; and wider work undertaken by others.

Finding the right approach

  • There is no one size fits all when it comes to supervision. For example, it can mean close personal supervision, or a managed support system with clear escalation protocols. Newer members of the team, or those who are newly qualified, will require much more support than more experienced individuals. 
  • Work together with the PAs and AAs that you supervise to establish the level of supervision appropriate for them: task to task, patient to patient, day to day and over time. Keep supervision arrangements flexible and under regular review. 

Key principles from our guidance:

Further resources: 

Delegation, teamworking and accountability

  • PAs and AAs should be supported to develop their roles and responsibilities through appropriate delegation of tasks and responsibilities. When delegating tasks, you should be sure that the person you are delegating to has the necessary knowledge, skills and training to take on the task. Give clear instructions about what is expected, and encourage the asking of questions, or for help, when needed.
  • Advocate for those you supervise. Support them to establish their role in the team by being clear with them and others about the skills and expertise they are contributing and how this interacts with the wider work of the team.
  • Promote a culture of psychological safety and encourage effective communication between all members of the team. Ensure that PAs and AAs are clear on how to escalate safety concerns.
  • Where you delegate care in line with the principles set out in our guidance, you are not accountable to the GMC for the actions (or omissions) of those to whom you delegate care. You will remain responsible for: the overall management of the patient, decisions around transfer of care, and the processes in place to ensure patient safety.
  • If you prescribe based on the recommendation of a PA or an AA, you’ll be responsible for any prescription you sign. Be sure that the prescription is needed, appropriate for the patient and within the limits of your competence. 

Key principles from our guidance:

Further resources:

Support and wellbeing

  • It is important that you are supported to carry out your role as a supervisor, including access to appropriate training. Establish clearly with your employer the scope of your role and the responsibilities it involves and that you have the time to carry these out. 
  • ‘Named’ supervisors establish longer term relationships with those they supervise, supporting individual wellbeing and development through regular review meetings and overseeing governance arrangements for progression to advanced skills. Our guidance on Leadership and management for all doctors (linked below) provides more detail on the standards expected of doctors with additional responsibilities. 

Key principles from our guidance:

Further resources

  • We intend to publish further advice on supervision of PAs and AAs when regulation commences, including as part of updates to our clinical governance handbook