Viewpoint: A Proposed role for physicians associates (PAS) in palliative care

GPs and primary healthcare teams have a key role in the delivery of end-of-life care in the community, much of which requires a generalist approach, supported by hospice and specialist palliative care colleagues. Consequently the role of primary care in the delivery of end-of-life care in the community is integral, but can be overlooked in policy and service development, including in pandemic planning for primary care. Owing to the diminishing workforce and a need to look at alternative solutions to address this, Physician Associates (PAs) are a relatively new member of the medical team in the UK. They assess and manage patients in the medical model, with supervision from senior colleagues when they initially qualify, but as they grow in skills and experience this can be provided as required. PA numbers are expanding across primary and secondary care in both generalist and specialist settings, especially due to additional roles reimbursement and funded preceptorship schemes. As PAs grow in clinical experience as permanent team members, could they become more involved in a multi-disciplinary team approach to end-of-life care? There are examples of PAs working in palliative care services overseas, particularly in the USA due to the vast PA numbers there, but little research has been published on the efficacy of this, and there are no known examples in the UK.