HSE review into physician associate role to conclude by ‘year-end’

A review into the role of physician associates/assistants (PAs) is expected to be completed by “year-end”, according to the HSE.

An independent expert is conducting a “comprehensive assessment” of the grade’s deployment internationally. The expert will “make recommendations for standardisation and scope of practice and deployment in the Irish health services”.

The HSE has “paused” the recruitment of PAs pending the assessment to ensure “appropriate governance and deployment”, said the spokesperson. “Physician assistants are not regulated by any of the Irish health regulators, and [we] must ensure that the appropriate and standardised governance arrangements are in place across the HSE before there is further growth in the numbers employed.”

There are a relatively small number of PAs working in the Irish health system, predominantly in public hospitals. The RCSI operates the only postgraduate PA programme in the jurisdiction. Candidates for the two-year MSc programme require a health science/science-related degree as part of the entry requirements. In 2024, the HSE provided funding to cover the fees of some RCSI PA students in return for a service commitment.

Separately, uncertainty arose about the proposed governance structure for PA students at Letterkenny University Hospital (LUH) last year. In August 2024, the hospital management team discussed the arrangements for an RCSI PA student who was due to commence a placement.

According to minutes obtained under Freedom of Information law, the meeting noted that PA students were “not medical students”. The minutes further stated the “consultant is fully responsible for the student physician associate”.

“The DON [Director of Nursing] said we want to expose the physician associate [student] to as many learning possibilities as we can… DON said it is important that the student is welcomed to the hospital.”

A HSE West and North West spokesperson said: “The student PA worked under the supervision and guidance of a consultant at all times. Input from the RCSI was provided prior to the placement and feedback was given to the RCSI in relation to the attainment of an agreed set of assessment criteria. At present LUH have no plans to provide placement for another student PA.”