Physician associate

A physician associate (PA) is a healthcare professional with a postgraduate qualification who sees patients, takes histories, examines, and helps diagnose and manage illness under the supervision of a doctor. Newly qualified PAs in NHS hospitals in England are usually employed on Agenda for Change band 7, which pays £49,387 to £56,515 from 1 April 2026. The General Medical Council (GMC) regulates the role, and its scope has been the subject of heated argument in the profession, so the job in 2026 is more tightly defined than it was a few years ago.

What a PA does day to day

PAs work in GP surgeries, emergency departments, acute medicine, surgery, psychiatry and many other specialties. In a typical hospital post you clerk new admissions, examine patients, request blood tests, interpret results, write in the notes and present cases to the supervising consultant or registrar. In general practice you might run your own appointment list for set types of presentation, with a GP available to review.

Two limits shape the work. PAs cannot prescribe medicines and cannot request ionising radiation (X-rays and CT scans) themselves, so a doctor signs those off. And every PA must have a named supervising doctor. How much autonomy you have in practice depends on the department and on local policy, which in many trusts has been tightened.

Training and entry

Most PAs have a first degree in a life or health science, then complete a postgraduate diploma or master’s in physician associate studies, usually over two years. The course mixes classroom teaching with long clinical placements across hospital and community settings. Some universities have closed or paused PA courses in response to falling demand and the review of the role, so check which are still recruiting before you apply.

At the end of training you must pass a national assessment and then register with the GMC before you can practise under the title. Registration means meeting GMC standards, paying its annual fee and going through revalidation in future years, in a similar way to doctors.

Applicants usually need some patient-facing experience. Work as a healthcare assistant or in another clinical support role counts for a lot at interview.

Regulation and the scope debate

The GMC took on regulation of physician associates and anaesthesia associates under new legislation. Before that, PAs had been on a voluntary register only. Regulation was meant to settle questions about accountability, but it came alongside fierce criticism from some doctors’ groups. The British Medical Association argued that PAs were being used in place of doctors and that patients could not tell the difference. Several royal colleges issued guidance limiting what PAs should do in their specialties.

The government commissioned an independent review of the role (the Leng review). It recommended renaming the job “physician assistant” to make clear that holders are not doctors, and set out tighter expectations on supervision and on which patients PAs should see. Job adverts and NHS policies are likely to move towards that wording. A vacancy that says “physician assistant” is the same profession.

For an applicant, the practical effects are fewer new posts in some areas, more detailed local scope-of-practice documents, and closer scrutiny at interview about how you would escalate. The profession is in flux, so read the employer’s PA policy before accepting an offer.

What the job pays

Agenda for Change band 7 in England, from 1 April 2026:

Point	Annual pay
Entry (2 years)	£49,387
Intermediate (3 years)	£51,932
Top	£56,515

Some trusts have employed newly qualified PAs on band 6 for a preceptorship year before moving to band 7. Band 6 runs from £39,959 to £48,117. The band 7 pay guide sets out how progression between points works. In London, the high cost area supplement adds 5 to 20 per cent of basic pay, depending on the zone, within set minimum and maximum amounts.

GP practices are independent contractors and not bound by Agenda for Change, so a practice-employed PA may be paid a locally agreed salary. In Scotland, band 7 runs from £52,769 to £61,377 in 2026/27. PAs in the NHS join the NHS Pension Scheme, and at band 7 pay the member contribution rate is 9.8 per cent or 10.7 per cent depending on actual pensionable pay.

Hours and working pattern

Hospital PAs often work a rota, including some evenings and weekends, though usually without the overnight on-call duties of resident doctors. Unsocial hours are paid under the standard Agenda for Change enhancements. Annual leave starts at 27 days plus 8 public holidays, rising with NHS service. GP-based PAs usually work standard surgery hours.

Where the job can lead

PAs who stay in the role can become senior or lead PAs with responsibility for supervision, teaching and service development. Some move into education, running PA programmes. A few go on to study medicine as graduate entrants, which means starting as a student again. The advanced clinical practitioner route is open mainly to registered nurses and allied health professionals, so it is not a direct step for PAs unless they hold another registration.

International applicants face the Skilled Worker visa threshold for healthcare jobs on national pay scales: at least £25,000 or the pay scale rate if higher. They would still need GMC registration, and UK PA qualifications are the usual route to that. Search for vacancies on NHS Jobs under both “physician associate” and “physician assistant”.