Partha Kar: Expanding roles of healthcare staff—where are the safety checks? (BMJ, 3 March 2026)

Summary

The past decade has seen a steady movement towards expanding the roles of different healthcare professionals, including physician assistants, nurses, and pharmacists, driven by the belief that there aren’t enough doctors to cover all the work. This has given other professionals greater scope to take on tasks traditionally performed by doctors.

This trend came to a head with the planned expansion of physician assistant roles, which led to pushback from doctors about how it could encroach on their roles, training, and progression. The escalation of the debate prompted the Leng review on the safety and effectiveness of physician associate roles. Seven months on from that review, the Royal College of Physicians hasn’t firmed up its interim document on scope, nor have steps been taken to stop these roles being advertised, although the adverts have declined. It feels as though everyone has ducked their responsibility to implement the review’s recommendations, writes Partha Kar in an opinion piece for the BMJ.