Why the BMA is campaigning against PAs, but not ACPs

The BMA is putting a lot of energy into campaigning against Physician Associates. But another group of clinicians, called Advanced Clinical Practitioners, is not in the firing line. When you find out about ACPs, you will discover this is another example of hypocrisy from the Doctors’ union and highlights that the BMA’s stance against PAs is simply corporate bullying

Advanced Clinical Practitioners (ACPs) are healthcare practitioners who have undertaken an on-the-job Masters level training, usually over 3 years. To be an ACP, you can be from any clinical background, eg. midwife, dietitian, physiotherapist but most commonly ACPs are from a nursing background. ACPs are not directly regulated, rather they are regulated by their originating regulator, so a nurse ACP will be regulated by the Nursing and Midwifery Council while a physiotherapist would be regulated by the the Health and Care Professions Council. 

  • ACPs get paid at band 7 level (£43-50k) during training and, once qualified, are paid at Band 8a (£50-57k). By contrast, PAs start on band 6 pay (£35-42) and progress to band 7 pay after one year.
  • Trainee ACPs are (technically) supernumerary. Theoretically a training ACP works wherever there is the greatest training need. 
  • Qualified ACPs are counted in the numbers. ACPs often fill positions on the medical rota which would otherwise be occupied by doctors.  
  • ACPs perform advanced clinical procedures, for example lumbar puncture and ascitic drains. 
  • ACPs get one day a week for study and admin.  

There are lots of similarities between ACPs and PAs; however the BMA is only objecting to PAs. So why is the BMA not campaigning against ACPs? The answer is simple: 

ACPs are predominantly nurses and if the BMA goes against ACPs they are up against 600,000 nurses. Not even the BMA is stupid enough to pick that fight. Instead, the BMA’s strategy is to pick on 4,000 PAs who do not pose a threat to UK doctors. And let’s call it what it is – bullying. The BMA strategy against PAs is nothing less than corporate bullying. Over 80% of PAs feel their emotional welfare has been impacted by the BMA campaign. 

We need ACPs, we need PAs. Diversity builds effective teams. ACPs and PAs add diversity and perspective to medical teams. 

The BMA needs to recognise that multi-disciplinary working and diversity are here to stay. And Doctors will always be a key part of the medical team. The BMA needs to create a new strategy that genuinely embraces multi-disciplinary working, then they can be part of the team that shapes the future of medicine in the UK.