Physician Assistants in Anaesthesia (legally known as Anaesthesia Associates)
Physician Assistants in Anaesthesia (legally known as Anaesthesia Associates)
Physician assistants in anaesthesia (PAAs; legally known as anaesthesia associates), formerly known as physician assistants (anaesthesia), were introduced in 2004 and the role is now established within many NHS hospitals, where they work within the anaesthetic team under the supervision of a consultant anaesthetist or other autonomously practising anaesthetists.
The College provides leadership and guidance on the education, training and professional development of physician assistants in anaesthesia (PAAs; legally known as anaesthesia associates). We support PAAs who are currently training or working in the NHS and we welcome them as affiliate members of the College.
Evolving work and context
Our work relating to PAAs is evolving, as is the wider debate about the role of Medical Associate Professions (MAPs). We have sought to ensure all the information and guidance on these pages is up to date, but it may be subject to change.
Following concerns raised by our members regarding patient safety at the October 2023 EGM, we have completed all required actions.
PAA Scope of Practice and the Leng Review
The Physician Assistant in Anaesthesia Scope of Practice 2025 was published in December 2025. It replaces the previous interim version, published in December 2024.
The Interim AA Scope of Practice 2024 was endorsed by the Association of Anaesthetists, and the Leng Review and the Secretary of State for Health and Social Care as a safe and appropriate framework for the contribution of AAs to high-quality anaesthetic care.
We expect all departments to continue implementing the PAA Scope of Practice 2025, which presents clearly defined phases of practice from qualification onwards, including the levels of supervision required.
Pause in the recruitment of new student PAAs
Recruitment of new student PAAs remains paused while we seek clarity on legal action threatened by United Medical Associate Professionals (UMAPs) following the publication of the Leng Review. Council and the Board of Trustees will review this issue again once the legal challenges are resolved.
