BMJ Warns Against Replacing NHS Resident Doctors with Physician Associates

Leading medical journal argues that substituting resident doctors with physician associates offers no benefits and poses significant risks to patient care across the NHS.

The British Medical Journal has published a stark warning against government plans to replace resident doctors with physician associates, arguing the policy will “achieve nothing and threaten everything” in NHS patient care. The article, published on 24 April 2026, advocates for collective solutions rather than top-down government impositions amid ongoing disputes over NHS staffing.

The Training Gap

Physician associates undergo a two-year postgraduate training programme, according to the General Medical Council. This stands in sharp contrast to the decade-plus training required for fully qualified doctors. Yet government plans aim to train 10,000 more physician associates by 2031-32 under the NHS Long Term Workforce Plan.

The BMJ article quotes BMA council chair David Wrigley, who criticised government plans to expand physician associate roles as a replacement for junior doctors. This criticism comes as junior doctors continue their industrial dispute with the government over pay and conditions, with no full pay restoration agreed as of April 2026.

Current NHS Staffing Crisis

NHS England data shows junior doctor vacancy rates reached 11.4% across England in the final quarter of 2025. Just 670 physician associates were registered in England as of March 2026 – a fraction of the workforce needed to fill existing gaps.

The government maintains that physician associates represent a safe, cost-effective way to expand the workforce and reduce doctor workloads without replacing them. But the BMA and BMJ argue that expanding PA roles without proper regulation risks misdiagnosis and undermines junior doctor training pathways.

For their part, the Royal College of Physicians supports regulated PA roles but warns against unsupervised practice or direct substitution for doctors.

Kent Faces Similar Pressures

NHS Kent and Medway ICB faces comparable staffing shortages, with physician associates already working at Kent and Canterbury Hospital and Medway Maritime Hospital. Kent hospitals reported 15% vacancy rates for junior doctors in the fourth quarter of 2025, contributing to A&E waiting times that averaged 4.2 hours in Medway.

Recent strikes by junior doctors between 2023-2025 have affected local services, with the latest ballot closing in March 2026.

Key Takeaways

• BMJ warns replacing resident doctors with physician associates threatens patient safety
• Government plans 10,000 more physician associates by 2031-32 amid ongoing junior doctor disputes
• Kent hospitals face 15% junior doctor vacancy rates with existing PA deployment

What This Means for Kent Residents

Kent residents should be aware that ongoing staffing disputes may continue to affect local NHS services, chiefly in A&E departments where waiting times remain elevated. The debate over physician associates versus junior doctors could influence the quality and availability of care at Kent and Canterbury Hospital and Medway Maritime Hospital. For non-emergency health concerns, residents are advised to use NHS 111 first, while emergency situations should always warrant a 999 call – this helps ensure appropriate use of stretched hospital resources during workforce transitions.