quote HEE facebook linkedin twitter bracketDetail search file-download keyboard-arrow-down keyboard-arrow-right close event-note

You are here

Impact Case Studies

Project Summary 

About this project

Health Education England (HEE) are undertaking work in the National Medical Associate Professions (MAP) programme to review the workforce transformational development of Physician Associate (PA) and Anaesthesia Associate (AA) roles within the NHS workforce. This includes the research and evaluation of their impact to inform NHS Long Term Workforce Plan development.

The aim of this project was to qualitatively evaluate the impact of PA and AA roles within the system. Yorkshire & Humber Academic Health Science Network (YHAHSN) were commissioned to design, develop and deliver the research approach, and present the findings in the form of case studies.


Data collection for this project consisted of semi-structured 1-1 research interviews, designed to gather qualitative data on the perceived value of PA and AA roles, how the roles are utilised within organisations, and to identify what impacts these roles are having on teams, clinical services, PA/AA employers, the wider organisation, and patients.

The target study population were:

a) individuals working in established or senior roles as a PA or an AA

b) individuals responsible for employing, managing or leading a team/service including PA or AA and with appropriate knowledge/oversight/decision-making regarding PA or AA.  

Invitations to participate were distributed via email, social media and other HEE and NHSE regional communication channels aimed at the target audience. Minimum sample thresholds  were set to ensure that appropriate numbers of PAs and AAs and their employers, across different sectors (PA only) and geographical regions, were recruited.

Thirty-six (36) research participants were recruited for this project, comprising the following:

a) 4 AAs and 8 AA employers from 8 NHS organisations across 5 NHS England regions (North West, North East, Midlands, London, South East)

b) 3 PAs and 9 PA employers from 11 NHS primary care organisations across 4 NHS England regions (North West, North East, Midlands, South East)

c) 4 PAs and 8 PA employers from 10 NHS secondary care organisations across 5 NHS England regions (North West, North East, Midlands, London, South East)


The resulting case studies illustrate the value and potential of the PA and AA roles as members of a multidisciplinary medical team. Key challenges and priority areas for development are also highlighted which, if addressed, will enable organisations, teams and services to increase the positive impact of these roles.


A notable limitation of this study is the potential for self-selection bias within the data, whereby only individuals who already perceive or experience a positive impact of PA and AA in the system volunteered to be part of the study. An additional limitation is that those who don’t currently employ AAs or PAs did not receive invitation to participate. Since a potential reason for not employing AA/PAs may be that they are perceived as having little or no impact, not interviewing these people may have introduced some positive bias into the data set.

How to Use

These case studies represent the first large-scale qualitative study of impact undertaken at a national level, and will therefore be of interest to a range of individuals, groups, and organisations. Interested parties will include patients and the public, service commissioners, employers, and current and future PAs and AAs who are seeking to increase awareness and understanding of the PA and AA roles; how they are utilised as part of a multidisciplinary team and currently working in services.