Physicians’ Assistant (Anaesthesia) (PA(A)s) were introduced in 2004 and are now established within many NHS hospitals. In July 2019 PA(A)s formally changed their name to Anaesthesia Associates (AAs), recognising their role within the anaesthesia team and also within medical associate professions.
Who are Anaesthesia Associates?
Anaesthesia Associates are highly trained, skilled practitioners that work in an anaesthetic team under the direction and supervision of a Consultant Anaesthetist. AAs have completed a Physician Associate Studies Diploma. Please note the RCoA and AAGBI position statements below.
What do AAs do?
The postgraduate diploma prepares and trains AAs in all aspects of general anaesthesia delivery. Some organisations have trained AAs to perform regional and local anaesthesia procedures.
Typically AAs work in a 2:1 model where there is one consultant anaesthetists supervising two AAs or a trainee anaesthetist and a AA simultaneously in two operating theatres (see the AA curriculum framework below). AAs may also be used to reduce operating theatre downtime leading to increased throughput on operating lists and theatre utilisation, preoperative assessment, provision of sedation, cardiac arrest teams, and for a range of other perioperative and non-perioperative roles consistent with their scope of practice at qualification.
Training and Careers
AAs are qualified healthcare practitioners who are currently voluntarily registered with the Association of Anaesthesia Associates and are invited to be Affiliate Members of the Royal College of Anaesthetists. A career as an AA can begin via two routes. The main groups of people eligible to commence training as an AA are:
- Registered healthcare professionals (examples are nurses or operating department practitioners) with at least three years clinical experience and/or degree level studies,
- Graduates with a biomedical science or biological science 2:1 honours degree or better.
Introduction of the role and AA training requires the support of individual NHS trusts or boards.
The AA postgraduate diploma is a 27 month full time course combining academic study and clinical training. The course comprises 12 modules which introduce trainee AAs to the clinical practice of anaesthesia, applied physics, the anaesthetic machine and monitoring principles. In later modules trainees study anatomy and physiology related to anaesthesia and surgery. The final assessments are based on the management of life-threatening emergencies and advanced practice. Nationally recognised examinations take place at eight and 24 months. The standards of training are high and demanding on the individual.
Anaesthesia associates pathway
Training and Education
This programme is intended for existing health care practitioners or graduates with a science background who wish to work as part of the anaesthetic team. The programme will develop a practitioner role that enables the anaesthesia team to have more staff working differently.
University of Birmingham
AAs are fully trained practitioners that have completed a Physicians Associate Studies Diploma. The diploma is studied over 24 months with an additional three months probationary period served in clinical practice. The course comprises 12 modules which introduce trainee AAs to the clinical practice of anaesthesia, applied physics, the anaesthetic machine, and monitoring principles. In later modules trainees study anatomy and physiology related to anaesthesia and surgery. The final assessments are based on the management of life-threatening emergencies and advanced practice. Weekly teaching and tutorials are delivered bya Consultant Anaesthetist through the university e-learning interface. A typical week may consist of 1/2-hour tutorial, two to four days in the clinical practice and the rest involving clinical skills training and self-directed study. The standards of training are high and demanding on trainee AAs. The RCoA has duties to set the standards of the training programme which are high and demanding on the individual.
More details can be found at Birmingham University Website
Assessment and Examination
Successful graduation requires passing assessments at eight and 24 months that consists of MCQ exams, Clinical skills Workbook completion, Record of In Training Experience Diary, Tutor Assessments and at 24 months the Objective Structured Clinical Examination (OSCE) that takes place at the Royal College of Anaesthetists. Only after this are practitioners awarded the status of Anaesthesia Associate and are invited to become an Affiliate of the Royal College of Anaesthetists. AAs are encouraged to join a voluntary register held by the Royal College of Anaesthetists.