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NHS to recruit more physician associates

The Department of Health wants to rapidly expand the number of ‘physician associates’ in the NHS.

Physician associates are usually science graduates who complete two years of intense training, rather than full medical training, and are deployed to support doctors.

They can take a patient’s history, make a simple diagnosis or do an examination, but cannot prescribe drugs, order X-rays or work without doctor supervision. The Department of Health said physician associates enable doctors to spend more time with patients.

There are 200 currently working in the NHS, and there are currently 105 training places on courses in Aberdeen, Birmingham and London.

The government wants to see more recruits and the number of training places is to be doubled to 225.

Three further schemes will be set up in Plymouth, Wolverhampton and Worcester.

The Royal College of Physicians and the UK Association for Physician Associates welcomed the announcement from the Department of Health that there are to be more physicians associates in future, but believe that statutory regulation would allow PAs to make a more effective contribution to the health service and the health economy as well as offering better protection to the public.

The RCP and the UK Association of Physician Associates are currently setting up a new Faculty of Physician Associates, which would support and develop the role, including revalidation of PA courses, expanding the current programme of continuing professional development and managing recertification.

Once PAs qualify they retake their exam every six years to ensure they remain competent and undertake 40 hours of continuing professional development (CPD) each year.

Currently, the number of PAs in the UK has been limited due to lack of regulation for the profession, the UK Association of Physician Associates said, which it has been actively pushing for since they were established in 2005. At present there is a Managed Voluntary Register for PAs until statutory regulation can be achieved. The Register is there to protect the public and employers, it said.

A spokesperson said: “PAs offer the NHS a flexible workforce and are people who want to make a difference in the NHS to improve patient care. As a profession we offer continuity of care and are not replacements for doctors, in fact we are supporting doctors not only in the care of patients and the hospital, but also in their own development and learning. There is an expanding patient population and the NHS needs to be creative about how it is going to continue to deliver high quality care.

“The majority of PAs are not previous nurses, they are new to the NHS and help deliver high quality care to a growing population with increasing health care needs.”

Some are concerned that physician associates will be used as a cheap alternative to junior doctors, rather than as a complement.

Dr Mark Porter, chair of council of the BMA, said: “Physician assistants can be a valued part of the NHS and, as long as the scope of what they do is clear, they can provide an intermediate level of care and help reduce workload pressures.

“Only doctors can provide certain types of care so the government needs to ensure that standards won’t be affected by these changes.”

A spokesperson for the Department of Health said: “There are already physician associates in the NHS, supporting busy doctors to spend more time with patients, not replace them.

“They can carry out clearly defined duties, but have to be under strict supervision of a doctor at all times.

“Many physician associates will already be trained physiotherapists, nurses or paramedics, and will have two years of intensive training on top of that.”

In the US, there are more than 80,000 physician associates.

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