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Developing the Role of the Physician Associate

News and presentations from today's conference chaired by Dr Neil Jenkins Executive Director, The National Physician Associate Expansion Programme. Focusing on developing the role of the Physician Associate in practice, how the demonstrated benefits of the role can support you and your service and improve patient care. 

Dr Natalie King Consultant Physician & Physician Associate Tutor Surrey & Sussex Healthcare NHS Trust opened the day and looked at: ‘Clinical Supervision: the Physician’s Perspective, focusing on:

  • the physician’s role: working in partnership with Physician Associates 
  • challenges and successes in clinical supervision 
  • variations on the role in practice 
  • moving forward and our experience in Surrey and Sussex 

Click here to see Natalie's full presentation

In her presentation Natalie stated: 

"Relationship is key. The Level of supervision – frequent reviews and appraisals, reducing over years as experience/knowledge increases."

"Roles in secondary care – ward rounds, new patient assessment, medical procedures, referrals, discharge coordination, MDT meetings, family liaison, patient counselling, out patient clinics, first assisting in theatre, minor procedures, audit and QI, teaching and training."

"Extended skills – allow PA development, let them become the trainers.  Can enhance junior doctor training.  Use a competency framework – chest drains, LP, ascetic drain."

"Funding – write a business case does it solve funding issues e.g. locum spend reduction, time release/improving training feedback, quality and LOS reduction by efficient working."

"Job Plan – Mon to Fri 37.5 hours AfC band 7 – continuity needed in these roles.  Mix of clinical duties, vary it to make it interesting and this will help with staff retention.  Time for PDP, access to additional training, audit/QI, Map to supervisors job plan."

"What makes an attractive post?  Variation, giving additional skills, opportunities to teach, supportive consultant supervision, appraisal, pdp, study budget, access to study leave."

"Advertising and recruitment – NHS jobs, recruitment events, try and avoid offering tie ins as if they decide they don’t want to be a pa longer term you get into difficulties.  Recognised pa course (accreditation), MVR members, indemnity is covered by NHS but could ask for them to also have their own personal indemnity which trust may pay for."

"In all the areas where there was feedback about strain/stress, they have added PA’s at E Surrey hosp."

"Introducing them – positive PR work to alleviate concerns about why they are being introduced.  Have peer support via a PA team structure."

"The Good – continuity, logistics, bridge workforce gaps, develop relationships with supervising consultants"

"The Bad – lack of knowledge from new rotating staff, perception of competition, can become too specialized, poor supervision arrangement"

"The Ugly – lack of knowledge, negative social media comments, demand outstripping supply, differing incentives to train, negative social media, misperceptions and misunderstanding"

"Kent School of PA’s – launched April 2016, oversee quality assure placements, provide support and guidance for post qualification development and employment."

Jeannie Watkins President Elect The Faculty of Physician Associates Physician Associate & Director for Regulation and Legislation Faculty of Physician Associates at the Royal College of Physicians continued the morning by discussing 'Developing the role of the Physician Associate?', covering

  • the Physician Associate role and duties 
  • how can the Physician Associate benefit your workforce and improve patient care? 
  • accountability of the Physician Associate 
  • supporting the Physician Associate in their roles 
  • national developments 

Click here to see Jeannie's full presentation

In her presentation Jeannie stated: 

"What is a PA? A healthcare professional trained in medicine specifically as a PA who works as part of a medical team in partnership with doctors to provide medical care to patients."

"Benefits and Impact:  building capacity, expanding skill mix, redistributing physician workload, defined profession to expand midlevel staff without depleting current roles, help meet demand for increased qulity of care, consistency of care and team stability."

"Supporting the PA - recruitment (get the right person, prepare the workforce)."

"Retention – there’s not a great deal of career progression, flat structure, but obviously remuneration should reflect levels of experience.  A clear job plan, sufficient time, clear lines of supervision, champions/lead."

"Regulation – PA regulatory framework should be finalised by New Year."

"How many PA’s currently work in UK?  350 currently."

"How many PA programmes? 25"

"How many PA students? 902"

"Prediction for 2020 3,000 qualified PA’s working in UK which is brilliant"

"Faculty of PA’s – enabling and empowering others, professional standards, exams, accreditation, competency framework, education, CPD, R&D"

"Challenges for PA’s – regulation, patient and public engagement and involvement, raising profile, supporting PA’s, employers & supervisors"

"Future – established, recognized, valued, sustainable.  People will know what to do with them, how to use them etc.  Significant numbers of programmes, qualified PA’s and those in training.  Achieved regulation.  Continue to deliver service and support medical workforce in provision of excellent patient care."

Chair Nick Jenkins concludes the morning sessions with an update on the The National Physician Associate Expansion Programme (NPAEP).  NPAEP is a specialist NHS transformation programme that has been created in order to expand the numbers of Physician Associates working in the NHS. His presentation covers:

  • how do we expand the numbers of Physician Associates working in the NHS 
  • demonstrating the benefits of the role 
  • supporting Higher Education Institutions to expand delivery of Physician Associates training programmes in order to meet the needs of their local health communities 
  • post qualification competency development and monitoring 
  • the role of the Physician Associates in Hillingdon Hospitals 

Click here for Nick Jenkins full presentation

In his presentation Nick stated: 

"PA’s are the answer to many problems including funding, resourcing. But not a miracle cure."

"They have already proven their worth – next challenge to accommodate the 1000 students per year by 2020 meaningfully into the workforce to fill the gaps we have identified."

"One Trust recruited a group of US trained PA’s"

"Interested trusts grouped in regional clusters with supportive LETB’s to receive NPAEP PA’s"

"Will it work? 

  • Programme employe full time director with PA & medical support – had board level support/buy in
  • Programme worked with host trusts before recruitment to establish number and speciality of PA’s required
  • Trusts trained in best use of PA’s
  • Contract includes hours, leave, training, outline of duties, etc"

"Challenges – its going to take time, this is difficult for people to appreciate the benefit of PA’s until they reach critical mass."

"Summary – PA’s offer chance to diversify and strengthen our teams with long term staff under consultant/gp leadership."

"American PA’s offer a ready trained, immediately deployable solution whilst we train our own."

"Evaluation will identify how best to support large scale deployment of PA’s to offer best value and chance of success."

Future conferences of interest:

Effective Clinical Director Training Course
Friday 3 March 2017 
De Vere West One Conference Centre, London

Consultant Job Planning
Friday 10 March 2017 
De Vere W1 Conference Centre, London

9 December 2016


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