Physician Associates NOTE: this presentation has audio accompaniment; just remove this or put to silent if this is not wanted.

Outline History of profession Education across country USA and UK Education across country Competence and curriculum framework Assessment Regulation / Registration RCP (London) & PA Faculty What do PAs do? A day in the life (HE WestMidlands): https://youtu.be/KnMyYRJrdCE

A Physician ‘Assistant’ is…… “a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and /or general practice team under defined levels of supervision.” (The Competence and Curriculum Framework for the Physician Assistant, Dept. of Health, 2006; revised 2012)

Or more inclusive… Physician associates (PAs) are healthcare professionals with a generalist medical education, who work alongside doctors, physicians, GPs and surgeons providing medical care as an integral part of the multidisciplinary team. Physician associates are dependent practitioners working with a dedicated supervisor, but are able to work autonomously with appropriate support. (Faculty of PAs at RCP)

USA 50 years >120, 000 PAs certified 1PA:9 MDs qualifying Canada Australia England & Wales USA 50 years >120, 000 PAs certified 1PA:9 MDs qualifying Canada Scotland & NI South Africa Netherlands Taiwan NZ &&&

Competencies Procedural Skills Matrix of Conditions DH specification for PA education Competence and Curriculum Framework 2006 revised 2012 Competencies Procedural Skills Matrix of Conditions Programme Specification ~ 3200 hours over 2 yrs ~ 50% clinical (incl. 200 simulation hours) ~ 50% theory http://www.ukapa.co.uk/files/CCF-27-03-12-for-PAMVR.pdf

Funding PGDip, F/T, 50+ hours per week No student loans (yet) From Jan 2018: 2.5k per student per year Some local support: Bursaries (local HE support) Trusts e.g Plymouth ’CCGs’ e.g. Powys

How did we get to here?

Projected number of PA graduates in UK as at 28/9/15

Physician Associate (UK)

Faculty of Physician Associates Royal College of Physicians UKAPA professional organisation FPA@RCP established 1/7/15 Combining ‘college’ & profession & ‘regulation’ & assessment & accreditation Other royal colleges (RCPRCS, RCGP, RCEM, RCPaeds) involved http://www.fparcp.co.uk/

Assessment National (MCQ & OSCE) Currently run by Faculty of PAs at RCP (London) RECERTIFICATION 6-YEARLY (MCQ only)

Regulation & Registration Not statutory ~85% of PAs ARE on Managed Voluntary Register (at FPARCP) = approx. 580 HCPC willing to regulate GMC: ‘we do believe that physician associates should be subject to statutory regulation’ ‘We would give the matter serious consideration if the four governments of the UK and the profession felt we should take on this role’

Public consultation on regulation of MAPs Closed December 22nd MAJOR progress High response rate Results next month

What do PAs do? Acute Medicine Cardiology Care of the Elderly / Geriatrics Dermatology Endocrinology Gastroenterology General Internal Medicine Genitourinary Medicine / Sexual Health Haematology Infectious Diseases Lymphoedema Nephrology Neurology Psychiatry Rehabilitation Medicine Respiratory Medicine Breast surgery Maxillofacial Surgery Colorectal Surgery Neurosurgery Orthopaedic Surgery Otolaryngology Paediatric Surgery Plastic Surgery Spinal Surgery Trauma and Orthopaedics Urology Vascular Surgery Paediatric Critical Care General Paediatrics http://www.fparcp.co.uk/about-fpa/fpa-census Drennan et al. Primary and secondary care publications

Recent reports/publicity RCEM RCP Future Hospital Commission GP Forward view Etc. Jeremy Hunt Times Guardian TorygraphBBC/ITV/radio ++ Sky news

Conclusion Significant growth of PA courses Newly qualified PAs will still be beginners BUT Can make a substantial contribution to continuity for - patients & - health care teams A very realistic option FOR BIOSCIENCE AND HEALTH SCIENCE GRADS AND THOSE WITH HEALTH CARE/LIFE EXPERIENCE

James Ennis University of Birmingham June 2018 j.ennis@bham.ac.uk Contact Details James Ennis University of Birmingham June 2018 j.ennis@bham.ac.uk