1. Physician Associates in Primary Care
Dr Tariq Khan

2. Aims & Objectives
To set out the case for Physician Associates in Primary Care
To briefly outline the PA Education and Training Programme
To discuss how PA’s work
To discuss the benefits of PA’s working in Primary Care
To discuss some of the perceived barriers to PA’s working in Primary Care

3. Context of Primary Care
Predicted shortfall of 275 GPs in East London in the next 5 years
“Demographic cliff” – early retirement and inability to retain our trainees

4. What is a Physician Associate?
‘…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’
(Department of Health, 2012 )

5. What is a Physician Associate?
288 physician associates in the UK working throughout the NHS currently
1,210 current physician associate students in the UK

6. How Do PA’s Work?
To the same medical model and ‘credentials’ to practice medicine with clinical supervision (GP/Consultant)
Within the scope of practice of their supervisor
As dependent practitioners
In a relationship between doctor and PA which is based on mutual trust and respect

7. PA Education Postgraduate course Healthcare experience
Motivated, mature students

8. What do PA’s do in Primary Care?
Is there a role for PA’s in your practice?
What are the potential benefits?

9. What do PA’s do in Primary Care?
Same day bookable appointments
Pre-bookable appointments
Telephone consultations
Requests for investigations/correspondence
Referrals for non-elective and elective cases
Home visits
Support nursing and residential home residents
Chronic disease management
Collaborative care co-ordination role

10. What do PA’s do in Primary Care?
Support the achievement of QOF
Contribution to clinical education meetings
Teach – medical, nursing and healthcare students.
Help with the achievement of Enhanced Services e.g. INRs, coil clinics, minor surgery
Take responsibility for audits
Notes summarisation

11. Benefits of PA Local workforce modelling for local needs
Recruitment & retention from the local population
Motivated, mature students
Working to a medical model – generalists capable of being moulded according to the needs of Primary care

12. Perceived Barriers
What are some of the barriers or concerns that you can envisage about the role of PA’s in Primary Care?

13. Perceived Barriers
Unregulated profession – there is however a managed Voluntary Register
Cannot prescribe – once the profession is regulated this may be rectified
Unable to request ionising radiation
Indemnity
Concerns about the training – new course and new professional role for the UK

14. Supervision
What is the role of the GP tutor in PA Education and Supervision?

15. Supervision Creating a bespoke service with a fellow generalist
Supporting career development and continuing education
Enhancing the role of the GP as a Co-ordinator of Care rather than purely a deliverer of care

16. How can you get involved?
Sign up your Practice to place QMUL PA students
Sign up to supervise a 4 week SSC – next opportunity in November 2017
Attend the Tutor Training Day September 2017

17. Conclusion
GP practices in London are effectively using them to support access and their numbers are growing and will continue to grow given the expansion of training programmes
Physician Associates not the only answer but it could be part of the solution

18. References
Alberti, H., Randles, H,, Harding, A., McKinley, R. (2017). Exposure of undergraduates to authentic GP teaching and subsequent entry to GP training: a quantitative study of UK medical schools. British Journal of General Practice, e248-e252 British Medical Association. (2016). Physician associates in the UK. London: British Medical Association.