What can Physician Associates (PAs) do in primary care?
PAs undertake postgraduate generalist medical training in an intensive 2 year university course, usually having already completed an undergraduate biomedical or healthcare related degree. PA training will typically cover placements in primary and secondary care (including medicine, surgery, emergency care, mental health, obs and gynae and paeds).
Roles they might cover include:
- History taking and examination
- Telephone triage
- Home visits
- Minor surgery (where appropriately trained and a GP with appropriate training is also in the building)
- Make referrals
- Order investigations (although not investigations requiring ionising radiation currently) and review and file lab results
- With appropriate further training could offer long-term condition/specialised clinics
- Support with teaching and supervision of students
- Issue sick notes and prescriptions, but not yet sign (these will need signing by a GP or other independent/non-medical prescriber)
- Complete reports with final sign-off from a GP
Further information about the role:
- A day in the life of a PA in general practice:
- Case study: NHS England » The physician associate will see you now – new role to assist patients in primary care
- Podcasts from James Catton, a qualified and experienced PA, including podcasts on topics such as the supervision of PAs in primary care. The Physician Associate Podcast on Apple Podcasts
- You’ll find a link to download an Employers guide on the right-hand side of this page.
Training
As above PAs complete a 2-year, full-time, intensive postgraduate course in Physician Associate studies, which includes over 1400 hours of clinical placement experience across acute and community settings. Please see the employers guide from the Faculty of PAs on the right of the page. The faculty also advise:
”We strongly recommend that employers only consider recruiting physician associates who are registered on the Physician Associate Managed Voluntary Register (PAMVR) . This is a register, managed by the FPA, of fully qualified physician associates who have been declared fit to practise in the UK. It enables supervisors and employers to check whether a physician associate is qualified and safe to work in the UK. American trained physician associates are required to have and maintain their National Commissions on Certification of Physician Associates (NCCPA) to work in the UK, and should also be a member of the FPA and listed on the PAMVR.
Because physician associates await statutory regulation, employers are strongly advised to be diligent in their recruitment process. Any job description advertising for the role must state that it is essential for applicants to hold a PG Diploma or MSc in Physician Associate Studies from a recognised UK or US programme, and that they have passed the UK Physician Associate National Exam. American trained Physician Associates would be required to have and maintain their National Commissions on Certification of Physician Associates (NCCPA) to work in the UK and should also be listed on the PA-MVR.
Please note that national exam results can take up to six weeks to be released. PA students who have passed the PA national exam will then need to apply for FPA membership to be added to the PA MVR. Employers should consider this when setting PA employment start dates.”
Once qualified PAs must maintain 50hrs of CPD per year and sit a recertification examination every 6 years. CPD should be recorded in the Royal College of Physicians CPD diary. Some PAs may choose to utilise appraisal platforms to provide further reflection on learning, in addition to the RCP CPD diary.
Supervision
A clinical supervisor is required to support a PA. The faculty of Physician Associates suggests supervision of a qualified PA is comparable to that of a doctor in training. Clinical supervision incorporates the need for supporting ongoing development including appraisal and PDP. For newly qualified PAs there is the option of PA preceptorship, with full details including funding on the right of this page. The preceptorship program lays out additional supervision to support newly qualified PAs.
Update August 2023- a new Core Capabilities Framework has been developed which sets a standard, and offers the opportunity to develop and evidence knowledge and skills. This framework also sets out clear expectations for supervision at the different tiers of practice. The Core Capabilities Framework for Medical Associate Professions
GMC guidance on PA supervision: Supervision of physician associates and anaesthesia associates – GMC.
Funded PA Preceptorships
NHSE WTE (Workforce, Training and Education—used to be HEE) offers a £5,000 preceptorship allowance paid to employers to support the supervision and educational needs of newly qualified physician associates working in primary care.
The preceptorship guidance can be found at: https://www.hee.nhs.uk/our-work/physician-associates, which outlines eligibility, criteria and regional contact details. Mentorship guidance for PAs undergoing the funded preceptorship can also be found at the above link.
Requests for PA preceptorship funding can be made to england.regionaltraininghubs.sw@nhs.net and please copy the training hub in on glicb.pcwc@nhs.net.
PA apprenticeships
There is now an option to employ PA apprenticeships under the ARRs funding. Please note that PA apprenticeships still need to follow the mandated hours across different specialities, including secondary care. This means a PA in training will not spend all their time in primary care. The pathway below details the steps to employ a PA apprenticeship in primary care.
A quick guide can be found on the right of the page.
Induction
There is a link on the right-hand side of this page to download an induction timetable which can be amended to suit the needs of your practice/PCN.
Peer support group– a group is being established so PA peers can connect with one another. Please do contact glicb.pcwc@nhs.net if you would like to be added.
Recruitment
Please find links on the right-hand side of this page to download a Job description and person specification template.
Physician Associate Ambassador for Primary Care in the South West
My name is Chris Gentry (christopher.gentry@nhs.net) and I am excited to introduce myself as the new Physician Associate Ambassador for Primary Care in the South West of England.
As an ambassador I will be focusing on several key areas:
- Workforce Engagement: Advocating for the Physician Associate (PA) role within primary care settings and representing our workforce, ensuring that our voices are heard and our contributions recognized.
- Supporting Qualified PAs: Providing resources and guidance for current PA’s as they navigate their career paths and professional development opportunities in primary care.
- University Engagement: Building strong partnerships withlocal universities to provide guidance and support for students interested in pursuing a career in primary care.
- Creating Job Opportunities: Working to identify and develop new job placements for PAs, ensuring that there are ample opportunities for students and newly qualified professionals.
- Encouraging Preceptorship: Promoting preceptorship opportunities that facilitate the transition from education to practice, enhancing the competency and confidence of our new PAs.