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New contract 'neglects' CHD primary prevention

American-style physician assistants need to have the same prescribing rights as GPs if they are to function properly,

a Government-commissioned study concludes.

The research into a pilot in the West Midlands found physician assistants hired from the USA to work at practices in under-doctored areas were effectively filling in for GPs, but were 'impeded' by their inability to prescribe.

Physician assistants in the USA receive two years training. They handle routine cases and examinations and in most states are allowed to prescribe.

Ministers are keen to roll out the new posts to help ease the GP jobs crisis and gave the go-ahead in February for an honours-level course to train assistants in the UK.

North-east and south-west London strategic health authorities have also begun trials of the scheme, with Waltham Forest PCT planning to hire three physician assistants to work in GP surgeries.

But assistants recruited from the USA and those trained here are able only to diagnose illness, not prescribe.

Study author Dr Juliet Woodin, senior fellow at the Health Services Management Centre at the University of Birmingham, said interim findings showed it was 'inherently inefficient' for assistants to have to interrupt a GP to get a script.

'In the US their training equips them to prescribe in most states. In the NHS they cannot practise in this way and this is clearly an impediment,' Dr Woodin said.

'It's for the regulatory bodies to determine when and how physician assistants could prescribe in this country.'

The study also found physician assistants ­ also known as physician practitioners ­ were well-received by GPs, practice staff and patients.

Dr Ian Walton, a GP in Tipton and chair of the Tipton Care Organisation, which launched the scheme with a local practice, said there were 50,000 physician assistants in America and the model had been 'tried and tested'.

'US primary medical care centres that have them have lower litigation rates than those that do not,' he said.

But Dr Peter Fellows, chair of the GPC prescribing sub-committee, said physician assistants were not doctors and should not have full prescribing powers. He suggested they could use the extended nurse formulary. 'I think the public needs the reassurance of full medical training if people are going to be given full prescribing rights,' he said.

Who are physician assistants?

·Have a science background or medical sciences undergraduate degree

·Undergo two years' intensive postgraduate medical training

·Can diagnose and treat illness, look after mental health problems and order and interpret laboratory tests

·Also draw up patient plans for managing chronic diseases and may do some minor surgery procedures, either supervised or unsupervised

By Nerys Hairon

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