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Gold, incentives and meh

CCG to recruit physician associates from USA to address GP shortages

A CCG is spending £600,000 on bringing over ten US-trained physician associates to work in local GP practices, in a bid to address its recruitment crisis.

NHS Leicester City CCG said the move comes in response to the city’s shortage of GPs and because many of the current GPs are set to retire over the next few years.

The £600,000 investment will pay the salaries of the physician associates for the first three years, with individual practices to pick up costs themselves the next two years, the Leicester Mercury reported.

The CCG recently said it is considering abandoning its pilot scheme giving ‘golden hellos’ worth £20,000 to new GPs who agree to work in the city after it failed to attract enough candidates.

The associates are being recruited by Health Education England East Midlands and will receive training on the UK primary care system, the CCG said.

It comes after Health Education England announced it was to commission hundreds of new ‘physician associate’ roles to support GPs, as part of a £5bn plan for the coming year.

The CCG said the physician associates will not be able to prescribe but they ‘will be able to take on a substantial amount’ of clinical work now being done by GPs’.

CCG chair Professor Azhar Farooqi told Pulse the CCG decided on the groundbreaking move after realising that the workforce shortage problem ‘is not about to diminish’ due to impending retirements.

Professor Farooqi said the move to employ the assistants from the US was ‘purely because there are not sufficient physician associates in the UK’, where he said there are ‘only around 250 of them’, whereas from the US there ‘is a ready supply of these staff available to us’.

He said: ‘This will enable GPs to focus on patients that specifically require their particular skills. The physician associate role is also significantly cheaper than a GP, however this is not the primary consideration for us as commissioners; the prime benefit is in enabling us to fill a staffing gap quickly and effectively…

‘Taking into consideration the current demand levels for primary care, the shortage of GPs and the move to seven day working set out by the Government, we need to develop a new model of primary care and deliver differently in order to deliver better.’

But Dr Saqib Anwar, medical secretary of Leicestershire, Leicester and Rutland LMC, criticised the plans.

He said: ‘While I accept that physicians assistants could play some role in primary care in the future I think we need to look at this proposal with extreme caution.

‘There is no strong evidence to support their effectiveness in primary care and I remain unconvinced that recruiting a handful of from America and spending over half a million of NHS funding in the process is the best use of a finite NHS budget.’

Relieving GP workload via the recruitment of physician associates also forms part of a Government 10-point plan to resolve the GP workforce crisis.

The RCGP had lobbied the Government to pilot a new similar but different medical assistant role, although some GP leaders have argued that these GP assistant roleswill not work.

Londonwide LMCs chief executive Dr Michelle Drage argued on the Pulse website that physician associates will not be able to work in the UK system, and they will not be able to save practices time.

She said about the Leicester scheme: ‘NHS Leicester CCG needs to ask itself how a supposedly GP-led organisation can prioritise USA-styled solutions to USA problems over the blindingly obvious need to hold on to experienced GPs and nurses providing the style of service Leicester patients deserve.’

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Readers' comments (50)

  • The CCG said the physician associates will not be able to prescribe but they ‘will be able to take on a substantial amount’ of clinical work now being done by GPs’. What planet????? And I presume the CCG is run by GPs too....Please tell me which bit of clinical work I do, that doesn't at some point involve prescribing??

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  • Pure desperation . You can smell the fear from here .

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  • Vinci Ho

    Mmmmm
    Why America?
    'The physician associate role is also significantly cheaper than a GP, however this is not the primary consideration for us as commissioners; the prime benefit is in enabling us to fill a staffing gap quickly and effectively…'
    What is your understanding of this? Come on , folks, send in your comments.

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  • Long overdue.Hopefully PAs will form the bulk of primary care in a few years

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  • Can't help feeling that the £600 000, would have been better invested in the local practices and training, there is no guarantee these people will stay even if we can find them a role. They might be able to fill out insurance reports, screen blood results and manage letters but a lot of this work is unnecessary anyway and some practices are better than others at delegating back office work. It's only appropriate for doctors to manage clinical risk.

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  • The CCG in Leicester should first meet all the GP surgeries in their locality and find out why the existing partners are making it so difficult for GPs to join their practices. Why is there no such recruitment problem in the neighbouring CCGs of Leicester. They may as well scarp all the GMS and PMS contracts in Leicester and allow APMS providers to take over and then all this recruitment problems will automatically come to an end.

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  • Salaried GP @9:49 am- I am sure that GP Partners could take further partners if they could to lighten their own burdens. If you feel that they are causing a problem, I invite you to join me as a partner with a view to taking over the GMS Contract from 1st of April 2016 in historical Rochester. Check us out at www.marloweparkmedicalcentre.nhs.uk
    Will happily lease or sell the freehold if you can afford it.

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  • 600,000K for 10 PAs - that's 60,000/PA

    Not sure if this is over 3 years (the article seems to suggest so), so £20,000/PA/year

    Seems to be about the same as (ok, a little cheaper when you consider on costs) full time HCA. Can they do more then a decent HCA? Mine does everything from taking bloods, ECG, BP, 24 hour BP, Spirometry, lifestyle advice, urine dip, resus trolly check, stock cupboard and PPA claims.

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  • Salaried GP @9:49. The recruitment in Leicester City is really in crisis, mainly due to demographics of GPs and lack of appeal to many GP of working in inner city. However surrounding CCGs also in trouble. I know of several good surgeries in Leicestershire leafy suburbs with sensible partners who have had 0 applicants to recent job adverts.
    Leicester City is just the start. I don't think PAs are the answer but golden hellos haven't attracted anyone and in a few years there will be surgeries with no one left to see the patients. At least they are recognising this and trying something.

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  • £600k for 10 PAs for 3 years. Who would want to do such a shite job for £20k/yr??? And if what an actual PA said in another article is true, takes MORE work to be one than a nurse?! I would put a bet on now that NONE of them stay after 3 yrs, after experiencing the shite that it is

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  • I have learned not to prescribe based on other's assessment.
    Once you signed the script its your call its your responsibility.
    Desperate move but it will not be the answer.

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  • I suppose the GP who host the PA will provide indemnity cover. Do you think our MPS subscription will come down if we have PAs?

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  • Here it comes, here it comes
    Here it comes, here it comes
    Here comes your 19th nervous breakdown

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  • well they could probably do a lot of the pointless crap the Government makes us do liek NHS health checks, dementia screening, asthma reviews(although would need to advise to see doc if not well controlled). ie all the stuff that we pester patients about bbut not the stuff they come to see us about. This is already done by nurse practitioners and practice nurses but I guess PAs are cheaper. Someone suggested in another thread that PAs have science degrees then do 2 year course then hands on training in hospital. How can they be happy on 20 grand?? Perhaps the american ones dont do all that training. Anyway well see if they are useful but as suggested i wouldnt want to sign their scripts other than for repeat inhalers. I have trouble keeping up with what I need to know I just dont know how these people will do a good job and I wouldnt want my family to see one with an actual concern of illness

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  • I feel sorry for the poor sods that fall for this. 600,000 / 10 / 3 = 20k a year to work in Leicester. No thanks.

    They won't even be able to prescribe, so surely a good HCA could do the role.

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  • Why not treat the GP's we have with a bit more respect, perhaps then they wouldn't all be looking for early retirement!

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  • Hopefully they will be given a fair chance to do a good job

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  • I certainly wont be signing any prescriptions generated by an american assistant with no grasp of the UK medical system and prescribing guidelines without seeing the patient or making my own judgement! ie the time it takes for me to sort it on my own without their help........why not just pay GPs what they deserve: for a specialist trained professional with over 15yrs of medical training. Make it an attractive role to newly qualified doctors and stop the government and media berating us and guess what you wouldnt have a recruitment issue at all......what i would give for a 11% payrise Rt Hion Jeremy Hunt!?!?!

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  • Leicester is a small island in the middle of the Pacific Ocean, and hence this difficulty by its local surgeries to find doctors who are willing to work there.

    The local GP surgeries in Leicester should introspect as to why they are in such a pathetic situation regarding GP recruitment.

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  • I am a PA, I am a PA, I am a PA................sounds like ape, ape, ape
    Did you see the yout ube clip on i-diots use i-pids
    https://www.youtube.com/watch?v=NCwBkNgPZFQ

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