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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)

  • Anonymous | NHS Manager | 04 June 2015 8:22am

    At a risk of being denigrated.......

    Well you took the risk so here goes

    1. Suggestions to ease those pressures? Loads that have been suggested already. Maybe you haven't been reading anything else on this site. get rid of managers who accomplish f-all, like yourself, CQC,GMC, current contract, revalidation, etc.
    The suggestions about PAs? doesn't actually solve any of these other problems does it, its a bandaid for a bullet wound.
    2. Most GP Partners, can't take on any other partners cos a. Nobody is stupid enough to want to be a partner anymore, b. What profit??? they've all been siphoned away by politicians (10.8% pay rise), and managers like yourself and lawyers...

    You are right in 1 thing, our leaders (GPC/RCGP) do not represent us as they are interested only in their own self-interest and hence, are cuckolded, in terms of any action the profession can take. If the GPC were to strike tomorrow, or vote to leave the NHS en-masse, I would do so in a heartbeat.

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  • you can get gp's from india. pakistan. mymar. malyasia
    etc .they will do good job

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  • we should be more innovative ... according to current theory - we live in a multiverse, so there are an infinite number of earths out there with an infinite number of GPs. Surely NHSE can come up with a checklist requirement mandating all surgeries need to consider hiring GPs from parallel earths. Statistically on one of those planets GPs work 24/7 for free - just recruit from that planet!

    Don't get me started about cloning.

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  • I realise this is stating the obvious but I still get the impression some don't recognise this has been the plan all along - the government recognises, and encourages the GP workforce crisis. Ultimately they want fewer of us, supervising a cheaper workforce. In fact they probably just want a much smaller primary care, particularly as we are effective gatekeepers and barriers to a lot of unnecessary medicalisation which will feed a growing private sector

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  • I am a GP and my husband is an orthopaedic surgeon, when my son had acute tonsillitis, I had to take time off work to take him to the WIC, he was seen by a nurse who kindly prescribed abx for his very obvious infection.What a waste of time and resources.

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  • Just another example of the governments insidious attempts to gradually phase GPs out , they will be able to exert control and get GP's dancing on puppet strings . Enjoy.

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  • its is astounding at to how ANP's and Physicians assistants think they can do the the same or eqivalent job as we GP. Sorry , but they did not slog through and attain high A levels and then go through rigorous clinical exams and training for 5 years minimum . They cannot have the same clinical acumen and problem solving acumen of a trained GP.

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  • Absurd
    Far better for all the gps to leave that ccg and go back to the surgeries and in fact annihilate the demonic evil of the fantastic waste of the insane internal market utterly wasting five .. Probably more like ten billion a year.... Think of how much suffering this failed national political disgrace has caused by siphoning resources from desperately needed patient care
    We must smash this system as has New Zealand with great success
    Both parties have failed us all

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  • There are many more comments and some answers to these questions on the artice 'GPs shouldn't dismiss PAs'

    I am a PA and have tried to shed some more light on the role in the comments at the end of that article. It is nice to have a discussion about things but it would be nicer if we could all work together to help the NHS and general practice in any way we can

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  • Samuel Lewis

    We might win a Welsh NHS award for our Advanced Paramedic Practitioner in our rural GP practice. :-

    http://www.nhswalesawards.wales.nhs.uk/meet-the-2015-nhs-wa…

    "The appointment of an Advanced Paramedic Practitioner in a rural Pembrokeshire GP practice is enabling more patients to receive care and reducing waiting times for an appointment.
    Preseli GP practice, which has one surgery in Newport and one in Crymych, was struggling to cope with increasing pressures and workload on its staff.
    There were challenges in attracting locum cover due to the rurality of the area which made it difficult to provide cover for annual leave and sickness.
    Research had also shown that 23% of the current GP workforce in North Pembrokeshire and 22% of nurses within practices would be retired within the next five years.
    To relieve pressure and introduce a broader skill mix, Preseli practice decided to employ an Advanced Paramedic Practitioner to deal with emergency appointments within the surgery, home visits, minor injuries and patients with chronic diseases.
    Although patients took some time to understand the new role they have now embraced it and regularly make appointments with the paramedic practitioner.
    Evaluation in one month showed that the paramedic appointment saved 279 GP appointments and dealt with 269 telephone calls for advice.
    The new role ensures more patients are seen quickly and provides the practice with the expertise to deal with pressures that would otherwise be added to the busy workload of the GPs."

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