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Independents' Day

Hundreds of physician assistants to support GPs in £5bn plan

Health education bosses have commissioned hundreds of new ‘physician assistants’ roles to support GPs, as part of a £5bn plan for the coming year.

Health Education England’s Workforce Plan for England reveals that it wants to expand the number of full-time equivalent GPs by 15% by 2020, and train up 15% more GPs next year.

It also said it expects co-commissioning to alleviate the current crisis in GP recruitment, and that commissioners will have to consider more recruitment from overseas to support NHS England’s plans for primary care.

The plan comes after Pulse revealed this year that there were huge recruitment problems in GP training, with some areas undersubscribed by as much as 40%, necessitating an unprecedented third round of recruitment.

The document, approved today, reveals that HEE will commission 205 physician assistant training posts, representing a 754% increase on last year.

It says: ‘Physician assistants are trained to perform a number of duties, including taking medical histories, performing examinations, diagnosing illnesses, analysing test results and developing management plans.

‘So by 2017, we expect to see real improvements in patient care, particularly in emergency care, general adult medicine and general practice.’

This follows moves by the RCGP to petition ministers to fund new ‘medical assistants’ roles, which the college said would see GPs gaining ‘valuable support’ in the timeframe of just a quarter of a year.

HEE said: ‘Sometimes, transformation can be achieved through encouraging commissioners and employers to create jobs for staff in different locations – such as increasing community-based nursing.

‘But increasingly, we will need to invest in entirely new roles and professions, such as physicians assistants, to help deliver more holistic care across different teams and settings.’

It also said it would commission 108 ‘broad based training pilots’ for doctors, representing a 50% increase on last year, to provide a more flexible workforce with general skills.

The document also revealed:

  • Plans to increase the number of GPs available for employment by 15% by 2020
  • Plans to train 3,100 trainees in 2015 – an increase on 2,688 this year
  • Following the publication of NHS England’s five-year view, it said further work led by Professor Martin Roland now needs to be done to see how many more GPs need to be trained to help run the new models of care, such as multi-specialty care providers and Primary and Acute Care Systems
  • HEE has been working closely with the RCGP on attracting medical graduates to become GPs

Explaining the new roles, HEE said: ‘Physician assistant training lasts two years, and although it involves many aspects of an undergraduate or post-graduate medical degree, it focuses principally on general adult medicine in hospital and general practice, rather than specialty care.

‘However, at two years, the training is much shorter than a qualified doctor who would typically take around 10 years to train as a GP (including medical school) and 14 years to train as a surgeon.’

HEE added that commissioners would need to look at overseas recruitment to solve the current recruitment crisis.

It said: ‘If partners require the GP workforce to grow more quickly than is achievable through newly trained supply, or at a greater scale, then they would have to consider alternate sources of supply such as retention schemes, more return to practice than is currently planned, and international recruitment of qualified GPs.’

Readers' comments (76)

  • How about stopping the leakage first.....or is this change in workforce what was planned all along?

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  • They are called nurse practitioners - we've had the for years but they are not GPs and never will be.

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  • Have they looked into who will provide indemnity cover for these people.

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  • The Nurse Practitioners cost OOH £50/hr and GP`s £65/hr and the problem is they see at half the speed and are protocol driven and refer more.
    The cost to OOH is almost same or slightly more expensive than GP`s -who are now scarer on the ground than unicorn.
    Some OOH have replaced Gp`s with ANP`s and no wonder the A&E referrals are skyrocketting.
    I would be one of the few GP`s who would think that they have a place in a well organised skill mix but just adding them randomly to the mix of skils available would cause more chaos.
    Soon A&E wil employ GP`sd to screen out the referrals from 111 and ANP`s and physician assistants.
    Seems the Health Education England is running into diaster three times in a row- MTAS, sub-consultant grade and now this.
    maybe they would be for the uninsured while those with Insurance will see "real doctors"

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  • PAs have no GMC equivalent at the moment.
    PAs would need their own insurance.

    The sentence "focuses principally on general adult medicine in hospital and general practice, rather than specialty care"

    Is contradictory - GP is not Gen Adult Medicine - what happens to the surgical patients, the children, obstetrics and gybae and psych?

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  • There are many reasons why GPs are jaded at present, but we do ourselves no favours with knee-jerk, uninformed negativity. Physician Associates (as they are now called are NOT the same as Nurse Practitioners. If you are interested to find out what PAs are and how they could help us google 'Physician Assistants' and read Prof Jim Parle's 2012 paper. Our legal colleagues have been emplying Paralegals for decades and they do an excellent job!

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  • I think at least some of the negativity stems from this being only the latest in a long list of things imposed by non-GPs without consultation, diverting funding away from general practice and potentially wasting it in untried politically inspired ideas.

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  • Took Early Retirement

    I think it works in the USA, sort of, but having, what? 700 odd will not fill the gap in GP manpower caused by emigration, early retirement, the age 55+ bulge, and the feminization of the workforce with the understandable need for maternity leave and part time working.

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  • I am not a religious person but God Help us! It is another cog in the wheel to removing and demoralising adequately trained GPs to look after the public. 2 year course....ha ha...offered as an alternative to a GP. It is utterly scandalous ! Doubt they would let Vet Assistants with 2 years training loose on the animal world never mind us!

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  • well somethings got to fill the 400 unfilled GP training vacancies. Shame it isnt GPs................................

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