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GPs buried under trusts' workload dump

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)

  • David Lewis | GP Partner | 16 December 2014 5:07pm

    Paralegals to lawyers and Physician associates to GPs are utterly not the same thing. The lawyers lose a case if the paralegals miss anything. The GP can lose his registration/lifelihood/reputation. Whether they have their own indemnity or not is moot. I certainly wouldn't want to be in anyway responsible or overseeing someone with just 2 years of training.

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  • Took Early Retirement

    Should they be called, "Apothecaries" perhaps?

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  • Its 2020. Patient rings. Reception "Surgery can I help you". "I's like to see a real doctor please" says the patient. "Sorry, they've all emigrated or only work privately.If its not to complex and you would like to risk it, I can offer you a physicans assisstant or nurse practioner if your interested, even an HCA". "no Thanks, I'll just go and pay what they were really worth. I know there are not many left in the uk. The public, the politicians and I never realised how good we had it in 2014".

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  • Oh dear the old chestnut of ANPs referring more and taking more time! Oh & how about the pay scale as suggested by the anonymous GP partner, (sadly you do not have the power of your conviction in you mistaken comments by telling us your name. However, I believe in and can proved what I write and Harvard reference it if need be! !) I am a well qualified and experienced ANP, I hold four masters degrees, I educate GPs, medical students, pharmacists and nurses in prescribing practice and therapeutics . I see the same number of patients as my GP colleagues, my referral rates are comparable as is proved by audit of my work load and neither do I rip off my employers by charging £50/hr but yes I am more expensive than the average practice nurse. ANPs and PA are not a complete solution, we need mixed teams of medics, nurses, pharmacists to assist our patients! We need an open minded approach to health care & not the narrow minded unsubstantiated rhetoric I have just had to read!

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  • Will HEE be diverting funding from medical - including GP - training?
    And if this is not another diminution of the medical training budget, how will it be funded?

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  • How about a nationally commisssioned minor ailments service through pharmacy?

    We will take your sore throats, conjunctivitis, athletes foot, thrush, headlice, impetigo, cough and cold, hay fever and constipation/ diarrhoea people who really shouldn't be tying up your surgery time...

    We could even take your LTC patients (If the proper management system, shared records and care plans were. In place)

    Leaving you more time for other patients, so there isn't a 2 week wait for GP appointments (like there is at mysurgery) . Long waits for appointments= patients go to ooh or a&e. 4 hrs in a waiting room is nothing if you can't see your GP

    Plus pharmacists are already here, and already accessible. 97% of the populationr live within 20 minutes of a pharmacy....

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  • If that is all the health service can come up with its time to scrap it all together. Anyone who can afford it at all is already going privately Patients want to be diagnosed by highly trained doctors who speak their language ,and who are not physically and mentally exhausted

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  • WOW....after retiring after 30 years this sounds just fabulous : a job ' practicing medicine and caring for patients ' without the bureaucracy, red -tape, hoops , adverse media portrayal, anti-single-handed Drs etc etc.etc....who in their right mind would want to be a GP. Goodbye to GPs

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  • Yes, physicist assistant, great idea. Great idea from USA where health care cost efficiency is one of the worst in the world. Let's implement it in a country where public health was recently voted one of the most cost effective and see if it's quality improves.

    Truly a great idea - for those in APMS sector may be. Certainly not fir the patients.

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  • As always if 5bn is being spent on this, where is the money being diverted from?

    I have seen some good ANP's and some poor ones, like always when a role is created to essentially save money you must expect compromises. Here we are accepting compromises to care.

    We as doctors must take out share of the blame. We can't have EWTD, privileged training schemes, access to part time work etc without emploers thinking how to be establish a basic rota. The failure of Royal Colleges and Deaneries to deal with these basic issues have got us here. Add in MTAS and now Junior consultants and you have a cynical group of young doctors who know what reality is. Add in the medical education establishment and their obsession with taking medicine out of medical training and we are where we are - a perfect storm.

    F2 and SHO's will be competing with ANP's and PA's for jobs - all to drive wages down.

    It all feels bleak unless we can find true leader with a vision we can get behind

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