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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)

  • medicine on the cheap, the government want to do away with gps and registered nurses and replace them with minimum wage people with littletraining

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  • @noaleen fearin, I suspect you have worked with unqualified ANPs who are using the title without right or study simply because they can. The title & qualification & role is not protected due to huge failings by the NMC. A qualified ANP has yrs of experience at a senior level, has at least as a minimum a masters degree and has been supervised by a doctor who has assessed the ANP as competent. If those you have worked with were useless then they need investigation!

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  • Having been made redundant this year as an ANP who saw nearly all the 'on the day' patients because , according to the CCG , ' ANP appointments don't count for access ' and the partners were advised they were in potential breech of contact for not providing GP appointments ... Would someone please sort out this mess before bringing another group of workers in to it?

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  • I am a ANP. I have never professed to being a mini medic, only wanted to be a mega nurse. I compliment the GP partners I work with, they respect my areas of expertise and I respect them. I have helped to relieve the pressure on a crumbling service due to patient demand. I am educated to masters level, prescribe and have 30 years experience. I am not a GP but the likes of me do have a lot to offer primary care. It is worth pointing out that PAs don't have prescribing rights in the UK. I remember when GPs didn't have PNs...and they couldn't function without them now!

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  • I have had the opportunity to work closely with PAs in the US and while I would not recommend the system, the care that the PAs deliver doesn't warrant the dismissive rubbish promulgated by some comments. It always makes me laugh to hear people compare time in training as the sine qua non of expertise at the same time they are complaining about the course work taken that is not relevant to their practice. It's about competencies whether GP, consultant or PA.

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  • ...blimey there is some 'chip on the shoulder' rubbish being spun on here. It's laughable

    ...'sine qua non'... give me a break!

    brightened up my evening ...thanks one and all. :) :)

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  • its is not new for the NHS to open up overseas recruitment for its convenience whenever it is in crisis such as at present and shut the doors to overseas drs whenever the crisis is resolved .
    What a sad state of affairs

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  • Could be worse I suppose, they could have followed the advice of that Space Cadet MP and invested in 400 astrologers. Though what some jumper clad Russell Grant fella would do for my Haemorrhoids I have no idea. Something to do with Uranus I suspect.

    Merry Christmas everybody!

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  • If they want more GPs why not allow those of us who want to return to practise back into the system? I have been back in the UK for 18 months, desperately struggling to retrain as a GP (MRCGP + 15 yrs experience in primary care overseas but that doesn't count) but I'm about ready to give up. I've had to hurdle pointless MCQs, a CSA I wasn't allowed to prepare for (no seeing patients until you've passed it) and now I've waited 3 months to get onto the performers list but it turns out my application was left "in a cupboard" because a reference was missing and no one thought to chase it up. It's galling to find that if I'd chosen to train as a PA instead I'd be closer to being considered "safe" to see patients than I am now. They keep telling me that "patient safety is a priority" so apparently it's better to train someone fresh for 2 years than allow me a few months of supervised practice to return to a role I have spent the last 25 years training for and practising. Good luck to any overseas GPs imported to plug the gap, or will they fast track them through a system that has attempted to trip me at every step?

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  • Is this like teaching assistants so that the numbers of trained teachers can dwindle and 'Free Practices' can be set up, to steal patients from valued services, that no longer need fully trained GPs manned by anyone with a first aid badge they gained in the scouts?

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