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Gold, incentives and meh

Only six US physician associates recruited for practices despite £50k salary offer

Exclusive A scheme intended to recruit 200 experienced physician associates to the NHS from the US through offering a salary of £50,000 and generous benefits is unlikely to meet its target, its leaders have admitted.

The London trust leading the recruitment drive has said that the national target to recruit 200 physician associates (PAs) across primary and secondary care for the two-year role - which will see them taking on tasks such as conducting comprehensive physical exams and diagnosing and treating some illnesses and injuries - has only recruited 35 individuals, including only six in general practice.  

GPs said the scheme was ‘gimmicky’, and this scheme has shown the Government has no ‘real commitment to proper workforce development’.

The announcement comes after a drive to increase the presence of PAs in general practice, with Jeremy Hunt’s ‘new deal’ pledge of 1,000 PAs to work alongside GPs by 2020, and plans to expand the non-medical workforce in the 10 point plan for GP recruitment.

In August, Pulse revealed the scheme - called the National Physician Associate Expansion Programme (NPAEP) - had begun advertising for experienced candidates from America to work in the NHS, offering salaries of £50,000 a year, 33 days paid leave and a financial contribution for relocation.

Pulse has learnt from Hillingdon Hospitals NHS Foundation Trust that 184 applications had been received by early November, with a handful of offers made after shortlisting and interviews.

A spokesperson clarified that to date (14 January), 35 provisional offers had been made with six candidates identified for work in general practice they added that the application stage had only recently closed, and selection was ongoing but it was not certain how many candidates would accept the offered position. 

They told Pulse: ’The NPAEP positions were advertised between 24 August 2015 to 7 January 2016 and the selection process for candidates is ongoing.

’To date, the programme has made 35 provisional offers. We do not know at this stage how many of these offers will be taken up. Six candidates are provisionally identified for GP/Primary care positions.’

A full update will be available in March, but the board papers conclude: ‘Progress will be reviewed with the Programme Board in January 2015. It is likely that NPAEP will continue to run, with smaller numbers than originally envisaged.’

BMA Council member and London GP, Dr Louise Irvine told Pulse: ’I don’t see what a physician associate can do that a good practice nurse or nurse practitioner couldn’t do. I think this is gimmicky.

She added: ‘I don’t think the Government’s shown any real commitment to proper workforce development, whether it be nurses, doctors or other health professionals..’

’It seems like a lot of money to be spending on people, for whom the role is very indeterminate.’

Physician associates are dependent practitioners are able to undertake delegated medical work, supervised by a qualified GP, such as obtaining medical histories, conducting comprehensive physical exams, requesting and interpreting tests, diagnosing and treating illnesses and injuries, and advising on preventive health care.

The job application states candidates must have ‘significant clinical experience’ as a PA and/or completion of a post-graduate residency or fellowship program, as well as valid US or UK registration and evidence of CPD.

The National Physician Associate Expansion Programme

NPAEP director Dr Nick Jenkins

NPAEP director Dr Nick Jenkins

Source: Dr Nick Jenkins

NPAEP director Dr Nick Jenkins

The original advert aimed to recruit PAs across four regions: North West London; the East Midlands; Yorkshire, the Humber and Newcastle; and North West England.

This included general practice roles in Leicester – where the CCG has already invested £600,000 in recruiting ten PAs from America to work in general practice – as well as in GP practices in Sheffield and across seven London GP practices.

The expansion programme will run until the end of 2017 and NPAEP director Dr Nick Jenkins said he hoped it would show the benefits PAs can bring, and create roles for the first cohort of physician associates trained in newly expanded UK university postgraduate courses.

But with such small numbers opting to take the plunge and forge a place for the profession in the NHS, it’s unclear what roles will await UK PA graduates when they compelte their postgraduate training.

Readers' comments (38)

  • Is that the Cavalry coming? No, just a man with two halves of a coconut shell. FFS.

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  • hahahahahahhaaaaaahahahaaaaaaaaaaaaaaaaaaaaa.....
    ha..cough, ha, hee hee

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  • Nhsfatcat

    Just watch the government throw even more money at this so that their pet project doesn't fail; instead of investing in proper general practice that is so unloved that 10 million people can't see their useless overpaid underworked GP.

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  • JEREMY HUNT SHOULD REALISE THAT GPs ARE CHEAP...FOR THE RIDICULOUS LEVEL OF RESPONSIBILITY TAKEN.
    THESE DAYS CONSULTANTS WON'T TAKE RESPONSIBILITY...ANYTHING VAGUELY COMPLEX AND CHRONIC...NAH, GP FOLLOW UP.

    HUNT HAS A PLAN..TO BRAINWASH THE GENERAL PUBLIC THAT DOCTORS ESEPCIALLY GPs ARE THE ENEMY.

    I FEEL SORRY FOR THE GENERAL PUBLIC, LAPPING UP THIS EFFLUENT THAT HE SPOUTS.

    IF UK GENERAL PRACTICE WAS SO GOOD THEN MARKET FORCES WOULD STOP THE EXODUS.

    GET A BRAIN AND WORK IT OUT

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  • This comment has been moderated

  • We might be cheap as per workload but we are massively inefficient. All those unnecessary follow up appointment, the so called just-in-casers, the DNAs, the Med3s, the GANFYDs, the incidetalomas ....the burnt out partners that surround themselves with trivia to get a rest...and the list continues.

    Hunt is spot on when it comes to wanting to demolish the NHS but I am not sure privatizing it is the way forward. Maybe if we stopped GPs from getting involved in non-medical matters....big egos do not recognize limitations.

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  • Mr. Hunt don't you have any cell in your body which has a bit of dignity, it is to go.

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  • Peter Swinyard

    I would be very concerned about taking on a "dependent practitioner" at £50,000pa when fully trained doctors are earning less. This, I assume, means that they cannot prescribe - also who carries the can for liability insurance? Would you sign prescriptions presented to you by a PA? If so, shows some considerable level of trust. But who gets sued if there is an error? Yes, right first time. You.

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  • Sorry if I am being thick but I don't really know what being a doctor means anymore. Who/what legislation defines who does what? It seems like a free for all.
    I don't undesrstand what privilages 5 years at medical and 15 years of ongoing professional development bring. Someone please explain.

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  • Rather disgruntled-sounding locum posting above. I don't recognise the description, I am happy to say, but then I work in a slightly under-doctored small practice in which we look out for each other. Better perhaps to judge general oractice as a whole and as it should be than assume everywhere is the same.

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  • 11.03 referring to 10.19

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  • 10.58 am
    There are no priviledges!!! None, zilch, wise up.

    It is offensive and ridiculous-the same kind of people who tell Soldiers back from Afghanistan that he/she is privilaged even though they have suffered horrific injuries and have a permanent life changing disability.

    It is about the government and regulators trying to brainwash us into crappy working conditions, come on work it out.
    I bet that slaves in the 17th century were told they should be grateful for getting beaten and worked all day and night.

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  • @Anonymous | GP Partner19 Jan 2016 11:03am

    'Rather disgruntled-sounding locum posting above. I don't recognise the description,'

    I am not in the least disgruntled. I am actually a happy locum that sees all kinds of practices day in and day out. When I was a partner I used to think of locums as losers, how wrong was I!. Partners are suffering from a kind of Stockholm Syndrome so you will not ,or cannot, understand where Im coming from. Hope you break free soon.

    A happy GP

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  • True you are smart. You got into a partnership during the golden years whilst those "loser" locums worked for you. Now you're a locum as the tables have turned. It's the partners' of the day fault for the mess we're in. They were oh so greedy.

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  • Only 994 more physician assitiants to go to reach target!Oh sorry I just laughed so hard I wet myself.

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  • Two years qualified mate. Not from the golden era at all. Just saw the light.

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  • I applied for one of these posts and didn't even get an interview. 10 years of full-time GP partnership wasn't enough experience, apparently. One of the partners who employs me as a locum is currently taking home £4K gross for 10+ sessions. Perhaps they assumed my application wasn't for real ;-)

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  • Doctors be alert, you are about to be edged out of your rigorously and painstakingly earned positions by gradual substitution strategy.

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  • 11.24
    I just wrote that you sounded disgruntled - perhaps disparaging, then? I was merely trying to point out that your experience of general practice is not everyone's. I have never considered locums to be losers and while it's not a way of practising that appeals to me, I am happy that some doctors prefer it as both are needed.

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  • I bet some overworked junior doctors would love this pay package , with less training,regulation and responsibility! Amazing there is loads of wonga for this iniative but none for unsocial hours

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  • To be frank I'm surprised anyone wanted to work in UK at all

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  • surprises all around who would have thought?

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  • well it isnt too surprising that the endeavour to recruit American PAs hasn't been especially successful, since they are busy expanding their health service (ie Obamacare) massively.
    I feel as if I am in groundhog day as no-one seems to bother to find stuff out before shooting themselves in the foot
    but
    hmm: indemnity; now why didn't we think of that (actually they can get indemnity, and do, so they will be sued, not you)
    government throwing money? err, no, vast majority of PAs to date have paid for their own training, with no grants nor bursaries
    So, can I suggest we all slow down a bit and ask ourselves: is there too much work? do we need help? Do we want to draw lots of nurses away from nursing?
    PAs, recruited from the 15000 or so bioscience and exercise science graduates in the UK per year, offer a really useful addition to the medical team. and that's what the evidence shows

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  • Who is going to regulate them. Is it the GMC ? Pity them

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  • As a fully qualified UK trained physician associate can I say how delighted I am that this lame scheme appears to be failing. I take this with a pinch of salt as, while I value Pulse for the majority of its content, its reporting on physician associates has often been a far cry from top notch! This scheme was ill timed, ill thought out and ultimately, I fear, have ill consequences.
    We initially had some brilliant US trained PA eductators and clinicians help introduce the role over 10 years ago. That introduction was a success and now our profession is growing and teams all over the country are seeing the benefits a PA can bring to their daily working lives. There is no place for a mass migration of US PAs in today's health service. We need UK trained PAs that can grow into their roles within teams, not 10 year experienced PAs who are used to working in an entirely different healthcare system who will already have their own ideologies about how things should work.
    As much as Jeremy Hunt is doing a terrible job pretending to know anything about the health service this scheme was actually nothing to do with him. His pledge for 1000 PAs was entirely separate. So although I'd love to blame him for this farce I can't; it was all Dr Nick Jenkins idea I'm afraid.

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  • Good job because the employment rate would be close to zero.

    I would rather keep my training time for FY2s who we might at least benefit from in the long run.

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  • I may apply as get similar take home pay.

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  • So, £50k = about US$ 76,850 at current rates (with the pound getting weaker recently). Contrast that with a median income of $87,342 or nearly £57k for US Physician Assistants. Seems Whitehall cannot even do simple maths.
    REF: http://www.payscale.com/research/US/Job=Physician_Assistant_(PA)/Salary

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  • Tried this in little old Weston-super-Mare 10 odd years ago for a fraction of the investment (local GP led initiative purely as recruitment of GP's was so hard in area) they didn't stay long... hasn't solved problem either, which as you'd imagine has just got worse. Doomed to repeat?

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  • Was an absurd foolish cloud cuckoo idea from the start
    We need more fully trained gps who save more money for secondary care than they cost
    Another symptom of the failure of doh to understand the real value for money of the Crown Jewels of the NHS

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  • I'm just wondering if I am allowed to downgrade from doctor to physicians assistant. I think I might make a better living working to the European Time Directive and without full responsibility for patients, GMC and indemnity costs.
    Does anyone know if this is possible?

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  • Only a fool would have taken these jobs. Paid less, live in overcrowded streets, nowhere to park your car, your children bullied in dreadful schools(it's ok to racially abuse Americans), having to leave for work at 6am to avoid traffic leaving work at 7pm.
    I feel sorry for the 6 who have taken the jobs. They think they're getting Harry Potter and Tintern Abbey. The reality is they'll wake up in the nightmare that is the UK and UKGP.

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  • well done .. we are getting there.

    add this to the '1000' figure of GPs who will stay on and delay retirement and GP trainees it means we are well on the way to reaching the promised 5000 'GPs' that the conservatives have pledged. i'm impressed 1006 already and it's only the start of 2016 !

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  • Good it was a stupid idea anyway we already have people in GP practice's doing the majority of the work Physician's Associates would do they are called Practice nurses and they don't get paid anything like £50,000 and a lot of them are Independent prescribers which the overpaid Physician's assistants aren't.

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  • What are you all afraid of? Intelligent, qualified people afraid of other intelligent qualified people coming to help!
    I see nurses disgruntled and doctors disgruntled by this new role.

    Nothing will ever take away from doctors, their seniority and position. You are losing nothing and yet have so much to gain by another health professional there to ease the burden - why resist?
    I honestly cannot see why so many of you continuously negate the PA development, I am a student pa.

    We have been told in no uncertain terms that we are not replacing doctors, we are there to support them in their roles and perform under the medical model in ways that nurses can't / don't.
    There is room for this new profession, you just need to be open minded. I am studying with some extremely intelligent people, not everyone wanted to be a doctor when they picked their career and to choose to do medicine later in life would be an awfully big ask financially and time wise.
    Those studying pa studies are no less intelligent than those who've studied medicine, their life just took a different route and whilst we are aware we won't be doctors many of us will get the patient contact we desire along with knowing that we are doing something worthwhile.

    Surely that's why so many of you joined medicine / healthcare? To improve other people's lives, to care for people and to make them better be it through medicine, nursing or care?

    I think you have all lost sight of the focus here that is to provide excellent patient care. It doesn't matter what the PA earns etc, it's what they can bring to the table and I think you'll be pleasantly surprised if you actually give them a chance.

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  • Oh dear - yet another government 'initiatve' goes 't**'s up' why not employ those that are manning nhs111- or is it nhs666? - some clever advisor has ensured they are another poorly conceived and sometimes frankly dangero
    us setup (no fault of those employed largely who might as well be a computer asking the endless questions) at least NHS direct had some clinical input and no doubt didn't send so many ambulances to a/e. They could take histories and pass onto clinicians to make the final decisions with all those sore throats, ' glands up' 'supposed uti' s', coughs and colds that ought to be dealt with by pharmacies so they almost never see a go who has enough more significant clinical issues to deal with - I'm sure 25000£ - 30000£ would be enough (plus crown immunity)

    Why aren't there true thinkers involved - just those who do 8.30 till 4pm who have no vested interest and not expected to work weekends - probably laid off like all those with experience in the former pct's what a stupid idea that was- ccgs often have no idea - not their fault - in a politically motivated idiotic sudden change by those with no appreciation of the expertise, knowledge and dedication that was there. No wonder the same incompetence presided over the carriers and aircraft, deals over nuclear ( green energy goodbye) no investigation into banking malpractice, laughable tax from multinationals..... Is there is a God where has she gone??

    Love to all and apologies to Christians if 'she' upset you!

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  • Why are we getting an unregistered physician associate that cannot prescribe or take cervical cytology (because they are unregistered) to work in General Practice when we have Practice Nurses that would be willing to train as Advanced Nurse Practitioners if they were funded and supported to do so (and they would be able to prescribe and take cervical cytology!) And I'm sure be paid less then £50k a year without the fair pay and conditions that Agenda for Change comes with.

    Practice Nusre and Primary Care Development Nurse

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  • They get £150 k in Iowa and can't manage like GPs

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  • 😄😅😆😆 - just checking if emojis work in comments!

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