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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)

  • 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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