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GPs buried under trusts' workload dump

Physician associate indemnity ‘costs practices upwards of £2,400’

Physician associates are a ’useful addition’ to practices, but could cost upwards of £2,400 to indemnify, a GP has revealed.

Dr Patricia Wildbore, a GP in Warwickshire, told delegates at a Pulse Live event in Liverpool yesterday that the junior PA - one of two they employ - sees around 40 patients a day and ‘couldn’t do without them’.

However, the practice has said that it is paying £2,400 to indemnify the junior PA - and she warned that this could be more for future physician associates, who may take on more clinical responsibilities and receive higher salaries.

She told delegates that since they replaced a departing part-time doctor with a fulltime PA, the practice has bucked the trend of falling income, alongside improved patient satisfaction and access.

The Government this year announced that it was going to introduce 1,000 physician associates into general practice by 2020 in a bid to alleviate GPs’ workload.

In the short term, a programme has been set up to recruit 200 physician associates from the US on salaries of £50,000 a year to work in under-doctored areas.

However, GPs have raised the issue of how much the indemnity costs will come to, which will have to be borne by practices.

Dr Wildbore told delegates: ‘I often get asked about indemnity. It costs £2,400 a year for our junior PA.’

She added: ‘At the moment in the UK they’re paid between £20,000 and £40,000, but if people are putting out adverts for £50,000 for a PA, that’s going to change. A salaried doctor doesn’t get much more than that. 

Dr Wildbore also said that the locum insurance for the PA costs around £1,000 to £1,500 and isage and sex dependent. 

She told Pulse that their junior PA was seeing around 40 patients a day, and any absences had a serious knock on effect that needed covering.

The practice has boosted income by having more ‘feet on the ground’, which has led to ’improving QOF attainment because we’re less stretched… and it also means we can do other things like increasing the number of research projects we run at the surgery.

The senior PA at the practice is a partner now, and has far greater experience than the majority of PAs who will be employed, Dr Wildbore said. He pays around £4,700 a year in indemnity costs but he is an ‘exceptional case’, she added.

It comes after Pulse reported that medical defence organisations increased the indemnity fees of an advanced nurse practitioner (ANP) from less than £900 to £7,995 in one year, even though she had no complaints made against her.

Readers' comments (18)

  • 2:29pm says GPs see too many worried well. Makes you wonder what a GP's job is? It's to listen to all of those people who desperately need someone to listen to them, sort out the real problems from the perceived, and to stop anxiety turning into serious mental illness or serious physical illness. Someone has to do it (and they have to be pretty expert) or our hospitals would become overwhelmed. Don't underestimate the value of listening!

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  • drop in the ocean

    GPs are on the way out - no point training for it.

    Physician associates are indispensable and the future. Not bad 2 years training, 55k a year, low indemnity costs, no clinical responsibility, supervised. Why run up a six figure debt for less (net pay) and more stress and responsibility. May as well stop training GPs.

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  • @2:29. You really must be trolling.

    If you are actually a GP and you see many worried well then you need to rethink your job or actually go and work in hospital like you suggested.
    I see at least 40 patients face to face daily and I get likely 1-2 worried well patients a week. Do not kid yourself.
    Secondly, you are likely ignorant about a clinically and cost effective healthcare system. Any healthcare system without a properly functioning primary care system is very expensive and inefficient. You think GPs should be in hospitals? You are a disgrace if you are a GP

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  • How can the junior PA be seeing 40 patients per day and only pay 2400 MDU? It doesn't compute , unless he is just doing 1-2 sessions per week surely ? I wonder what type of patients he is seeing and what problems are being dealt with . I would be concerned that a junior PA ( considering the limited duration and intensity of their training) is able to safely see 40 undifferentiated GP cases per day safely . This would be taxing even for an experienced GP . All very bizarre .

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  • We were asked to pay 8000 by MDU for ANP. They are high risk. You can't afford to pay PAs and ANP 50k then NI then pension then 8k MDU.....

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  • The PA is a partner? Do these GPs have no self respect?

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  • I'm a PA GP indemnity only costs that much if you go with the most expensive provider...which you wouldn't..

    Also 40 patients a day is a joke. NO PA would be happy with that, that's abuse. Im sure that PA will find a much better job soon.

    Also as per usual a few other facts here are wrong e.g. The GP salaries for PAs etc...

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  • I woudl also like to point out the 50k stuff is a bit irrelevant; it is a project, short-term, trying to bring about 200 v experienced US PAs into UK, and so having to compete with their salaries over there.
    Vast majority of PAs (who remember have science degree as wel as 2 full-tiime years of PA education) are on about 30k

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