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Physician associates may be given prescribing powers, says DH

Exclusive The Government is considering whether physician associates should be given prescribing powers as part of its ‘new deal’ to relieve the pressures on GPs, Pulse has learnt.

The Department of Health has told Pulse this was one of ‘a range of issues’ it was considering ahead of recruiting 1,000 new physician associates to work in practices by 2020.

Jeremy Hunt promised the physician associates as part of a plan to recruit 5,000 new practice support staff over the next five years.

Giving them prescribing powers would add to their working role - as currently listed by NHS Careers - that includes taking medical histories; performing examinations; diagnosing illnesses; analysing test results and developing management plans.

But GP leaders have warned that adding prescribing to this list is unlikely to make much difference to the ongoing workforce crisis.

Mr Hunt recently watered down his committment before the election to recruit 5,000 more GPs saying that this was ‘a maximum’, but a Department of Health spokesperson told Pulse it was pressing ahead with plans for 1,000 more physician associates.

He said: ‘Together with NHS England and Health Education England we are considering how to ensure 1,000 physician associates will be available to work in general practice by September 2020. A range of issues and possible solutions have to be considered, including prescribing responsibilities and whether and how they need to be regulated.’

Physician associates are currently science graduates who have completed a two-year training course, however, it is not mandatory for them to be officially registered.

Research from Kingston University and St George’s University of London this year claimed that physician associates can take on some of GPs’ daily work without any harm to patients and at lesser cost to the NHS.

But Family Doctor Association chair Dr Peter Swinyard, a GP in Swindon, warned offering them prescribing powers could result in a ‘real deception pulled on the public’ if they thought they were seeing a medically qualified member of staff.

He added: ‘If they can also prescribe then we have even more of the potential mismatch of what people think they are getting and what they actually are getting.’

GPC prescribing lead Dr Andrew Green said he supported ‘in general’ the extension of prescribing rights, when used responsibly.

He added: ‘However it would be a nonsense to suggest that the promise of 1,000 PAs in five years, even with prescribing rights, will make any difference to the crisis we are in right now. The underlying reasons must be addressed as to why today’s young doctors are not becoming GPs. Improving skill-mix within primary care might help, but people can forget how difficult it is to do our job well, and complex and undifferentiated care needs the most highly trained professionals available.’

Amid the Government drive to boost numbers, Sheffield Hallam University will become the 10th institution to provide the course from January next year and last week Royal College of Physicians launched a new arm, the Faculty of Physician Associates, especially for the staff grade.

Meanwhile, NHS Leicester City CCG is spending £600,000 on bringing over ten US-trained physician associates to work in local GP practices, in a bid to address its recruitment crisis.

Readers' comments (39)

  • 1000 PAs - aren't there about 8000 practices in England alone? How on earth will this help? Even if extremely competent, I would imagine the buck would stop with the supervising GP and therefore increase workload. I am far happier to make decisions about people I have seen.

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  • If everything was so easy in GP then why do trainees have to go through the hardship of passing their clinical exams.I think RCGP is partly to be blamed for this chaos.

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  • Regulate them,allow prescbing,insure them and let them help us !

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  • @Anonymous | GP registrar | 07 July 2015 4:30pm who wrote "If everything was so easy in GP then why do trainees have to go through the hardship of passing their clinical exams"

    To make them look as clever as their MRCP and MRCS counterparts...but fails dismally!

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  • Third-world medicine in one of the most economically developed countries in the world. What a disgrace!

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  • Turkeys voting for Christmas. Ten years agoI remember as a public health registrar when the then FPHM opened specialty training to non-medics, with the promise it would 'increase the capacity of the public health workforce'. Many of us argued it would be a back-door way of ridding medics who were too independent and replacing them with non-medics who were cheaper to employ, and easier to corral, and simply a way of cutting costs not increasing capacity I read in a recent BMA news about how the BMA PH committee were worried now that many Local authorities were not employing medics (Why bother when a non-medic is £20K less per annum) to save money. This will happen in the UK now: the RCGP will be happy as long as they get to regulate and oversee PA courses and will open membership to all (just wait for the rebranding to the Royal College of Primary Care Practitioners). The DH will be happy as they can still claim to offer a "free at the point of primary care NHS" but it will not be staffed by doctors, and will be cheap and cheerful. This is the beginning of the end of GP land. I was right 10 years ago about PH; I suspect I will be right 10 years hence about GP land, and there will be no jobs for GPs, just PAs (of course, as a GP you would be welcome to apply for a PA post should you wish, on their terms and conditions of service).

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  • @above

    So what if there are no jobs for GPs.Doctors should be working in hospitals where the really sick are.That's where they add value.Not signing sicknotes or sorting out verrucas and fungal toes.It's a complete waste of the country's resources to have them dealing with the unadulterated crap that constitutes general practice.It's no wonder they end up becoming deskilled and demoralised.The only reason why the youngsters are still choosing it is that it offers the opportunity to work part time.Once you remove that there is nothing to commend it.And at the end of the day the British public will get the health service that it deserves.Now they always find something to complain about GPs.Well they've got their wish because most of us will have packed our bags and left.

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  • Well ok as long as no one in my family has to see one. Im sure they will be helpful to us but I'm not keen on taking responsibility for them or the nurses(who didn't work out cheaper either).

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  • looks like anyone who wants to see a Doctor in the UK is going to have to go private soon.

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  • @Chris Kent | GP Partner | 07 July 2015 5:07pm
    Regulate them,allow prescbing,insure them and let them help us !

    That's fine but why should we have to pay our own extortionate insurance and they get it free with the same risks involved?

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