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Physician associates are 'self funding', says Royal College of Physicians

The Royal College of Physicians has expressed concern about news that money cut from GP training support is being spent on educating physician associates (PAs).

At Health Education England's board meeting on Tuesday, finance director Steve Clarke said that they had 'decided we needed to make reductions in education support so we could afford… programmes like developing physician associates, and the nursing associate programme'.

But, despite the comments, RCP and its subdivision Faculty of Physician Associates (FPA) have suggested it is 'misleading' to claim cuts have taken place to fund PA training.

RCP president Professor Jane Dacre and FCA president Jeannie Watkins said in a statement that they were 'very concerned by the headline which appeared in Pulse yesterday, claiming that cuts to the overall HEE budget, and the direct negative impact this will have on GP training, can be blamed on the reallocation of training resources to physician associates'.

They added: 'Physician associates are essentially self funding and it is misleading to claim that the cuts have taken place specifically in order to support their training. HEE as a whole is facing budget cuts of 30%, as well as a reduction in its staff numbers.'

The RCP statement added that is was 'deeply worrying' that the HEE budget is being cut 'at a time when the NHS is underfunded, overstretched, and in need of more staff', including GPs and PAs.

They went on to stress that PAs will 'not replace GPs' because they 'require a dedicated GP supervisor in order to practice' but said they 'add value to the primary care team, increasing access for patients and the capacity of the practice to see more patients, and provide them with more time'.

The Government has pledged to train an extra 1,000 physician associates by 2020, at a cost of over £15m including covering bursaries and course fees.

Note: HEE's overall budget is not facing cuts of 30% but rather it has been asked to trim its 'running costs' by this proportion.

Readers' comments (9)

  • *

    I'm glad the Royal College of Physicians is of the opinion PAs won't be used to replace GPs. The problem is the RCP doesn't set the government adgenda, the Government does that bit, and they have a strong track record of ignoring the opinions of Royal Colleges. If there simply aren't any GPs because the Government doesn't think they are worth training and/or paying for who else are they going to employ? ..and how long before the rules are 'tweaked' so they receive 'clinical supervision' from any other 'appropriate clinician'. I'm not down on the idea of Physicians Assistant at all just deeply cynical of the direction this is taking us and the potential for Government dumbing down for short term financial savings. If something is cheep and someone can make the argument for organising primary care without the need for expensive, irritating, challenging Drs do you really think a government will say anything other than 'yes please!' ...regardless of the fact it'll probably increase hospital work load/referral rates/medical indemnity costs/over treatment. Is what they are doing to the NHS at the moment driven by sensible clinical reasoning? .. why would this issue be any different.

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  • Vinci Ho

    Imagine a primary care 'world' flooded by PAs without enough frontline GPs to supervise. What would happen to teferrrals to secondary care ? Yes , PAs certainly can have a role in primary care but which is the horse and which is the cart in here ?Hence , spending the money to buy more presumably cheaper carts and put them in front of the horses , is totally short-sighted reflecting the lack of vision and intelligence of a technocratic government led by a zombie prime minister and her vampire ministers. Time for all of us to expose them to blistering sunlight......

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  • Vinci Ho

    Correction
    .... referrals to secondary care ....

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  • PAs are just cheap labour.Does the government really care about patients?Obviously not.
    You pay peanuts.

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  • Once the PAs are taking the same risks and working as hard as us, their MDO fees will rise and they will also be asking for a pay rise.

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  • Prepare for the '5000 extra GPs' promise to be watered down to '5000 extra GP equivalents' or '5000 extra primary care clinicians'.

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  • Even as young GPs we need supervision and when older we need to supervise younger colleagues for patient and doctor safety and to ensure proper care is provided. PAs will have little or no supervision if GP numbers fall- a disaster hideously devised. RCP and FCP presidents are just fooling themselves or naïve to think that PAs are -'self-funded'- does that mean they are going to pay their own training fees and or salaries??

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  • I won't be using my indemnity to supervise PAs

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  • Please stop knocking the Physician Associates. They are being trained to help you. I am a GP, a trainer and TPD. My daughter is a trainee PA. Her peers are highly motivated, intelligent and sensible. They have simply chosen a role where they can help patients and doctors but without having to accept ultimate responsibility. Many of them have taken pay cuts to train, and accept they will never earn as much as doctors.
    I suspect that if we had had this choice at their age, some of us might have chosen their pathway.
    They are trying their best to train to support us - the least we can do is be friendly.

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