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A faulty production line

'We want to show what physician associates can do'

Dr Nick Jenkins, who is running a programme to bring physicians associates over from the USA, explains how they could help the health service in the short-term and convince some of their long-term doubters

The whole raison d’etre of the National Physician Associate Expansion Programme is to do ourselves out of business. We’re not here for any long-term purpose. I’m an A&E consultant, and I can tell you the problem is we’re spending a lot of money on locums, we’ve got patients who need seeing, and I think PAs are part of the solution to many of the challenges we face.

But to train them takes time, you can’t train them overnight. So the only way to help in the short-term is to bring some experienced people from elsewhere. We’re also trying to ready the system for many of the PAs that are going to be produced in the UK, by showing how good PAs can be and what they have to offer.

We’ve picked four regions which have no significant PA workforce and no PA school at the moment. So we’re carefully going into places where PAs by-and-large are not established, so we can introduce the concept to places that haven’t heard of it.

I realise that sometimes we are so challenged by the business of today that it’s hard to look to what we might be doing tomorrow. But I think we have to see if this works, we wouldn’t be doing it if we didn’t think it would work, but if we could guarantee it worked we’d already be getting on with it.

So we want to publicise the programme, and we’re keen to focus on the positive aspects PAs can bring. The trouble is there are an awful lot of people who say “the answer is no, what’s the question?” We’re trying to combat that, and I understand that because it is new and it’s scary if you don’t know what’s going on.

But patients need to understand these are trained and qualified people, they’re not some kind of lesser doctor. They’re not doing what doctors do, they’re doing similar work. It’s a subtle difference but an important one. They’re trained to understand therapeutics, they will propose to a doctor “I’d like to give Mrs Jones some salbutamol for her asthma”, but we have to understand that a lot of patient interactions in primary care or hospital don’t require a prescription at the end of it.

There’s a lot of talk about social prescribing, and that’s something PAs are able to do.

Dr Nick Jenkins is director of the National Physician Associate Expansion Programme, and is deputy medical director at Warrington & Halton Hospitals NHS Foundation Trust

Readers' comments (8)

  • With all due respect to the undoubted talents of PAs, we also need to make sure that Jeremy Hunt doesn't try to count PAs as full GPs under his '5,000 more GPs' promise

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  • that may be be the plan

    JH is back tracking on his defn of 'full GPs' and on the numbers!

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  • They are not doing what doctors do , they are doing similar work . This is a specious statement . In reality they will be assessing , formulating management plans and treating patient in the same way that doctors are doing . However they will NOT have undergone several years of rigorous clinical training and tough assessments in that doctors have . Are you seriously telling me that the training these PA's are undergoing will equip them with the ability to make differential diagnoses and safe management plans in a limited time as Emergency med doctors and GP's are doing ?

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  • Dear, Anonymous | Salaried GP | 28 August 2015 4:19pm.

    Yes! They are trained the same way as Drs and do very similar exams e.g. OSCEs etc. The training mirrors a medical degree but focuses on common conditions covering 85-90% of the same material. That is what PAs in America have been doing since the 1960s and what UK trained PAs have been doing for the past 5 years or so and doing it very well.

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  • A sick patient needs a Doctor
    This is about money and nothing else
    A patient seeing a PA is being short changed and
    Lied to
    The poor patient thinks he is seeing a Doctor
    And guess what ?
    Nobody tells him otherwise
    If they want to be Doctors get the A level grades
    and go to University
    What a con

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  • This is totally a rubbish idea. A fully registered junior doctor basic salary start from £27000.00 per annum. Why do you want to get a PA's from USA with £50000.00 salary per annum. You need to increase the basic salary of the doctor to attract them. I am almost sure that most of the Locum doctor will do the permanent job. No one prefer to move around one place other place but Locum doctor does it just to make a bit of more money. But if you give them attractive salary,they will stay permanently and work for the trust. It's a common sense. You don't need a top class degree or higher experience to understand that.

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  • Trained in the same way as doctors... but take less than half of the time to do it. Tell me, are they advanced learners? Twice as capable as medical students? Or intact are they nowhere near as well trained or clinically capable as an FY1, let alone the CTs that they will be paid more than for less responsibility.

    We have a responsibility as a profession to kick this far into touch. Abysmal work force planning is not our problem.

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  • "The whole raison d’etre of the National Physician Associate Expansion Programme is to do ourselves out of business."

    Pretty much sums it up.

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