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Less than 30% of GPs willing to employ physician assistants

Exclusive Less than a third of GPs would be prepared to employ physician assistants, despite the Government promoting them as a way of solving the GP recruitment crisis, a Pulse survey has revealed.

A poll of more than 450 GPs across the UK found that only 32% of practices would be prepared to employ physician assistants – alternatively known as physician associates (PA), who take on a more clinical role – while over 40% ruled out any possibility of hiring them.

The pushback from GPs on the PA scheme comes less than a month after health secretary Jeremy Hunt announced that there would be 1,000 new PAs working in general practice by 2020 as part of the ‘new deal’ to alleviate the GP workforce crisis.

Pulse reported last week that the Government is going even further, considering whether PAs should be given prescribing powers.

But GPs said that the scheme, designed to alleviate GPs’ workloads in a cost-effective way, could in fact cause huge problems for practices.

GPs said that their lack of medical training were causes for concern, adding that there was little evidence to prove that the scheme would save cash.  

Dr Zishan Syed, a GP in Kent, said: ‘PAs have not sat the essential (and expensive) components of the assessment trainees have to pass in order to become GPs.  It is an unacceptable threat to patient safety to allow other professionals to work in GP-like roles without doing these assessments.’

Dr Syed added that PAs would pose a threat to GP jobs as the Government would ‘inevitably employ them for reasons of cost rather than quality.’

Dr Amit Tiwari, a GP practising in Colchester, said that liability was also a key concern for practices.

He said: ‘This is going to cost more for practices in terms of indemnity and time and patients would much rather see a qualified GP who can do all this, provide a prescription and management plan.’

However, Dr Simon Gilbert, a GP at Cricket Green Medial Practice which has been employing PAs since 2008, said that if skills sets and experience were understood, PAs could work well in a practice environment.

‘Our current PA does see unselected and acute patients but also spends a lot of time seeing patients with known diagnoses, doing much of the daily home visit list and reviewing patients recently out of hospital. PAs clinical skills are valuable where there may be less time pressure to rapidly assess and prescribe,” said Dr Gilbert.

GPC chair Dr Chaand Nagpaul said that not enough was known about how the cost-effectiveness or scope of the PA scheme yet.

‘They are being trumpeted as a support to GPs before we really understand what they can do. More immediate concerns like retaining existing GPs need to be addressed,’ Dr Nagpaul said.

A Department of Health spokesperson said: ‘The GPs that are already working alongside PAs say they love them.’

Survey results in full

Would you consider employing a PA in your practice?

Yes – 148 (32%)

No – 186 (41%)

Don’t know – 125 (27%)

The survey launched on 9 June 2015, collating responses using the Survey Monkey tool. The survey was advertised to Pulse readers via our website and email newsletter, with a prize draw for a Samsung HD TV as an incentive to complete the survey. Some 459 GPs answered these questions.

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