Introducing Physician Associates

You may have come across the term Physician Associates or PAs but may not be entirely sure what they can do – especially in general practice. Would it surprise you to learn that they are clinical graduates trained in the medical model to consult, examine, understand the patient’s problems and plan care?

They work to complement GPs and the practice team. They are dependent practitioners who remain under the supervision of a named GP, to add extra capacity and flexibility. Like all clinicians, they are committed to on-going learning and development.

Focus on general practice

Physician Associates (PAs) must pass an intensive 2-year university course at diploma or masters level to learn clinical knowledge and skills after completing a 3-year biomedical or healthcare related degree. They train in both the acute sector and primary care to gain a rounded patient centred clinical experience.

The Faculty of Physician Associates (FPA) set and run the PA national exam, oversee standards for education and maintain the voluntary UK register of PAs (known as the PAMVR).

Health Education England are supporting the cost of increasing clinical placement time for student PAs in primary care from 180 up to 510 hours. There’s a £5000 preceptorship allowance to support the supervision and educational needs for any qualified physician associate working in primary care for their first year.

Indemnity

All PAs are required to have their own personal indemnity insurance, available from the current indemnity providers. PAs can be included in practice indemnity contracts, like GPs and nurses.

What do physician associates do?

Physician associates work within a defined scope of practice and limits of competence. They:

  • take medical histories from patients
  • carry out physical examinations
  • see patients with undifferentiated diagnoses
  • see patients with long-term chronic conditions
  • formulate differential diagnoses and management plans
  • perform diagnostic and therapeutic procedures
  • develop and deliver appropriate treatment and management plans
  • request and interpret diagnostic studies
  • provide health promotion and disease prevention advice for patients

“I’m in the final year of my physician associate training and am enjoying the flexibility and wide range of skills that I’ve been able to apply to general practice. Best of all is seeing how I’m able to support the team and working with and getting to know the patients.

At the practice, I will be involved in the diagnosis and management of common and important long-term conditions such as asthma and COPD, performing reviews, facilitating medication compliance and signposting/care navigation. I would like to perform smears, offer contraception advice and complete 6 -week baby checks as well as managing minor ailments and following up patients after interpreting their test results.

I have structure and regular supervision to ensure patient safety and love working closely with the wider clinical and admin team.

I’ve discovered that I am particularly interested in mother and baby well-being and developing quality improvement and systems changes”

” I work from a combined list with the GPs so none of my work is filtered and I see patients who walk through the door in the same way that the GPs do.

I do a bit of everything but have a specialist role in diabetes – I take on-call with GPs, home visits and palliative care. I also run a family planning clinic and an in –house anticoagulant centre at the surgery.

The GPs have invested time and money into me which has enabled me to develop much faster – I know I make a huge difference, the work is extremely rewarding and the team element at the surgery is great.”

Practice costs and access to resources

It’s not uncommon for a newly qualified Physician Associates to start on a salary of £31,696 (equivalent to an NHS Band 6/7 salary). Depending on the level of experience, a PA will be able to manage a proportion of a GPs workload in a supportive and complementary role, rather than as a substitute.

PAs need access to similar resources such as a treatment room and equipment to carry out their work in the same way as other clinical practice staff.

The flexibility of a range of clinicians in the team can open up new service provision opportunities. PAs may effectively free up a GPs time.

Resources