Category: Reimbursable Role Summaries

Concise summaries of the new, reimbursable roles, accompanied by links to additional reading and resources.

Clinical Pharmacists

Questions?

If you have any questions relating to clinical pharmacists, please send your queries to us at [email protected]

Clinical Pharmacists

"Clinical pharmacists work in primary care as part of a multidisciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas."

Source: HEE's Role Overview

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What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Are there any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

What employment routes are there?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do they need?

What should practice induction include?

What ongoing support is available?

What are clinical pharmacists?

Clinical pharmacists are primary care health professionals, who work in a patient-facing role as part of a multidisciplinary team (MDT) to clinically assess and treat patients using their specialised knowledge of medicines. They are responsible for medicines optimisation within their respective primary care network (PCN) and conduct clinical medication reviews for patients with complex polypharmacy, especially the elderly, care home residents, or individuals with multiple co-morbidities.

If not already able to prescribe, clinical pharmacists can achieve an independent prescribing qualification following completion of the Centre for Pharmacy Postgraduate Education’s (CPPE) 18-month pathway (completing this or an equivalent, approved course is necessary for clinical pharmacists receiving funding through the Additional Roles Reimbursement Scheme (ARRS)).

For more information:

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What benefits can clinical pharmacists bring?

Clinical pharmacists can help to ease the workload of and release time for GPs — as a case study provided by NSHEI suggests, the inclusion of a clinical pharmacist in an MDT can reduce the patient need for GP appointments to a significant degree (by 30% in the case of Wallingbrook Health Group, Devon). By extension, clinical pharmacists can help to decrease prescription error rates and medication-related, non-elective hospital admissions.

In short, clinical pharmacists can help to improve not only the quality of care provided to practice’s service-users, but also the efficiency and well-being of other members of staff.

Please read NHSEI Devon Case Study and Clinical pharmacists in general practice: a necessity not a luxury? below, for more information.

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

What is their scope of practice?

Clinical pharmacists are qualified to carry out the following activities, as part of their scope of practice:

  • Collaborate with care homes to provide support on medicines-related issues
  • Conduct clinical switching protocols and alternative prescribing policies
  • Conduct evidence-based Medicines and Best Practice reviews
  • Conduct structured medication reviews
  • Domiciliary reviews
  • Educate other members of their MDT and patients on the use of specific medicines
  • Manage polypharmacy and co-morbidity complexities
  • Provide high-risk medicines monitoring
  • Provide medicines information and advice to other members of their MDT, patients, and the general public
  • Provide medicines reconciliation, supporting safe transfers of care
  • Provide prescribing and clinic management (e.g., Minor Ailments Clinics)
  • Treat patients with complex long-term conditions, like “difficult” hypertension

Please note that this is not an exhaustive list, however.

For more information on the scope of practice of this profession, please consult HEE’s Clinical Pharmacist Role Overview and the Dorset Training Hub’s page on clinical pharmacists.

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

Is funding available for them?

HEE stipulates that from April 2020, clinical pharmacists will be reimbursed via the Additional Roles Reimbursement Scheme (ARRS) at 100% of actual salary plus defined on costs. This is up the maximum reimbursable amount of £55,670 over 12 months.

Source:

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

Are there any case studies?

NHSEI is able to provide a couple of case studies, focused on clinical pharmacists located in Devon and Norwich, and the valuable contributions they made to their respective practices.

For more:

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

What characteristics, training / qualifications, and competencies should they have?

Please find information on what you should look out for when employing a clinical pharmacist below:

Personal Characteristics

Clinical pharmacists should have personal characteristics that are in keeping with the Standards for pharmacy professionals provided by the General Pharmaceutical Council, with the most recent standards being published in May 2017. They outline what is expected from pharmacy professionals, and serve as a reflection of how pharmacy professionals view themselves and their colleagues.

In short, clinical pharmacists should adhere to these nine standards:

  • Provide person-centred care
  • Work in partnership with others
  • Communicate effectively
  • Maintain, develop and use their professional knowledge and skills
  • Use professional judgement
  • Behave in a professional manner
  • Respect and maintain patient confidentiality and privacy
  • Speak up when they have concerns or when things go wrong
  • Demonstrate leadership

To read the Standards themselves, which include a breakdown, please click here.

Training and Qualifications

Clinical pharmacists must have completed a General Pharmaceutical Council-accredited (GPhC) Master of Pharmacy (MPharm) degree. This is typically a full-time, four-year course, provided by a number of universities from across the country.

A clinical pharmacist should also be registered with the General Pharmaceutical Council (GPhC). To see what is required to register with the GPhC, please consult the guide linked below, published in January 2021.

To access it the guide, please click here.
For a list of all accredited courses and qualifications, please click here.

To be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that pharmacy technicians must meet.

For a breakdown of these, please click here.

Competencies

Clinical pharmacists should have experience with the following competencies:

  • Working with GPs and patients to address medicine adherence
  • Reviewing patients on complex medicine regimens
  • Triaging and managing common ailments
  • Responding to acute medicine requests
  • Managing and prescribing for long-term conditions (often with the practice nurse)
  • Holding minor ailment clinics
  • Prescription management
  • Dealing with medication for patients recently discharged from hospital
  • Helping the practice deliver on the patients recently discharged from hospital
  • Helping the practice deliver on the Quality, Innovation, Productivity and Prevention (QIPP) and Quality Outcomes Framework (QOF) agenda and enhanced services
  • Delivering repeat prescription reviews
  • Being the point of contact for all medicine-related queries
  • Overseeing the practice’s repeat prescription policy
  • Taking over clinical medicines reviews from GPs
  • Audit and education
  • Medicines management
  • In dispensing practices, pharmacists can take responsibility for the business management of the dispensary

This list has been sourced from HEE’s Clinical Pharmacist Role Overview. To see the original, please click here.

Are there any requirements to receive ARRS funding?

As noted under ‘Is funding available for them?‘, clinical pharmacists can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that clinical pharmacists must adhere to.

For instance, as stated in Annex B of the Clinical Pharmacist Direct Enhanced Service (DES) contract:

  • “B1.1. Where a PCN employs or engages a Clinical Pharmacist under the Additional Roles Reimbursement Scheme, the PCN ensure that the Clinical Pharmacist is enrolled in, or has qualified from, an approved 18-month training pathway or equivalent that equips the Clinical Pharmacist to:
    • a. be able to practice and prescribe safely and effectively in a primary care setting (for example, the CPPE Clinical Pharmacist training pathways);
    • b. and deliver the key responsibilities outlined in section B1.2.”

Section B1.2. relates to the key responsibilities that clinical pharmacists must undertake.

To read the full annex, please consult ARRS Minimum Role Requirements below.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What employment routes are there?

According to the General Pharmaceutical Council (GPhC), there are two routes to registration for clinical pharmacists intending to work in Great Britain. As laid out in their Criteria for registration document, the routes are:

  • Initial registration by UK- and internationally-qualified pharmacy technicians
  • Initial registration by an applicant not in possession of a relevant European qualification
  • Returning to registration after a period of absence

All three routes are detailed in the Criteria document, linked below. In addition to education and training checks, the registration routes also look at candidates’ health, character, identity, and grasp of the English language.

For more information:

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

Please note: to be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that clinical pharmacists must meet.

For a breakdown of these additional requirements:

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

Any example job descriptions?

NSHEI have developed a job description, in addition to a recruitment pack — these are both available on the FutureNHS site. Accessing the site requires you to create an account; once done, you can visit the role selection page to find the resources in question (click here to jump to the role selection page — remember, you will need to be logged in to access it).

Alternatively, you can download HealthWest’s job description by clicking here.

The Primary Care Pharmacy Association (PCPA) have also kindly provided several example job descriptions, for various bands of working, on their site, accessible via the button below.

Any sample interview questions?

The Primary Care Pharmacy Association (PCPA) kindly provides sample interview questions for clinical pharmacists on their website, accessible via the button below. The sample interview questions themselves are at the bottom of the page.

What clinical supervision do they need?

When employed in primary care under the Additional Roles Reimbursement Scheme (ARRS), clinical pharmacists must be part of a professional clinical network and receive clinical supervision. Specifically, they must have:

  • A minimum of one supervision session per month, delivered by a senior clinical pharmacist
  • Senior pharmacists should receive a minimum of one supervision session every three months, delivered by a GP clinical supervisor
  • All pharmacy professionals must have access to an assigned GP clinical supervisor, whom can provide support and development
  • There should be a ratio of one senior clinical pharmacist to five clinical pharmacists — and in all cases, appropriate peer support and supervision must be in place for each pharmacist

Sourced from:

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

The Centre for Pharmacy Postgraduate Education (CPPE) offers training to become a clinical supervisor for individuals supervising pharmacy professionals on the CPPE Primary Care Pharmacy Education Pathway. This is a half-day workshop generally, but it can be completed by attending two webinars.

Interested individuals can apply for a space via the CPPE website, here. If you are not a pharmacy professional, you will need to create an account on the site before you are able to book a place.

For more:

Primary Care Pharmacy Education Pathway

This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.

To read it, please click here.

What should practice induction include?

Practice induction for clinical pharmacists should include:

  • Signing them up on e-Learning for Health (e-LFH) to complete mandatory training | Please click here to access e-LFH
  • Signing them up on TeamNet, so that they can access relevant policies | Please click here to access TeamNet
  • Provide them with EMIS training, via the CCG
  • Familiarise them with the BNSSG Joint Formulary | Please click here to access it
  • Link with the CCG Medicines Optimisation Team, particularly if they should need Eclipse / Radar training
  • Provide them with Docman training
  • Set them up on the CPPE site and with access to Canvas, so they that can undertake the Centre’s e-Courses | Please click here for more information

Clinical pharmacists should be sure to meet and shadow your PCN’s current pharmacists and prescription team. They should meet practice manager(s), deputy practice manager(s), reception manager(s), reception lead(s), clinical staff, and their supervisor(s), in addition to the CCG’s Medicines Optimisation Pharmacist.

What ongoing support is available for clinical pharmacists?

There are various ways in which clinical pharmacists can receive support, including:

The ACP Forum

Organised and led by our ACP Lead, Kerri Magnus, The ACP Forum can assist clinical pharmacists on the journey to becoming an advanced clinical practitioner. The Forum can signpost to relevant education and training, provide 1-to-1 guidance, and facilitate networking with like-minded colleagues from across BNSSG.

To visit The ACP Forum’s site, please click here.

The Hub's Physiotherapy Lead

We hope to soon be welcoming a new member to our team: a Physiotherapy Lead. They will provide a point of contact for clinical pharmacists, helping you to set objectives and career goals, and to keep in the loop with our pharmacy-related work.

Please stand by for more.

Centre for Pharmacy Postgraduate Education (CPPE)

The CPPE is part of the Division of Pharmacy and Optometry in the University of Manchester’s Faculty of Biology, Medicine, and Health. It is dedicated to providing professional development opportunities and support to pharmacy staff, including through coaching and networking.

To find out more, please click here.

Literature
ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

Primary Care Pharmacy Education Pathway

This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.

To read it, please click here.

Standards for pharmacy professionals

Regulated by the General Pharmaceutical Council, these standards outline what is expected of pharmacy professionals, including clinical pharmacists.

To read them, please click here.

A/V resources
I'd like to see the clinical pharmacist

Produced by NSHEI for the NHS’ 70th anniversary in 2018, this video explores the role of a clinical pharmacist in their primary care MDT.

To watch it, please click here.

[This video was uploaded on 07.05.19.]

Nursing Associates

Nursing ASSOCIATES

A new role in England, bridging the gap between care assistants and registered nurses

NURSING ASSOCIATES

Deliver hands-on, person-centred care for people of all ages, and in a variety of settings in health & social care

Nursing Associates

The NMC became the regulator for this role, in England, in July 2018

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What can nursing associates do?

What benefits can nursing associates bring?

What should I look for from a nursing associate?

What is their scope of practice?

What benefits can nursing associates bring?

How much training do they have?

Can I receive funding to employ them?

Can I see some case studies?

Am I eligible for the apprenticeship levy?

What academic qualifications should an NA have?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do I need to provide?

Who can supervise a trainee nursing associate?

What ongoing support can I provide?

What can nursing associates do?

The nursing associate role is a new role in the NHS, bridging the gap between a healthcare support worker and a graduate registered nurse. Nursing associates are qualified at foundation-degree level and work with individuals of all ages / backgrounds, across a range of health and social care settings.

Nursing associates work alongside registered nurses, carrying out much of the same clinical duties and care, but they do not share the same status and therefore cannot perform certain tasks

What benefits can nursing associates bring?

The nursing associate role was introduced in 2015, in response to the Shape of Caring Review from Health Education England. This document stipulated that healthcare assistants and nurses require high-quality education and training, if they are to provide the highest standard of patient care, and identified three key problems within primary care:

  • A lack of training / development opportunities for HCAs, despite their supporting the bulk of over 60% of care work
  • An aging population with increasingly complex needs which demanded nurses delegate tasks more, so that they are able to focus on these complex issues
  • A shortage of nurses in the NHS and social care

Including nursing associates in your MDT will help address these issues and convey the following benefits:

  • Improved service delivery and patient care
  • Improved staff retention
  • A ‘grow your own’ nurse workforce
  • A tried-and-tested nursing programme, accredited by the NMC
  • Nursing associates, once qualified, can go on to registered nurse status
  • Providing supervision and preceptorships can improve recruitment and retention rates
Sources

HEE’s Why hire a nursing associate?
Click here

HEE’s Nursing Associates page
Click here

What should I look for from a nursing associate?

The Standards for Proficiency for nursing associates, as set out by the NMC, outlines six standards:

  • Be an accountable professional
  • Promote health and prevent ill health
  • Provide and monitor care
  • Work in a team
  • Improve safety and quality of care
  • Contribute to integrated care

Two annexes emphasise that nursing associates should be able to communicate effectively and sensitively, and to manage relationships with people, too.

For more information, please read the Standards themselves, by clicking the button below.

What is the scope of their practice?

Nursing associates work with people of all ages, in a variety of settings in health and social care; contribute to the core work of nursing; and free up registered nurses to focus on more complex clinical care.

Duties / areas nursing associates cannot perform:

  • Act autonomously to change the prescribed plan of care
  • Act autonomously in situations where there may be limits to confidentiality – for example, in safeguarding situations
  • Decide to make specialist referrals
  • Decide to share information across multiagency boundaries
  • Interpret and resolve risk issues (they must be able to identify risk and halt practice if necessary)
  • Decide to discharge an individual from a service
  • Manage situations of conflict or risk beyond immediate actions to maintain safety
  • Administer medicines under a patient group directive
  • Prescribe medicines
How much training do they have?

In addition to complying with the NMC’s Standards for Proficiency, registered nursing associates must have completed a foundation-level qualification approved by the NMC over the course of two years. This usually involves 2,300 hours of training and studying, split between academic and vocation-based learning.

A condition of the programme is that nursing associates must gain experience of all nursing areas: mental health, learning disability, adult, and children, to ensure they have the breadth and depth of knowledge and experience needed to support and enhance the quality of care. This is achieved by trainees taking on placements outside of their usual employment setting.

Can I receive funding to employ them?

As an employer, you can fund your nursing associate programme through the apprenticeship levy scheme. This is paid by all employers who have an annual bill of £3 million or more, which they can claim as funding for a max of 15,000 per employee.

Nursing associates are commonly taken on by employers via the apprenticeship route, but there are a number of self-funded university-level courses.

You can find out more about how you can employ nursing associates through the apprenticeship route below.

NAs and the apprenticeship levy: A quick guide for employers

To read this document from HEE, please click here.

Apprenticeships Procurement Toolkit: Guidance for Employers

To read this document from HEE, please click here.

Using the apprenticeship levy

To read this article from NHS Employers, please click here.

Your Future Nursing Associates infographic

To view this infographic from NHS Employers, please click here.

Can I see some case studies?

There are a number of case studies available from HEE, with many NHS Trusts across England – including Devon, Birmingham, Pennine, and Mersey – having employed nursing associates.

You can access these studies below. Please do note, though, that many of them pertain to settings other than primary and social care.

Am I eligible for the apprenticeship levy?

Employers with a payroll of more than £3 million can use their apprenticeship levy contributions to pay for places on apprenticeship programmes. Any business with a payroll below £3 million is eligible for government funding that will cover at least 95% of the cost of an apprenticeship course.

As an employer, you must be able to meet any costs exceeding the 15,000 per employee allowance, and this includes clinical supervision. For more information, please click the button below.

What academic qualifications should an NA have?

A nursing associate should have:

  • A foundation-level qualification accredited by the Nursing and Midwifery Council, completed over two years
  • This must include 2,300 hours of on-the-job training and academic study, with varied clinical placements
  • This is principally achieved through an apprenticeship or self-funded university route

Additionally, trainee nursing associates must:

  • Be employed within healthcare, for 30 hours+ per week
  • Have the support of their employers
  • Confirm eligibility for apprenticeship funding *
  • Have evidence of study at level 3 (e.g., A Levels, BTEC Health & Social Care, or evidence of ability to study at or above this level)
  • Level 2 / GCSEs in Maths and English, at C+
  • Have an Enhanced DBS Adult and Child Workforce, dated within the last 12 months
  • Have occupational health clearance from their employer

* Please note: entry requirements will vary between universities

Any example job descriptions?

At present, HEE have not issued any job description for the nursing associate role. However, it is clear that this will likely cover and include experience, skills, and attributes described in previous sections as core to the nursing associate role.

Once qualified, a nursing associate will be able to undertake skills including, but not limited to, compression bandaging, drug administration, cervical cytology and childhood immunisations.

Any sample interview questions?

At present, there are no guidelines on job interview questions. But HEE shall be releasing some guidance on the job description details for nursing associates in the near future.

What clinical supervision do I need to provide?

Trainee nursing associates are assigned a practice supervisor, a practice assessor, and an academic assessor. Practice supervisors can be any registered health and social care professional, though it is typically a registered nurse, in the case of nursing associates. Practice assessors cannot simultaneously be the supervisor for a student.

Supervision is outlined by the NMC’s employer guidance as follows:

  • Sharing, demonstrating, and providing support
  • Confidence building
  • Encouraging and developing reflective practice
  • Developing appropriate skills and competence
  • Supporting learning
  • Providing any required guidance, signposting, and information
  • Helping the trainee nursing associate to make progress

Additionally, whilst in your employ, trainee nursing associates should have:

  • A thorough induction into work
  • Preceptorship * and mentoring (especially if newly-qualified)
  • Ongoing access to professional development

For more information on supervision standards, supervision codes of conduct, and the * principles of preceptorship, please look below.

Standards for student supervision and assessment

To view this document from the NMC, please click here.

Practice supervisor preparation

To read this article from the NMC, please click here.

Principles of preceptorship

To read this article from the NMC, please click here.

Who can supervise a trainee nursing associate?

The curriculum framework states that supervision can be provided by an appropriate manager or any registered health professional (e.g., a registered nurse (across any of the professions)) working in practice that has been prepared to take up the role and is up-to-date on the knowledge and experience relevant to the student.

Supervision can be provided directly / face-to-face or indirectly / virtually.

What ongoing support can I provide?

You can:

  • Assign supervisors for each trainee nursing associate on placement
  • Manage both poor performance and recognise good performance — and, legally, you are responsible if a nursing associate carries out duties beyond their defined capacities and this results in errors or harm
  • Conduct annual appraisals, to review the progress and performance of nursing associates in your practice
  • Take all steps to improve management of the employee’s fitness to practice

You can read more about the support you should provide and your responsibilities by clicking the button below.

Additional literature
HEE's easy-read

To download HEE’s easy-read guide on nursing associates, click here.

Additional A/V resources
New Roles: Nursing Associate

To watch HEE’s video on the work of nursing associates and their invaluable opportunity the role provides, in the words of an nursing associate ambassador, please click here.

[This video was published on 25/10/19]

Becoming a nursing associate

To watch HEE’s video on becoming a nursing associate and joining the wider nursing team, please click here.

[This video was published on 08/01/20]

Physician Associates (PAs)

Physician associates

Use their generalist medical education to work with GPs, physicians, and surgeons

Have been in the UK for over ten years, with the knowledge, skills, and attitude to deliver supervised holistic care in general practice

The Department of Health predicts there will be 1,000 qualified PAs across the country by the end of 2020

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Questions?

If you have any questions relating to physician associates (PAs), please consider contacting the South West Physician Associate Network (SWPAN) by clicking here.

Join the SWPAN

If you’re a physician associate looking to network with other PAs in the South West, consider joining the South West Physician Associate Network (SWPAN); it was formed as a central hub to keep PAs across the region connected and up-to-date.

Find out more by clicking here.

NEW: What are they?

What can a physician associate do?

What should you look for from a PA?

What is their scope of practice?

How much training do they have?

NEW: Can I receive funding for a PA?

Can I see some case studies?

How should I go about recruiting a PA?

What academic qualifications should a primary care PA have?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do I need to provide?

What ongoing support can I provide?

What should practice induction include?

NEW: What are they?

Physician associates (PAs) are clinical graduates, trained in the medical model and intended to seamlessly integrate with the modern healthcare workforce. They have received 5 years of training, having completed an intensive 2-year university course at diploma or Masters’ level and a 3-year biomedical or healthcare-related degree. With 37 Higher Education Institutes providing PA training programmes, there is an increasing number of qualified PAs in the UK.

PAs are intended not as a substitute for GPs, but as a complementary role, to work alongside the wider practice team in providing continuity of care for patients, especially those with long-term conditions. PAs can diagnose illnesses, develop management plans, and perform physical examinations (see What is their scope of practice? for more). With support, PAs can conduct themselves autonomously; they require a named consultant for supervision purposes, but as they gain experience, the necessary level of supervision will decrease.

What is a Physician Associate? [SWPAN]

Produced by SWPAN, this page outlines what PAs are and what their qualification process is like.

To visit this page, please click here.

Physician Associates in General Practice [Health Careers]

Available on the NHS Health Careers site, this page elaborates on the role of PAs in primary care specifically and serves as a landing page from which to learn more.

To visit this page, please click here.

Physician Associates in Primary Care [HEE]

Likewise, produced by HEE, this page also explores the role of PAs in primary care and offers links to further information.

To visit this page, please click here.

What can a physician associate do?

All PAs can:

  • Access, manage, and treat patients with a variety of acute conditions
  • Conduct telephone consultations
  • Develop and deliver appropriate treatment and management plans
  • Formulate differential diagnoses and management plans
  • Perform diagnostic and therapeutic procedures
  • Perform peak flow examinations
  • Perform physical examinations
  • Perform urine dip sticks
  • Provide health promotion and disease prevention advice
  • Request and interpret diagnostics studies
  • Review laboratory test results
  • See patients with undifferentiated diagnoses
  • Send out referrals
  • Take medical histories from patients
  • Triage patients

Some PAs can:

  • Carry out home visits (including to care homes)
  • Offer specialised clinics, including family planning
  • Run checks for COPD, asthma, diabetes, and anticoagulation

With more experience, PAs can:

  • Provide service development and design, serve as clinical placement leads for students, and undertake minor operations
What should you look for from a PA?

When identifying PAs to join their PCN, GPs should look for candidates whom:

  • Are recognised and qualified by the Faculty of Physician Associates (FPA) register
  • Are on the Managed Voluntary Register (click here to learn more)
  • Have completed their postgraduate medical training in PA studies
  • Have trained in the UK
What is their scope of practice?

A PA’s scope of practice covers:

  • Taking medical histories from patients
  • Carrying out physical examinations
  • Seeing patients with long-term chronic conditions
  • Formulating differential diagnoses and management plans
  • Performing diagnostic and therapeutic procedures
  • Developing and deliver appropriate treatment and management plans
  • Requesting and interpreting diagnostic studies
  • Providing health promotion and disease prevention advice for patients
Can I see some case studies?

Click here to read Physician Associates and how they could help your practice.

This document, produced by NHS Castle Point and Rochford, pertinently features a piece on the day-in-the-life of a physician associate, as well as some discussion of how they are educated and trained, and how to supervise a graduate PA in practice.

Click here to read about several examples of PA graduates working in general practice.

This document was produced by the University of the West of England.

Click here to find five more case studies from and about five PAs, ranging from students to senior PAs, at the RCP’s Faculty of Physician Associates site.

How should I go about recruiting a PA?
Recommended guidelines:
  • Ensure that your GP practice is clear on what role they need to fill, and the duties involved in primary care
  • Write a clear job description* detailing the duties of the role / what is expected of the PA. Bear in mind that the PCN will need to grant the PA some variation in working hours when offering the job position
  • Produce a clearly-defined and thorough job plan for the PA, taking into account CPD / career progression and a means by which to monitor their progress in primary care
  • Remember that newly-qualified PAs will require regular supervision
  • Allow for one dedicated GP / supervisor whom can get to know the PA, and vice versa

* Example job descriptions can be found in the ‘Any example job descriptions?’ section.

Click here to read HEE’s guide on recruiting PAs in general practice.

Click here to read An employers guide to physician associates.

This document was produced by the Royal College of Physicians’ Faculty of Physician Associates.

What academic qualifications should a primary care PA have?

A PA should have:

  • A post-graduate qualification consisting of 2 years of study, with 1,600 clinical hours and 1,600 hours of theory
  • An undergraduate degree in biomedical science / life sciences
Any example job descriptions?

To download a generic job description for a PA position, please click here.

For another example of a generic job description for a PA position, please click here.

To download a generic PA person specification, please click here.

Any sample interview questions?
  • What made you want to be a PA, not a doctor?
  • Why do you want to be a PA in primary care?
  • How do you see the role?
  • How do you deal with stress / teamwork / decision making?
  • What would you want to specialise or work towards in primary care?

  • Questions based around safeguardingScenarios might include:
    • You have a patient with a high NEWS score whom you think needs admitting, and your supervisor says they are able to go home. What do you do?
    • You have concerns regarding domestic violence and the person has a child with them. What do you do?
    • You are asked to stay late and hold a clinic beyond your level of competencies. What do you do?
What clinical supervision do I need to provide?

Each PA employed will require regular and ongoing supervision to develop in their role and within the PCN, with newly-qualified PAs requiring more than more experienced PAs.

Click here to download GP Supervisor and Physician Associate Guide: A step by step handbook for the first year in general practice as a PDF.

And click here to download it as a Word document.

What ongoing support can I provide?
  • You should provide one dedicated supervisor (a GP or otherwise) per PCN, whom the PA can get to know and form a bond with, and vice versa
  • There should be a six-month probation period with a review
  • The PA should be appraised on an annual basis
What ongoing support can I provide?
  • Employers should meet with PAs in their first week of work
  • Assess their skills and knowledge in and around general practice
  • Create a structured programme of specific educational goals
  • Establish a review process, with yearly appraisals and reviews every 3 – 6 months
NEW: Can I receive funding for a PA?

From April 2020, the PA role will be reimbursed at 100% of its actual salary plus defined on-costs, up to the maximum reimbursable amount of £53,724 over 12 months, via primary care networks.

As of 1 March, 2021, physician associates are on the list of healthcare professionals eligible to apply to the New to Partnership Payment Scheme (N2PP). This scheme offers participants up to £20,000, plus a contribution towards on-costs of up to £4,000 (for a full-time participant) and up to £3,000 as a training fund, all for PAs transferring into a partnership role.

PAs on N2PP

For more information on and a breakdown of N2PP, please click here.

How much training do PAs have?

PA students already have an undergraduate degree in life science, and / or a significant background in health care. To become a PA, students must complete a two-year, full-time, intensive postgraduate course at diploma or masters’ level in Physician Associate studies, which includes over 1,400 hours of clinical placement experience in both acute and community settings.

A new route to becoming a PA, via a four-year undergraduate Masters’ programme, is being considered.

Once qualified, PAs must maintain 50 hours of CPD per year and sit a re-certification exam every 6 years.

Additional literature
UWE's quick-reference placement guide

To download UWE’s easy-read guide on hosting PA students, click here.

HEE's easy-read

To download HEE’s easy-read guide on physician associates, click here.

South West Physician Associate Network

The South West Physician Associate Network (SWPAN) was formed as a central hub for PAs across the South West, enabling them to network, stay up-to-date, and contribute to the betterment of the profession as a whole.

To visit their site, please click here.

Additional A/V resources
A day in the life of a PA

To watch HEE’s video on the day in the life of a physician associate, click here.

Karen's storey #1

To watch part 1 of HEE’s video on physician associates working in general practice, click here.

Karen's storey #2

To watch part 2 of HEE’s video on physician associates working in general practice, click here.

South West ARRS Workforce Summit case study

To download HEE’s easy-read guide on physician associates, click here.

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