Physician Associates (PAs)

Physician Associates (PAs)

Physician associates

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

Have been around for four 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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…who use their generalist medical education to work with GPs, physicians, and surgeons in providing medical and direct patient care as part of a multi-disciplinary team.

with a number of organisations promoting them as “a new healthcare professional” whom, while not doctors, work to a medical model, with the attitudes, skills, and knowledge to deliver holistic care and treatment in general practice under supervision.

…as part of the Royal College of Physician’s (RCP) ‘future hospital commission’ report, published in 2013, and the Department for Health approximates 1,000 qualified PAs by the end of 2020.

Scroll over or click on the panes above to learn more about the PA role.

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?

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?

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: Safeguarding
    Scenarios 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

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.

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

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

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

Additional A/V resources

For the physician associate case study presented at HEE’s South West ARRS Workforce Summit (held October 2020), please click here

A day in the life of a physician associate

Physician associates working in general practice:
Karen’s story – part 1

Physician associates working in general practice:
Karen’s story – part 2

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