More awareness needed for physician associates to be accepted into GP workforce
- New study shows patients would welcome physician associate support for General Practice teams
- Research highlights need to address concerns, and pre-conceptions about physician associates
- Findings have informed changes to Post Graduate Diploma in Physician Associate Studies at the University of Sheffield
Physician associates may be prevented from providing support to general practice at a time of staffing crisis due to a lack of awareness and understanding, a new study has found.
Research from the University of Sheffield has shown physician associates (PAs) – whose role is to support doctors in the diagnosis and management of patients, and who have been described as one possible solution to the workforce problems facing primary care – may meet resistance from GPs, despite being welcomed by patients.
The study, published in the British Journal of General Practice, found more needs to be done to remove the barriers and prejudices facing PAs in order to establish how effective they may be in helping to relieve the unprecedented pressure on frontline staff.
Dr Ben Jackson, lead author of the study and Head of Teaching in Primary Medical Care at the University of Sheffield, said: “General Practice is the cornerstone of the NHS and the workforce issues are critical.
“Although PAs will not offer a complete solution to the NHS crisis they may help to reduce waiting times in surgeries for patients and allow GPs to focus on patients with more complex needs.
“It is really important to understand what barriers might be in place preventing PAs from effectively integrating into the general practice workforce in order to address them.”
Researchers from the University of Sheffield found that although GPs expressed concerns regarding PAs non-prescriber status and the supervision burden, they recognised that support for general practice was needed to improve access for patients.
Advanced nurse practitioners (ANP) who took part in the study highlighted their own negative experiences entering advanced clinical practice, and the need for support for new PAs to counteract stereotypical and prejudicial attitudes.
The findings showed patients were more accepting of a PAs role and were less concerned about specific competencies as long as there was effective supervision.
“Although we desperately need more doctors and nurses, the physician associate profession allows an additional route for people with science backgrounds to be involved in health care who would not have otherwise done so,” said Dr Jackson.
“Patients broadly welcome the new role and the potential support this would provide. Their training in the medical model was identified as a factor that may make them especially suitable to work under the supervision of GPs as part of their teams.
“This research does not assess how effective PAs are - but highlights that more understanding about the role is necessary.”
This research does not assess how effective PAs are - but highlights that more understanding about the role is necessary.
Dr Ben Jackson, Head of Teaching in Primary Medical Care
In response to the findings, researchers from the University of Sheffield have proposed a conceptual model to help regulators and educationalists support the integration of PAs. This could have relevance to other advanced clinical roles emerging in primary care such as practice nurses, paramedics, pharmacists and even physiotherapists.
The University of Sheffield is one of a number of UK universities who offer a Post Graduate Diploma in Physician Associate Studies aimed at talented graduates who have achieved a high grade at degree level in Biochemistry, Physiology or Biomedical Science.
The new study has already informed curriculum changes to the Physician Associate Studies course at the University of Sheffield in order to help PAs overcome the barriers highlighted and improve the chances of successful integration, in collaboration with NHS stakeholders.
Additional teaching and learning on clinical decision-making and managing complex health care, increasing the minimum amount of time spent in general practice and A&E settings and enhancing learning on drugs management have now been implemented on the course in response to the new study.
The role of the PA was originally developed in the US in the 1960s, primarily as a method of increasing access to healthcare for underserved communities. In 2003, a number of PAs were recruited from the US to both accident and emergency (A&E) and general practice in the West Midlands in response to an acute workforce shortage at the time. The first UK-trained PAs graduated in 2009 and as the ongoing workforce crisis in A&E and primary care continue, there is a renewed interest in the role with Health Education England now starting to invest in its development.
There were 51 participants in the study – 30 GPs, 11 ANPs and 10 patients.
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