Physician Associate (PA) is a relatively new profession in the UK, formally introduced in 2003 though having already been established for over 40 years in the United States.
PAs are medically trained; they work with dedicated doctors as part of the team and provide medical care. Given how stretched health services are and the immense pressure faced, PAs demonstrate their valuable contribution to the field by taking some of this load and providing patients, especially those with long-term conditions, the continuity of care they need.
As outlined in the NHS Long Term plan for England, roles such as PAs are important in meeting current and future workforce demands. The NHS Interim People Plan estimates that there will be over 2,800 physician associate graduates by the end of 2020, rising to over 5,900 by the end of 2023.
The General Medical Council (GMC) has announced that PAs are to be regulated. With the end of 2021 being the anticipated date, the UK and devolved nation governments are working together alongside stakeholders to develop the legislation. Once implemented, PAs will see an expansion of their duties to cover prescribing and ordering radiology investigations.
About the online event
In February 2020, we held an 'RCPCH Advanced Clinical Practitioners and Physician Associates Event' at the College. The feedback regarding the event was very positive and deemed a success by all those involved. There was much learning and reflection on both sides which we highlight in a report that can be accessed at the bottom of this page in the resources section.
Determined to not letting the COVID-19 pandemic hinder our progress in this important area, we decided to launch our second event, a focus day on PAs in Paediatrics which we held virtually. Our online event took place on 6 October 2020. The aim of the event was to bring together people interested in the field – whether they were currently in the profession, working with PAs, interested in employing them or interested in entering the profession.
Over 220 people registered for the event, of those 44% were currently PAs, 28% were student PAs and another 7% were Paediatric Consultants. Other registrants included Nurses and Advanced Clinical Practitioners (ACP).
The event was chaired by Dr Nicola Jay, RCPCH Officer for Workforce, who started off the day with an introduction and state of play of PAs in paediatrics, followed by a talk on the importance of a multidisciplinary team in achieving better child health outcomes.
We received abstract submissions from PAs about their own projects. They presented these in a series of 10-minute presentations, and posters were also available to view in the breaks. The abstracts submitted were phenomenal and provided a great insight into the vast area PAs work on and what the profession brings and contributes to the workforce. The oral abstract presentations were assessed by a panel of judges and a winner was selected.
Projects presented on the day included:
- Response to strangulation cases in child protection medical assessments (winner)
- PA-led constipation clinics
- Optimising pain management in the Emergency Department
- Rectal suction biopsies
- The expanding role of the Surgical Physician Associate in the diagnosis of colorectal cancer
- Infant feeding audit
- Investigating opportunities for training using virtual clinics
- Improving epilepsy patient care
- Developing a referral pathway for managing children and young people with severe obesity
In the afternoon workshops, discussions in small groups took place. A group of PA ambassadors and the RCPCH Workforce Team facilitated two topics of discussion:
- The added value of PAs to a team and organisation. How should their effectiveness be demonstrated and measured?
- How to improve support for PAs with discussions covering the barriers/ facilitators of integrating PAs into the team, career progression and what PAs need from their employers and the RCPCH.
Through these discussions, barriers and facilitators in the profession were identified, for example:
- Upon recruiting PAs, it is crucial for consultants to explain to the team what the PA role is, their purpose, and the remit of their duties.
- The importance of embedding knowledge about the specified role of the PA in a team was a recurring point raised during the workshop discussions.
- There was also mention of a reluctance to train PA in Paediatrics if the PA was to be present in the role for a short period.
- It is important for there to be a plan as to what the PA is expected to do upon arrival into the role at the organisation/ department and the training which they will undergo.
- For instance, a participant gave an overview of their work which involved creating a coding system that quantifies effectiveness based on the daily duties of the PA (e.g. examination, requesting investigation).
- The importance of having a champion in the workplace and supervisors who are enthusiastic and committed to education and training.
Attendees shared their personal career paths, experiences, and expected career progression. This provided others with awareness as to how they may steer their own routes towards their area of interest. Attendees reported that they appreciated the opportunity to network and communicate with PAs from various Trusts/ specialties and found the exposure to Paediatric PA peers insightful. It also provided a platform for learning and hearing about the experience of different PAs and how effectiveness was proved in respective roles.
Following the event, attendees were invited to complete a feedback form. Overall feedback from the event were very positive and deemed a success by those involved, achieving a rating of 4.5/5 stars. The event provided an opportunity for learning on both sides. Discussions were stimulating and provided further insight into this relatively new profession and the needs to be addressed going forward.
Free text feedback from participants included:
I appreciate the input that came from different medical professionals. It gave me a more realistic understanding of the current contribution and further potential that physician associates can impart in Paediatrics. The event has also nicely elucidated ways on how we can improve health care in general with greater teamwork and more diverse collaboration.
Variety of topics & different speakers, very interesting & informative. Great to hear such enthusiasm around the PA role in paediatrics!
A very wide ranging and informative meeting.
As for the next steps, given the importance of this area and multidisciplinary paediatric teams coupled with the great level of interest in the event and the successful outcomes of the day, we are looking into the opportunity of holding PA focus day events on an annual basis.