1. The Physician Associate Jeannie Watkins PA-R Senior Lecturer & Clinical Placement Lead St Georges’ University of London

2. Physician Associate (PA) O What is a PA? O What can they do? O PA Education and Training O Benefits of PAs to the medical team O Regulation O Employment O Salary O Closing Thoughts…… O Questions

3. What is a Physician Associate? A physician assistant is a healthcare professional trained in a medical model who works as part of a medical team with doctors to provide medical care.

4. What can they do? O Take medical history O Physically examine a patient O Diagnose with possible differentials O Diagnostic tests/procedures O Treatment and Management Plans O Referrals accept and receive O Medications* O All with physician supervision*

5. The Physician Associate Role O The Doctor-PA Relationship O Trust O Competence O Centrepiece O Context for extension of care O From within the Doctor-PA relationship the PA exercises autonomous medical decision making to extend healthcare to the doctor’s patients.

6. Examples of Conditions PA’s See

7. Supervision Required Out of a total of 391 patients seen 367 23 6

8. Education

9. PA Programmes Curently 5 Programmes  Aberdeen University  Brimingham University  St George’s University of London  Wolverhampton University  Worcester University Starting 2015  Plymouth, Reading At least 5-6 others planning programmes for 2015/2016 starts

10. Prospective Students  First degree  Healthcare experience  Self funding  Clear about career pathway  Motivated

11. SGUL PgDip PA Studies Course Outline O 2 year full-time programme (92 weeks) Theoretical & Clinical elements O Year 1 I nduction period 80%/20% theoretical/clinical Clinical Placements: GP O Progression Point O Year 2 20%/80% theoretical/clinical Clinical Placements: 1600 hours over 2 years *Students must pass all elements of programme both 1 st and 2 nd yr to progress to national exam

12. SGUL PgDip PA Studies O Theoretical Elements O Foundations in Clinical Medicine O Evidence Based Medicine O Pharmacology O Personal and Professional Development O Research Methods

13. SGUL PgDip PA Studies Clinical Placements Core PlacementsMin Hours O General Practice 300 (120 yr1) (180 yr2) O General Medicine 360 O A & E 180 O OBGYN90 O Paediatrics90 O Mental Health90 O Surgery90 Electives:eg. Cardiology, GI, Renal, GUM270 (total for electives)

14. PA are trained to be: O Aware of the limits of their competence O Team players O Lifelong learners

15. Benefits of a PA Flexible O Complement the medical team O Do not deplete existing workforce O See a variety of undifferentiated patients with a range of problems O Outpatients O Ward work O On-take MAU/A&E O Home visits GP O Covering Nursing homes etc

16. Benefits of a PA Stable and Consistent O No rotation O Increase access to healthcare O Provide capacity in the team sick patients, juniors training, cover for sickness and leave O Familiar with patients - can trouble shoot

17. Regulation O Currently no Statutory Regulation O unable to prescribe O unable to request ionising radiation O Established Managed Voluntary Register O Public protection and safety O PAs sign up to: O Code of Conduct and Scope of Practice O 50 hours CPD per year O Recertification exam every 6 years (SBA’s) O Fitness to Practice Mechanism O UKAPA – Professional body – Faculty of PAs at RCP

18. Employment O 220 PAs working across the Country in over 20 specialties O Demand is currently outstripping supply O We will only accept PAs who are UK and US trained as demonstrable and comparable standards of training and education O Employers must check if PA on the MVR O PAs must pass their University Exams and the PA National Exam to practice – cannot practice without both of these

19. Salary Currently AFC banding in NHS O New Graduate - £30k + (band 7 AFC) O *Internship (one year of closely supervised training following qualification)– £26-£30K (band 6) – then band 7 O More experienced PAs 3-5yrs £35-£40K O 5 years + £40k -£55K NB: Can be negotiated if in GP

20. Closing Thoughts…….. O PAs are coming to a town near you O Complementary part of medical workforce not replacements for medical staffing O Properly introduce into the workforce O They will not be right for every post you have vacant O Will not solve all of the problems in the NHS……..but are definitely part of the solution O Consider PA student placements!

21. Questions?