Kate Straughton President FPA 2002 2004 2008 2010 2013 2015 Professional organisation moved to FPARCP A bit of history 1 Woodin J McLeod H McManus R Evaluation of UStrained physician assistants working in the NHS in England Interim Report The introduction of UStrained phys ID: 1047145
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1. The future of the PA profession in the UKKate Straughton, President, FPA
2. 200220042008201020132015Professional organisation moved to FPA@RCPA bit of history…1. Woodin J, McLeod H, McManus R. Evaluation of US-trained physician assistants working in the NHS in England: Interim Report: The introduction of US-trained physician assistants to primary care in Tipton: First impressions2. Buchan J, O'May F, Ball J. New Role, New Country: introducing US physician assistants to Scotland. Human Resources for Health. 2007;5(1).Name changed to Physician AssociateManaged Voluntary RegisterFirst permanent courses started trainingPilot schemes in West Midlands 1 & Scotland 2First US-trained PAs came to work in the UK
3. National Curriculum and Exam2 year post-graduate course Approx. 2,000 PA students1,600 hours of clinical placements35 Courses across the UKPA training
4. New curriculum currently being written by FPA, RCP, PA Schools Council (PASC) and GMCThis will be a capabilities based, rather than current competency based curriculumHEIs will then either independently, or collaboratively design a syllabus to sit alongsideConsultation Autumn 2021Working towards publishing July 2022PA training
5. PA Training – Where does it happen?
6. Generalist role across many different specialties of medicine and surgeryTake written recertification exam every 6 years (currently)Currently not regulated but have a Managed Voluntary Register – Code of Conduct; Scope of Practice; CPD; FTPApprox. 2,700 qualified PAs working across England, Wales, Scotland and Northern IrelandPAs in the UK
7. PAs in the UK
8. Generalist Settings9% Emergency Medicine30% General Practice13%Acute Medicine1%Community MedicineAdult Medical Settings2% Cardiology5%Care of the Elderly0.4%Dermatology1.8%Endocrinology3%Gastroenterology2%General Internal Medicine<1%Genitourinary Medicine/ Sexual Health2%Haematology<1%Nephrology3%Neurology / Stroke2.3% Oncology3%Respiratory MedicinePaediatric Settings1%General Paediatrics<1%Neonatology<1%Paediatric Psychiatry1%Paediatric SurgeryPsychiatry Settings2%PsychiatrySurgical Settings<1%Cardiothoracic Surgery<1%ENT 5%General Surgery<1%Neurosurgery1%Obstetrics & Gynaecology<1%Plastic Surgery<1%Transplant Surgery3%Trauma & Orthopaedics1%Urology<1%Vascular SurgeryPAs in the UK: 2020 CensusFurther census findings available at fparcp.co.uk
9. Carry out Physical ExaminationsTake Medical Histories from patientsSee patients with long term chronic conditionsSee patients with undifferentiated diagnosesFormulate differential diagnoses and management plansDevelop and deliver appropriate treatment and management plans Request and interpret diagnostic studiesPerform diagnostic and therapeutic proceduresWhat do PAs do?Provide health promotion and disease prevention advice for patientsTaken from the Competence and Curriculum Framework, DOH 2012
10. But what impact does that have?Add continuityAct as additional resource for other staff members, patients, relatives…Can help to free up junior doctors to get to teaching or clinicsMore experienced PAs can support junior doctors in clinical setting, teach them, provide stabilityConcern re ‘stealing teaching opportunities’, ‘cherry picking jobs’ Evidence shows junior doctor training is not negatively impacted by having a PA 44. Roberts S et al. Experience of the impact of physician associates on postgraduate medical training: A mixed methods exploratory study . Clinical Medicine 2019 Vol 19, No 1: 4–10
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12. Career Progression“Lack of Progression” for PA professionCareer Framework in developmentNational Job ProfilesPortfolio or equivalentAdditional avenues – research, education, management, leadership, national representation
13. COVID-19Flexible generalist medical workforceInstitutional continuityhttps://www.fparcp.co.uk/covid-19
14. COVID-19https://www.fparcp.co.uk/covid-19
15. E-portfolio and other resources to support education and developmentMore regional representation for membersIncreased research about the UK PA role and working as part of the teamWork towards prescribing rightsEnsuring patients are informed of the PA role International recognitionStatutory Regulation with GMC45637281Moving ForwardCareer Framework to support progression
16. Thank you! kate.straughton@rcplondon.ac.uk @KateStraughton fpa@rcp.ac.uk @FPARCP