Overview
Physician associates are healthcare professionals who work as part of a multidisciplinary team with supervision from a named senior doctor (a General Medical Council registered consultant or general practitioner), providing care to patients in primary, secondary and community care environments. PAs are part of the government’s medical associate professions (MAPs) grouping in the health and care workforce and have been working in the UK since 2003
(Faculty of Physician Associates, 2024)
The Faculty of Physician Associates (fparcp) provides professional support to physician associates across the UK. The FPA oversees and administers the running of the Physician Associate Managed Voluntary Register (PAMVR). The FPA reviews and sets standards for:
- the education and training of physician associates
- physician associate national certification.
Statutory regulation of the PA profession by the General Medical Council will start in December 2024.
Scope of Practice
Role Responsibilities
Physician associates work within a defined scope of practice and limits of competence. They:
- take medical histories from patients
- carry out physical examinations
- see patients with undifferentiated diagnoses
- see patients with long-term chronic conditions
- formulate differential diagnoses and management plans
- perform diagnostic and therapeutic procedures
- develop and deliver appropriate treatment and management plans
- request and interpret diagnostic studies
- provide health promotion and disease prevention advice for patients.
Currently, physician associates are not able to:
- prescribe
- request ionising radiation (eg chest x-ray or CT scan).
(fparcp, 2024)
For more information please see fparcp FAQ page
Entry Requirements
- Completion of recognised Physician Associate Studies programme
- Voluntary member of the Faculty of Physician Associates
Training and Development
Mandatory
Please see above ‘Entry requirements’
Standard (on entry to Primary Care)
The first year
Employers of newly qualified physician associates, or of those who have just moved to a new specialty, may wish to offer a one year “internship” so that the physician associate is able to consolidate their core knowledge and skills, and demonstrate their competence in practice. During this period, they should be supervised more closely, have experiential learning in the clinical area in which they are working, and should maintain a portfolio of cases and case discussions with clinicians which may also be reviewed with their clinical supervisor (FPARCP, 2024)
PA and AA generic and shared learning outcomes
The Faculty of Physician Associates in a collaboration with the General Medical Council have published a document ‘Physician associate and anesthesia associate generic and shared outcomes’ whichdescribes the generic and shared professional capabilities and outcomes that newly qualified PAs and AAs must meet to be registered by the GMC. This document will apply to physician associates (PAs) and anaesthesia associates (AAs) once they are subject to regulation by the General Medical Council (GMC).
PA and AA Generic and shared learning outcomes – GMC
Faculty of Physician Associates code of conduct – Royal college of Physicians
Supervision Requirements
Supervision is a process of professional learning and development that enables individuals to reflect on and develop their knowledge, skills and competence, through regular support from another professional.
Supervision can have different forms and functions and a number of terms are used to describe these. For this guidance we use the below terms and define them as follows:
- Clinic/practice supervision: day-to-day support provided by a named/duty senior/more experienced clinician for issues arising in the practice.
- Clinical/professional supervision: regular support from a named senior/experienced clinician/practitioner to promote high clinical standards and develop professional expertise.
- Educational supervision: supports learning and enables learners to achieve proficiency.
Physician Associate Supervision:
It is recommended that PA’s have access to appropriate clinical supervision and an appropriate named individual in the PCN to provide general advice and support on a day-to-day basis. This would typically be a GP. Recommended minimum frequency of a supervision meeting is daily. A physician associate must work under their GP clinical supervisor during their day-to-day clinical practice. Supervision Guidance for primary care network multidisciplinary teams (NHSE, 2023):
NHS England » Supervision guidance for primary care network multidisciplinary teams
The supervisor and physician associate relationship
Physician associates’ ability to practice is enabled by collaboration and supportive working relationships with their clinical supervisor, meaning that there is always someone who can discuss cases, give advice, and attend to patients if necessary.
Supervision of a qualified Physician Associate is comparable to that of a doctor in training or a trust grade doctor, in that the physician associate is responsible for their actions and decisions; however the consultant is the clinician who is ultimately responsible for the patient.
As a clinical supervisor there is also a responsibility for ongoing development of the PA including appraisal and development of a professional development plan (PDP). (FPARCP, 2024)
The FPA Code of Conduct may also be of use. As it sets out the key areas that the FPA deems of particular interest including, professionalism, knowledge, skills, risk analysis and communication. FPARCP – Guidance for employers and supervisors.
Funding
AFC Band 7
100% of actual salary plus defined on costs covered via ARRS Scheme.
Training and development funding
Physician Associate Preceptorship Programme – Primary care
NHS England have developed an initiative (not mandatory) which is designed to support newly qualified physician associates (PA) and physician associates who have less than two years’ primary care experience to start/develop their careers working in a supported and structured environment.
The aims include:
- recognising that newly/recently qualified PA need time and support to develop within the multidisciplinary clinical team,
- providing employers with financial assistance to support newly/recently qualified PA,
- maximising the benefit of the PA role within primary care.
Following substantive appointment of a PA in primary care, the employer will enable the PA to join the Physician Associate Foundation Intern Programme in Primary Care | East of England (hee.nhs.uk)
Recruitment Information
Where a PCN employs or engages a Physician Associate under the Additional Roles Reimbursement Scheme, the PCN must ensure that the Physician Associate meets the ‘Minimum Role Requirements’ stipulated in Annex B of the Network DES
Please find various resources in this section to assist in the recruitment and embedding of the Physician Associate role in General Practice.
ARRS
Where a PCN employs or engages a Physician Associate under the Additional Roles Reimbursement Scheme, the PCN must ensure that the Physician Associate meets the ‘Minimum Role Requirements’ stipulated in Annex B of the Network DES: Network Contract DES (england.nhs.uk)
PA Register
The Faculty of Physician Associates strongly recommend that employers only consider recruiting physician associates who are registered on the Physician Associate Managed Voluntary Register (PAMVR) . This is a register, managed by the FPA, of fully qualified physician associates who have been declared fit to practice in the UK. It enables supervisors and employers to check whether a physician associate is qualified and safe to work in the UK Physician Associate Managed Voluntary Register