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Physician associates plough same furrow as advanced nurse practitioners

The recent surge in training places for physician associates (PAs) will not fix the issues in practice nursing recruitment, says a leading nursing figure.

The recent surge in training places for physician associates (PAs) will not fix the issues in practice nursing recruitment, says a leading nursing figure.

Crystal Oldman, the chief executive of the QNI, said that recruiting PAs into general practice did not get to the bottom of the real issues in the primary care workforce. 'The reason why PAs are being trained is because there is a lack of nurses in primary care. They are a quick solution to the problem but do not necessarily address the core issues in nursing.'

Health Education England (HEE) has committed to recruiting 200 more PAs in the next year across all settings.

PAs are a new profession in the UK but have been established in the US for over 40 years where they support doctors in primary and secondary care.

The UK Association of Physician Associates says there are currently 250 PAs working in the UK. Only 25% are employed in general practice.

It is unclear how many of the newly qualified PAs will go straight into working in general practice.

Their work in general practice includes consultations, reviewing test results, and chronic disease management.

PAs are currently an unregulated workforce. They are dependent on doctors and are unable to prescribe.

'I can see why they are being recruited and I can see how they would help GPs, but it just doesn't seem to me to do anything for the recruitment crisis in nursing,' said Ms Oldman. 'They are a quick solution and some have said that they don't want to disturb nursing but it doesn't really get to the route cause of the problem.'

Raj Gill, a PA in general practice said he understood why nurses and nurse practitioners would be sceptical about the introduction of PAs. 'In theory, yes there is some crossover between the two roles and it is quite similar to the nurse practitioner role. However, in practice, in the practices I've worked in, I have found that we have worked very well with the nurse practitioners. In fact they often end up being our champions and we have found that we can learn from each other. We are not a substitute for nurse practitioners but an addition to the workforce. In the way that there are certain things a nurse practitioner can and can't do, we are able to see almost anything.'

Richard Vautrey, deputy chair of the BMA, said: 'The introduction of PAs will not take anything away from the role of the practice nurse. Some practices really want to recruit more nurses, but there are not enough nurses working in the community. We have to expand this workforce as well, but as there aren't enough nurses we need to look at other avenues.'

A biomedical graduate and third year medical student spoke to IN about his concerns over how PAs would fit into the structure of the current NHS workforce. 'I'm not on one side or another. It is an interesting idea and it seems to work in America, but that is an entirely different healthcare system. It's important to figure out what this will do to the role of the doctor or nurse. I don't know what the role is on paper.

'Nurse practitioners are highly valued by doctors. This is a role that's been around for a while and we know they are good, so why are we training another group of people that will take a while to embed within the NHS. We know nurse practitioners work so why not train more?' IN

Do you think there is place for practice nurses and physician associates in general practice?