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Physician associates plough same furrow as advanced nurse practitioners

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Physician's associates could conflict with ANPs Physician's associates could conflict with ANPs

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?

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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Comments

This piece is completely biased. It would have had more impact if it was neutral and really explored the positives and negatives of both sides. It appears to me that training more NP's would reduce the number of nurses. P.A's are increasing workforce numbers. NP's are fantastic as are P.A's. In practice, they do very much the same thing.
Posted by: ,
Hi Jenna,
I work as a Practice Nurse and DO have a BSc Hons Degree, like most of my colleagues. I inform you of this so you may be clear regarding qualifications Practice Nurses hold.
Posted by: ,
My plans are to become a Physician associate, my reasons for doing so are as simply because I feel sick during my nurse training and having a long time out my university never let me back in. I struggled to get a place to restart my training so I went ahead and did a degree in Biomedical science. I think Biomed graduates have a sound knowledge base of medicine as a science to use in clinical practice, a) because of their deep knowledge of pathology down to chemical level, and are aware of the diagnostic processes involved to make a diagnosis. It does fit in nicely with the medical model.
Posted by: ,
The main dispute is between ANPs and PAs (NOT Practice Nurses and PAs, as your report suggests). The PN role is completely different to the ANP role. I am an ANP, I have a MSc and prescribe independently. I see undifferentiated patients - just like my GP colleagues - and spend all day diagnosing and prescribing. The Practice Nurse has an RGN qual. and no degree. She does smears, chronic disease, travel medicines - the difference it she does not diagnose. She is a band 6 and I am a band 8. I work from a medical model approach, the PN works from a nursing model. I get so frustrated with the continual blurring of roles by journals and news reports. It's quite clear there is a huge difference in responsibility, salary, and job description!
Posted by: ,
The main dispute is between ANPs and PAs (NOT Practice Nurses and PAs, as your report suggests). The PN role is completely different to the ANP role. I am an ANP, I have a MSc and prescribe independently. I see undifferentiated patients - just like my GP colleagues - and spend all day diagnosing and prescribing. The Practice Nurse has an RGN qual. and no degree. She does smears, chronic disease, travel medicines - the difference it she does not diagnose. She is a band 6 and I am a band 8. I work from a medical model approach, the PN works from a nursing model. I get so frustrated with the continual blurring of roles by journals and news reports. It's quite clear there is a huge difference in responsibility, salary, and job description!
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