A PA is a generalist healthcare professional who is trained in the medical model. They work alongside doctors to provide medical care for patients. They work under the supervision of a doctor as they are dependent practitioners however; they often work autonomously with support.
As PAs are generalists, they are a very flexible member of the medical team. They carry out many tasks however, their scope of practice is vast and depends upon the speciality that they are working in. Their core skills are as follows:
- Take medical histories (from patients presenting with acute and long term conditions)
- Perform clinical examinations
- Order and interpret investigations
- Formulate differential diagnoses
- Develop management plans
- Perform diagnostic and therapeutic interventions
PAs are awaiting regulation from the General Medical Council which is due to come into force in 2021. Due to the lack of statutory regulation, PAs are unable to request ionising radiation (x-rays and CT scans). They are also unable to prescribe medications and cannot enrol on non-medical prescribing courses.
PAs are part of the MDT but tend to be more affiliated with doctors. They reduce workload for the team by seeing patients and sharing work which would traditionally be done by doctors. As PAs don't rotate, there is a permanent member of the team which provides continuity. This proves invaluable on the ward and in clinics around doctor change over time, teaching and on-call rotas. Many PAs also work in primary care; they provide support to the team by seeing patients (both patients with acute and long term conditions), making referrals and carrying out a house or care home visits. PAs work symbiotically with doctors.
Most PAs have a life science degree or healthcare background. All PAs complete a postgraduate master's degree or diploma and must pass a national examination before working as a PA.
Currently, PAs are unregulated. However, the General Medical Council will begin to regulate PAs from 2021. Until that time, PAs should be on the Managed Voluntary Register (MVR) which is held by the Faculty of Physician Associates. This ensures that PAs abide by a code of conduct. A condition of remaining on the MVR is that the PA must recertify every six years with a single best answer exam and complete 50 hours of CPD per year.
Most commonly, PAs are paid at a band 7 (£38,890-£44,503) on the agenda for change contract. Newly qualified PAs may complete an internship year at a band 6 level (£31,365-£37,890). More experienced PAs may be paid at a band 8a (£45,753-£51,668) level or above, depending on their role. PAs in general practice are not on an agenda for change contract and are paid competitive rates depending on their level of experience.