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Nigel's surgery 82: Physician associates in general practice
This mythbuster aims to clarify the role of the physician associate in general practice.
It has been written by Jim Parle, Professor of Primary Care and course director for the Physician Assistant programme, University of Birmingham.
The role of the physician associate in general practice
The Department of Health's Competence and Curriculum Framework for physician associates defines the physician associate as:
'…a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision.'
Physician associates can supplement and complement GPs and nursing staff. Under supervision of a doctor, they can see a range of patients whose cases vary in complexity. As with any practitioner, the amount of supervision they need depends on their level of knowledge, skills and experience.
On CQC inspections this relates to staff having the skills, knowledge and experience to deliver effective care and treatment (key line of enquiry E3).
Qualifications and registration
To enter the profession, all physician associates must have a:
- relevant degree (for example bioscience or healthcare-related) and
- postgraduate diploma which takes two years of full time study to complete.
Physician associate courses in the UK all follow a national curriculum and competence framework. All physician associates must pass a national examination of knowledge and skills. They must recertify in the knowledge component every six years to ensure they keep up to date. This is the only clinical profession in the UK which currently has a national skills and knowledge test.
The Faculty of Physician Associates at the Royal College of Physicians keeps a managed voluntary register. This acts like a General Medical Council or Nursing and Midwifery Council register, although is not statutory. Practices should only employ physician associates who are on this register.
The register gives assurance that physician associates:
- have qualified from an appropriate UK or US programme
- have passed the national exams (and recertification exam if appropriate)
- are maintaining their continuing professional development (50 hours a year)
- do not have any code of conduct, scope of professional practice, or fitness to practise concerns
Regulation and indemnity
Physician associates are not statutorily regulated, so they work under the ’delegation clause’. This means they are the responsibility of the supervising doctor. According to GMC guidance, doctors can delegate tasks to non-clinicians but must be sure that person is capable. Physician associates are indemnified in the same way as doctors.
Physician associate cannot prescribe. Many doctors give them ‘proposal rights’ like medical students or non-prescribing nurses. If the profession becomes statutorily regulated, physician associates may be able to take prescribing courses to add to their skill-set.
Available from the Faculty of Physician Associates:
- Last updated:
- 10 August 2017