Yeah, it seems there was some conflation here between the recruitment issue - GPs not being able to find jobs and the GP shortage - which appears to be both lack of funding and overall lack of GPs (despite the recruitment issue) - the fact that a bunch of current GPs are near retirement + the population has grown + the population is older and sicker on average is worrying, even if the current recruitment issues are fixed do we have enough?
Physician Associate
- Thread starter Dr House
- Start date
Yeah, it seems there was some conflation here between the recruitment issue - GPs not being able to find jobs and the GP shortage - which appears to be both lack of funding and overall lack of GPs (despite the recruitment issue) - the fact that a bunch of current GPs are near retirement + the population has grown + the population is older and sicker on average is worrying, even if the current recruitment issues are fixed do we have enough?
Caporegime
Paramedics in primary care are a total liability, let alone ICU.
Caporegime
The amount of IMGs completing VTS and leaving the UK is also a huge issue. We're just training Canadas GPs at the moment.
Caporegime
Quite common to see some PAs do everything they can to hide their role introducing themselves as "one of the clinicians" "one of Dr X's team" and some of the buggers even have a make believe 1 year doctorate to call themselves "Doctor".
The ex-head of the Faculty of PAs bragged about how he'd take his lanyard off and be allowed to run cardiac arrests when he'd never be allowed near the role with his PA lanyard on.
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Soldato
This is not the fault of the positions people find themselves in but the fault of management and clinical staff who can affect change. Why don't they?
Caporegime
Intentionally misidentifying themselves to mask their true role isn't a management or clinical staff issue, it's an individual issue.
I'm not sure I understand what change is not being affected?
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Soldato
People will inflate their position in every setting however the professional associations and the hospital management should protect the standing of their members and staff and clamp down on this misuse. Surely that is possible without offense.
Caporegime
The Royal Colleges and BMA have moved to formalise this but the PA bodies resist it along with any suggestion of scope. The GMC want to register them but don't want any role setting PA scope or standards.
The hospitals rely on the unregulated and scopeless use of PAs as its the only way they are economically viable. Once they get scope in place (like RCGP recently did for PAs in promary care) they become non-viable.
I feel sorry for the majority of PAs, they are in trouble, they've been sold a career and studied for a role that is becoming non-viable. The qualification is next to useless and they've been used by NHSE/Government.
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Cause: Tories.
Soldato
There is obviously a role, taking blood, normally a nurse function in my experience and similar tasks where a doctor is not necessary. However boundaries need to be set and a career path should be devised if not already in place. Not every brilliant engineer went to university and you still get ones who did responsible for Grenfell.
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This is the problem. We have a PA as an ARRS worker. He’s actually quite good, but with the new RCGP guidance it makes zero sense as he essentially can’t be allowed to provide any actual service and we have to debrief every patient. It’s now essentially having a medical student but you (or the PCN) are paying for the privilege and unfortunately he will be made redundant shortly by the PCN as it’s totally non viable.
We have trained PAs before and were involved in preceptorship for new ones. We’ve had a 50:50 on quality. 1 we had concerns and contacted the deanery as we were frankly astonished he had been allowed to pass and we couldn’t employ him. If they had been regulated I’m sorry to say we would actually have had to go to his regulator he was so poor. We had one who was ok in a very limited scope, but he didn’t really understand his limitations, however he moved to a job that he hoped would lead to actually being partner in a GP practice. We probably dodged a bullet with him in all honesty. We had one who was a good safe pair of hands but she went lured by money of somewhere that hoped to run its service on PAs so was paying over the odds even by PAs at that point. I think they had offered her £65k it was crazy high salary for the role
We have never particularly wanted PAs but the only investment in primary care has been into PCNs and you kind of get what is on offer, so we have tried to make it work, but it’s just not worth it
I feel terribly sorry for them as a group. They have been sold and absolute pup of a career by NHSE
The thing is they are far too highly paid for a role like taking blood. That is an HCA or TNA type of role. A nurse is too qualified for taking blood to be a main part of their job in reality
I disagree with this entirely.
If someone is going to stick a needle into someone's arm (and all the associated risks that go with it, Hepatitis, HIV / Aids etc..) It should be done by someone with adequate training and qualifications to understand and comprehend the ramifications if they screw it up.
HCA's should not be sticking needles in anyone, IMO.
And as for "PA's" they should be restricted entirely to doing the GP / Doctors paperwork. If they want to practice medicine (in ANY form) they should go through the appropriate training to do so, not try and shortcut it.
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an HCA or TNA is entirely capable of that. It's a band 2/3 type of role on the pay scales. Practical things like that don't take an enormous amount of training in reality. The reason someone should be on high pay is around responsibility and decision making and clinical assessment type of roles in practice. If they can have clear guidance on what things they can see then PAs can do stuff, but unfortunately it shouldn't merit the current remuneration as you cant give them undifferentiated work. An ANP makes more sense financially than a PA really now that the RCGP has made recommendations
Soldato
Have listened to more than a few Drs (from junior to senior consultants) at work criticising the PA role.
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If this was 1979 this whole PA pretending to be a doctor thing would be the main serious segment on That's Life, between the bit where a dog can be manipulated to say "sausages", and Cyril Fletcher doing a bit about a vegetable that looks like a scrotum.
Suspended
This goes back to what I've said previously about us needing some form of tie in to recoup training costs.
Now, only approx. 30% of medical graduates stay within the NHS. Back in the mid/late 90's that figure was nearer 70%. The "missing" 30% was always foreign students ... but it's appalling that a further 40% have drifted off using the degree as s stepping stone to other careers. Successive governments ( and the Royal colleges ) have just stood back and watched.
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what training costs?
The cost to train a doctor from undergraduate level to foundation level is at least £230,000. And that figure is 7 years out of date.