PulseCurrent

  In the first of our series  looking at the role of physician associates in general practice, Eliza Parr looks at whether they really are replacing GPs ‘There are literally no salaried jobs in Birmingham at all. Where has all the work gone? You could explain it away for a few months, you could explain it away for part of the year. But this is getting ridiculous now. Can you really say that the work in general practice has disappeared? Of course it hasn’t – they’re just paying somebody else to do it.’ It is not just salaried roles. When the same GP looks for shifts on his locum platform, he says there are ‘literally zero’. The 15 practices in his local area that used to take on ‘regular locums’ have now ‘completely substituted’ them with additional roles. When he does sometimes pick up a shift at one of the practices, he finds that ‘literally all clinics are filled with ANPs, physician associates, and clinical pharmacists’. The controversy surrounding physician associates has ...

  In the third part of our series on physician associates in general practice, Eliza Parr asks whether the increase in numbers is worth the money, and whether they are easing pressures on GPs For those cynics among you, it may seem unlikely that the Government will listen to doctors’ concerns about the clinical safety of the physician associate role, or how its expansion might be contributing to GP unemployment. Indeed, former  Conservative health minister Lord Bethell  likened doctors trying to slow the rollout of PAs to ‘Luddites’ who seek to prevent progress. But if there was a strong argument on the cost effectiveness of PAs, and whether they do in fact relieve pressures on the NHS, the Government might be forced to take note. At the moment, it seems ministers and NHS England are convinced – at least publicly – that PAs are helping. The Government has previously said that growth of the PA role will ‘reduce pressure on frontline services and improve access for patients...

  In the second part of our analysis of the role of physician associates within general practice, Eliza Parr looks at what clinical responsibilities they are being given, and the potential risks in their practice A handful of high-profile, tragic cases involving physician associates have caught public attention over the last year. Emily Chesterton, a 30-year-old patient at a GP practice in North London, died at the end of 2022 after seeing a PA. She had suffered a pulmonary embolism, and the coroner concluded that  poor quality of care provided by the PA contributed to her death . Worryingly, her family revealed that Ms Chesterton believed she had been seeing a doctor. It’s no surprise that tragedies like this make it into the national consciousness. And the case of Ms Chesterton has raised awareness about PAs among the public and across the political spectrum, with several politicians citing it in Parliament when debating the regulation of these professionals. Singular cases ...

  Madeline Sherratt and Jaimie Kaffash dig into the data to see the areas where physician associates are most likely to be employed. See how much your region relies on them Our  investigation into the rise of the physician associates  has revealed that, while numbers remain relatively low, they are increasing. The data analysis into what kind of practices and primary care networks employ them reveal that they tend to be  more widely used in cities, and in practices with lower funding per patient. We have also looked at their spread geographically. We used the old clinical commissioning group areas because they are large enough to show trends, while small enough to have meaning. The map below supports the contention that physician associates are more likely to be employed in towns and cities. Have a look at the map below to what percentage of the total clinical staff comries physician associates in your area. And scroll below for the table of the areas that have the h...

  In our latest eLearning CPD module, consultant endocrinologists  Dr Peter N Taylor   and  Professor Kristien Boelaert   share their insights on key challenges in hypothyroidism management, including diagnostic thresholds, persistent symptoms, appropriate use of liothyronine and treatment in special circumstances such as in those planning pregnancy. Complete the full module  on Pulse 365  today. Learning objectives This module will support your knowledge and confidence in managing hypothyroidism, with a focus on: How to interpret thyroid function tests and decide when to treat subclinical hypothyroidism. How to support patients who remain symptomatic despite normal biochemistry. When thyroid pain or goitre changes the diagnostic or management approach. How and when liothyronine can be considered. How to manage hypothyroidism caused by or complicated by other medications. Hypothyroidism is one of the most common chronic endocrine disorders, affecting a...

  In the fourth part of our series on the rise of physician associates, Madeline Sherratt and Jaimie Kaffash dig deep into the data to look at the characteristics of GP practices and PCNs that are more likely to employ PAs. And the results are illuminating… We have already reviewed the  effect of physician associates on GP recruitment , the  clinical responsibilities of PAs  and  how effective they are . Today, we are taking a look at what kind of GP organisations are more likely to take them on. We have dug deep into the data to take a look at practice income, deprivation levels, geography, rurality and contract type. There are roughly 1,950 PAs in general practice in England – what kind of practices are most likely to employ them? The first thing to say is they some physician associates are employed directly by practices, and others – the majority – are employed by primary care networks (PCNs), usually through the additional roles reimbursement scheme. For the...