Educate Yourself it May Save Your Life

If that’s all it was they’d just use the Band 2 HCsW, most of the ones at the hospital where I am can cannulate, take blood, do obs, remove catheters…..not sure if they place catheters but certainly the nurses can.

So their intended role must be wider.

Plus they work in some GP surgeries doing to all intents and purposes the same role as a GP. But being “supervised” and not being able to prescribe.

Surely the theory behind using a PA is to free up the doctors from the more “manual” tasks like Cannulation, Catheters etc… so they can spend more time doing things like Patient Assessments. I think this is a great idea. They are surely a great addition to the work force when appropriately used.

More regulation is not a bad thing but I think spreading the idea that seeing a PA is dangerous and they are all basically agents of malpractice is really stupid.

out of curiosity where do you stand on acute settings with HCAs or Phlebotomists who only have to have GCSEs and are trained on the job?

I agree with the BMA that these roles need to be more clearly defined and it's right that they call out the issues in recruitment, both in PAs, and that numbers for medical professionals in training and recruitment are far too low for the UK's needs and PAs should not be used to plug those gaps.

That said, I think the emotive language of 'this may save your life' and acting like there is a clear divide between GPs safe, PAs unsafe is unhelpful. Yes, there are cases of PAs acting horrible consequences -- there are also cases of GPs, nurses, midwives doing the same and major issues within the system on handling cases of abuse of patients. Vigilance has not been strong in many parts of the NHS for a long while and the issues of PAs working beyond the role they were intended for is another symptom of that lack of vigilance needed.

But not studying medicine for five years. It’s a two year training course following a normal science degree.

i was actually offered a place on a PA course over a decade ago when it was really new and there were no fees and a 10k a year bursary. I was a qualified midwife. Everyone else on the interview day were either bio chem or biology graduates. So while I’m sure they had a good knowledge of biology and chemistry I’m not sure how good their knowledge of different illnesses and symptoms were. My interviewers were excited to interview me and said I was the first person they’d interviewed with actual health care experience.

i turned down the offer. I wasn’t sure about the lack of autonomy and just had real reservations about long term job security. The govt like this sort of thing on a whim and then scrap it. My local hospital trust still don’t employ any so I’d have struggled to get a job so glad I didn’t.

i don’t see why the govt/trusts don’t train more Advanced Nursing Practitioners. Who will already have three year nursing degree, years of nursing experience, do their ANP training and can do a prescribing course. I think a decent experienced ANP can be as good as a junior doctor

@Onthepage in exactly what capacity is your extensive NHS experience?
Presumably not in a regulated profession, or your regulators social media guidance would inform you that post such as this which seek to incite distrust and alarm amongst the population are unwise.

There are legitimate concerns around emerging roles and the quality of supervision/scope of practice that is needed.

There are also orchestrated attempts by some areas of the medical profession to create and fuel public outcry, perhaps with some good intent, but also with an element of protectionism and not wanting 'others' in the club. Look at the appalling racism, classism and sexism in medicine before assuming an altruistic motive.

In all contacts with healthcare professionals you are at risk of someone overestimating their skills, knowledge or ability. To rely purely on holding a medical degree as the indicator of safe care is naive.

It happened to me. He said "I am a physician".
I had been vomiting blood. He said "I could send you for an endoscopy but they are very unpleasant so we'll just see if it happens again".
When I finally saw a GP she referred me urgently.
So I feel that PA misrepresented himself and failed to take the appropriate action.

Not quite the same, but my GP surgery has an unhelpful habit of forcing you to see a Nurse Practitioner over a GP.

Which as a triage or minor symptoms situation is fine.

But when you present something more serious it is useless.

My DH was brushed off when he called with the MH issue as he seemed "okay enough". Leading to a lot more suffering before he got help.

I have an auto immune condition that I was totally fobbed off about by the NP who refused to see me and would only speak over the phone. It took me over 2 years to go back to get answers after she offered me antidepressants and a patronising tone for my "unexplainable" symptoms.

From a patient perspective, if I felt like I needed a Dr again, I'd trust my instincts and know that I actually need a Dr.

role not roll.

I think the problems are that they don't have a governing body and their roll isn't defined.

My only direct experience is second hand, my carer came back from holiday covered in insect bites, I looked at them and said I thought they might be infected.

It was the weekend so he went to a pharmacy who told him to see his GP because it was infected.

On Monday morning he got an appointment with the PA who took one look, said it was infected and he needed to see the Dr. The PA went to fetch the Dr who wanted to send him to hospital for IV antibiotics.

Anyway two lots of antibiotics and dressings changed every other day by a HCA and all is well.

I think I would be wary in a GP scenario where anything could be wrong, but have experience of a PA post surgery- she attended with the surgeon to do initial post operation checks and then came back by herself subsequently. I had not heard of the role (despite a lot of hospital experience) so queried and she explained. In that limited scope role (assisting the surgical team with post surgery inspections) I thought it was a good use of resources. However broader roles not suitable. And hospital doctor friends don’t seem to like PAs much….

An old school friend of mine is a PA, she was mediocre at school, never in top set for anything. Her degree is psychology, so doesn’t lend itself to treating patients in a medical capacity. So all she has really is the 2 year course.

I always choose GP wherever possible when online booking and avoid the PAs who I have found to be absolutely useless in the past. One told me my son didn't need vaccine which he did need. In fairness I have been forced to see one a few time this year when it's the receptionists making the appointment and it's been this young guy in his early 20s who told me he is training to be a paramedic? Nice guy and tries to be helpful but a complete waste of everyone's time as a 10 minute appointment becomes a half hour one as he keeps having to go out to check with a doctor whether he should prescribe something, what dose and then has to go out again to get a doctor to do the prescription, as he can't. Waste of everyone's time...

I'd rather speak to a qualified pharmacist tbh and that does seem to be an option now at my GP.

I have another teaching topic that I have delivered loads of times with medical students, very interactive, needs them to use a bit of logic and apply their prior learning. I was asked to do the same topic with PA students. I was asked to deliver it at the same level, as "they're just as good" and not to dumb it down. Perhaps unsurprisingly it was a total disaster. They had a fraction of the background knowledge compared to the 3rd year medical students. Which wasn't their fault. It just shows that there aren't shortcuts to having a doctor's knowledge and experience. I heavily simplified things before the next time, and honestly half of them were still struggling. I feel sorry for them, because they have been sold a lie.

The underlying problem is that PAs really aren't a profession. The idea is that you can take someone with a degree, give them 2 years training and that's enough to work alongside doctors with 5 years undergrad followed by postgrad training. What training they get after qualification is pretty unspecified, and the expectations of what they can do vary enormously - but I get the impression they are typically told they can work like F2/ST1 doctors (ie doctors 2-3 years post qualification) in a limited area (and they are paid more than them). The fundamental problem is that their training is not enough for them to understand what they don't know. The other problem is that PAs don't have a defined career path to progress after a few years in work.

I was in a position to do some informal teaching with some PA students recently which left me thinking they were being totally let down - they would all have been much better served by doing a proper medical degree and having proper breadth and depth rather than skating quickly over so much and being left with massive gaps.

It's critical that the general public know that "Physician Associate" and "Physician" are two very different things. Allied health professionals of all kinds are a very important part of health care, but for safe diagnosis of medical problems you need medical training and the risk is that people with limited training are limited in diagnostic ability, because when something is uncommon they don't have the knowledge and/or experience to spot it.

"Most people don't even know what a physicians associate even means!"

Well not having heard of them before, I've just read this entire thread and I'm none the wiser, so perhaps you could explain what they are / are not trained to do.

But you can’t possibly know that’s how they all introduce themselves @Catza . I’ve no personal axe to grind here but it does irritate me when posters say authoritatively that something happens when they have no idea. What you mean is it should happen, but without following every PA up and down the country, you cannot know.

I don't know as much as you about PAs and AAs as I do not work in healthcare, but the General Practice needs to be totally overhauled.

There need to be fewer GPs and more specialist nurses and PAs who deal with diabetes, mental health issues etc.

No-one wants to be a GP and I don't blame them. They are just overpaid adminstrators and their skills could be much better used in hospitals.

What’s the basis of your grudge against an entire profession OP? Your posts don’t read as terribly well-informed or balanced so I’m just very curious as to why you’re stirring up even more online discontent against a profession that’s had more than it’s fair share of hate-mongering online lately. The tone and scope of your posts just seem really odd.