Physician's Assistants

[MissMarplesNiece]

How would you feel as a parent if you knew your seriously ill child's treatment was being managed by a Physicians Assistant who had just two years training, only 3 weeks of which had been spent in paediatrics?

This isn't the first advert I've seen recruiting PAs into paediatric departments. This is a post at Registrar level so why isn't a qualified medical doctor being recruited for the post?

Why are NHS Trusts playing fast and loose with children's health?

Our one does, as do the nurse practitioners.

No, PAs are not eligible to be prescribers.

Advanced nurse practitioners can prescribe but PAs can't. The GP will have prescribed on behalf of the PA as PAs don't have prescribing rights. Advanced nurse practitioners can prescribe in their own right.

Could have been @WorriedMama12 to be honest I probably wasn't paying that much attention! I just remembered her very specifically introducing her role and asking if it was OK for her to do the assessment and I was so grateful to be seen I was just yes please !

I don't blame you for not knowing, as I say, very confusing! But yes, I've only seen the ANP 2 or 3 times in our surgery but he's always been great and got to the bottom of something that I'd seen the GP for a few times and hadn't gotten anywhere.

Is there anything we can do about this to voice concern re this aside from
requesting a doctor, are concerns going to be raised with the new health secretary?

There is a thread in education warning that their future is uncertain if looking at courses.

Yes, they can!

A nurse practitioner is a highly experienced and additionally qualified nurse. A PA is someone who has done a 2 year postgraduate course. The first degree doesn’t have to be nursing or anything relevant. It’s not the same thing at all.

When I ask to make an appt with a GP and I get an appt and ask the receptionist what was the name of the doctor again and she admits not a doctor a PA I feel aggrieved and hoodwinked. The trust is eroding.

What people are complaining about is the misrepresentation of PAs, by PAs as to their job and role. If you have a look in the doctorsUK subreddit there are several reports of PAs doing things they’re not supposed to, e.g. https://www.reddit.com/r/doctorsUK/comments/1d41pbk/advice_about_seeing_a_pa_prescribing_and/

The GMC’s guidance for supervisors “If you prescribe based on the recommendation of a PA or an AA, you’ll be responsible for any prescription you sign. Be sure that the prescription is needed, appropriate for the patient and within the limits of your competence“

They are recruiting them because they are cheaper than qualified doctors. It’s not ideal

Not currently. They need to ask a doctor to prescribe on their behalf. The doctor needs to check the history, examination findings. The responsibility lies with the signing doctor. That’s why it’s more hassle for the doctor as they don’t currently have enough time to do their own work, let alone supervise and take responsibility for someone else’s. I think there have been a few cases where the shit hit the fan and it was the doctor found to be at fault.

Weird thing is they're not cheaper. Starting salary is tens of thousands above qualified doctor so paying more for people less qualified who only work business hours

I’m looking to career change and at first look the PA role looks ideal for me - I have an appropriate degree, I’ve always liked the idea of medicine but don’t want to train for 7 years like doctors, the starting pay is excellent. But I haven’t seriously looked in to it because it all looks a bit too good to be true from the PA perspective (level of pay compared to time spent training) and I just cannot see how 2 years can be enough time to learn all you need to learn when it takes doctors more than 3x that long. I’m currently a teacher and consider it unacceptable that TAs with no teaching degree are expected to cover classes more than occasionally. As far as I can see this is the medical equivalent but with far more serious potential consequences, obviously.

I don’t understand how they are cheaper than doctors - the starting salary is higher than a junior doctor isn’t it?

I think concerns are starting to be raised and I think I saw that one university has cancelled the next cohort of their course. I think sooner or later someone is going to die because of decisions made by a PA and the role will have to change/be phased out (another reason I decided not to go for it, along with not wanting to be the PA who makes a catastrophic wrong decision!) I hope it doesn’t come to this and the role is changes or clarified before anyone gets hurt.

Oh absolutely, totally agree. I was responding to the pp’s certainty that they can do a prescribing course, which they can’t.

Oh no they can’t… There are reports of them prescribing, or trying to give the impression that they are prescribing, but they are not legally allowed to.

They are much, much cheaper to train than doctors. Training doctors is extremely expensive for the taxpayer. The difference in salaries is a drop in the ocean compared to training costs.

It’s a good comparison with TA vs teachers or cabin crew vs pilots. All have a role in the team, but they’re not interchangeable. I have two nieces training to be doctors, I know how hard they work and how they weren’t ready after year 2, which is a PA training.

That’s the point, isn’t it?
If senior nurses and doctors with years of training and experience can make mistakes that shows how difficult it is to diagnose and treat patients.
Not suitable able for someone who has only had 2 years of training

But from what I e read on here doctors are coming out of uni and currently struggling to get jobs so they’re going overseas whilst we are recruiting more experienced staff from overseas here. It’s utter madness and a complete mess .Was it Tory policy that caused all this?

I agree that a PA shouldn’t be leading the care of someone who is seriously ill but that doesn’t mean they don’t have a use for the more mundane work, leaving doctors with more time for the more serious cases.

DS had an ear infection, we were offered an appointment within an hour with a PA and diagnosed quickly. Yes if it had been a doctor we would have got the prescription immediately rather than having to wait a few hours, but we wouldn’t have been able to get an appointment that day so using a PA meant he was treated quicker. So I’m all for them if used appropriately.

I tend to agree my older son was diagnosed with Diabetes last year and sees an advanced nurse practitioner at the Diabetes clinic
And she's great ,but she's an expert in one area

Yes, I think AI will take over soon and will be able to make better decisions than a doctor.
Personally I would rather all my symptoms and results were put into a computer as there is no way a human can think of everything.

That is exactly why the public are urged to remind doctors about sepsis

A computer wouldn't need reminding as it would be in the algorithm to think about it.

But if I had a condition like diabetes, I would much rather see a specialist nurse rather than a GP who cannot possibly know everything about diabetes.

I think PAs will soon have GMC numbers too