Employing a Physician Associate

Studies from general practice in both England and Scotland have shown physician associates to be safe, effective and liked by patients. The Faculty of Physician Associates run an annual census for all UK PAs and student PAs

Other examples include:

• Physician associates in general practice: Continual professional development will be key to retention March 2022 
• Remote consultations for physician associates in primary care: qualitative feedback from a regional cohort study November 2021 
• Clinical supervision of physician associates (PAs) in primary care: who, what and how is it done? March 2021
• Preceptorship scheme for newly qualified physician associates working in general practice in Sheffield 2020

There has been some misunderstanding about what this means for individual practices. Under the new primary care network (PCN) arrangements, the directed enhanced service (DES) means each PCN (not every practice) may apply for funding for a qualified, experienced PA.

A PCN is entitled to claim 100 per cent actual reimbursement of the aggregate WTE salary (including employer on-costs of NI and Pension) up to the maximum amount per role as outlined… and within that PCN’s overall Additional Roles Reimbursement Sum, for the delivery of health services.

The maximum amount payable for a Physician Associate in 2020/21 is £53,724.

The payment is subject to conditions and these can be found in sections 9.10.4 – 9.10.8 of the Network Contract Directed Enhanced Service: Contract Specification 2020/21.

You’ll find  more information on the NHS England pages  https://www.england.nhs.uk/gp/investment/gp-contract/ and  BMA website.

There's a short 3 step guide to recruiting a PA along with a job description and person specification template that you can download at the end of these FAQs. These resources are for guidance and may be adapted as required.

We strongly recommend that any employer looking to recruit a physician associate checks the applicant is registered on the Physician Associate Managed Voluntary Register (PAMVR).

We have a list of active PA programmes with links to their websites and contact details. Most course directors are happy to speak with clinicians or practice managers about their students/graduates and the profession.

Many new graduate PAs begin work at a salary of £31,696 (equivalent to an NHS Band 6/7 salary). Depending on the level of experience, a PA will be able to manage a proportion of a GPs workload acting in a supportive and complementary role, freeing up a GPs time rather than as a substitute.

A study by Drennan et al (2015) compared aspects of physician associate consultations with those of GPs. It found that processes and outcomes of PA and GP consultations for same day minor illness patients were similar, while the cost was cheaper. Anecdotal evidence from GPs suggests PAs can contribute to reducing GP workload and freeing up time.

As you might expect, GPs report different benefits according to the need of each practice. There are a number of short case studies that can help to give you a better idea of how PAs are most useful in ageneral practice setting. Or use the local contacts on this page to be put in touch with a practice who employ a PA in your area and can offer a first-hand practical point of view.

There is a £5,000 preceptorship allowance to support the supervision and educational needs for newly qualified physician associates working in primary care in England. Get in touch with your HEE area lead (details on this page) for more detailed information including the process for application and payment.

As an initial guide the preceptorship programme eligibility criteria is listed below:

• The preceptorship programme will be undertaken for a minimum of 1 year [whole time equivalent] and must entail a minimum of 50% [or 6 months’ full time equivalent in any rotation of placements] being spent in Primary Care.
• It is open to PAs who are commencing a programme in the first twelve months of practice after first gaining registration on the national register or PAs taking up their first post in primary care since gaining registration. Also includes PAs transitioning from secondary care with a maximum of 3 years’ experience
• Open to all PAs commencing a programme in the year after gaining registration on the national register or any PAs transitioning from secondary care with a maximum of 3 years experience.
• The weekly timetable should include at least 1 dedicated session for education. 
• Placements should have an educationally approved primary care clinical supervisor.

The Preceptee must have access to a trained mentor for the duration of the Preceptorship. The mentor should be external to the employing practice or Primary Care Network (PCN).

• If employed by a PCN, the Preceptee must work in no more than 2 practices for the first 6 months of their preceptorship year.
• At the start of employment, newly qualified PAs in Primary Care should have 30-minute patient consultation time allocation with a debrief after each patient. This should be reviewed between 3-6 months and the consultation time adjusted as appropriate.
• The preceptor should have an induction period – a meeting with their supervisor, with mid-point and an end of programme review.

• The preceptor should take part in the employer’s annual appraisal system.
• Access to a professional development programme from a local HEI or equivalent should be available which will include alumni activity.
• The preceptorship programme should enable the post–holder to engage in multi-professional learning activities.
• Where the post-holder’s objectives include a further course of study, this should usually be funded from the support payment. This could be up to the cost of a postgraduate certificate qualification if appropriate for the preceptor and the service context. This funding should be used flexibly to meet the needs of the preceptor.
• Individual post–holders will be expected to complete and maintain all the requirements of the UK PA managed voluntary register (PAMVR).
• Employers must consider a rota with a maximum of eight patient-facing clinical sessions a week for the first 6 months of the Preceptorship programme.
• At the start of employment, newly qualified PAs in Primary Care should have 30-minute patient consultation time allocation with a debrief after each patient. This should be reviewed between 3-6 months and the consultation time adjusted as appropriate. 
• Ideally the preceptorship programme will set out expected outcomes for the preceptor in the form of competence acquisition or a brief curriculum which may be locally derived but based on established national guidance, eg the FPA guidance.

When new roles are introduced there is bound to be an amount of speculation and misunderstanding until the benefits of the role are better understood and established. It’s worth remembering that the PA role does not replace a GP. There is significant evidence (see under research) that PAs are safe clinicians. They are trained in the medical model to consult, examine, understand the patient’s problems and plan care. They have to complete a rigorous, academically demanding programme to qualify.

Yes they can and from 1 March 2021, the new to Partnership Payment Scheme includes physician associates.

The scheme gives eligible participants a sum of up to £20,000 plus a contribution towards on-costs of up to £4,000 (for a full time participant) available to support establishment as a partner, as well as up to £3,000 in a training fund to develop non-clinical partnership skills. Applicants will be required to submit an application form and supplementary evidence to NHSEI and meet the eligibility criteria.