The first study into the impact on the NHS of a new type of health worker in hospitals known as Physician Associates has found that they benefit medical and surgical teams and their patients over a wide range of specialities.
Researchers found that Physician Associates safely supported the workloads of clinical teams and helped provide team continuity, as well as positively contributing to patient experience and patient journey.
The researchers, funded by the National Institute for Health Research (NIHR), set out to investigate the use, acceptability and impact of Physician Associates within a hospital setting in a sample of six acute care hospital organisations in England.
The Physician Associates worked in 13 adult and paediatric specialities, including emergency departments. The researchers carried out the study by interviewing medical staff including consultants, managers and nurses; interviewing patients and relatives; reviewing Physician Associates’ work diaries, and observing them at work.
Physician Associates were mainly deployed in hospitals to undertake inpatient ward work during core weekday hours.
They were reported to positively contribute to:
- continuity of staffing and knowledge within their medical or surgical team
- patient experience and flow
- inducting new junior doctors
- supporting their teams’ workload
- All of the above released doctors to attend to more complex patients and training.
Physician Associates are medically trained generalist healthcare workers. They train at post-graduate level to work in all settings and undertake medical histories, physical examinations, investigations, diagnosis and treatment within their scope of practice as agreed with their supervising doctor.
While they are able to carry out medical procedures such as taking arterial bloods, and taking and interpreting electrocardiograms, they are at present not allowed to prescribe medicines or to order x-rays. As well as working in hospital settings PAs may also work in primary care in the NHS supporting GPs.
Professor Jim Parle, of the University of Birmingham's Institute of Clinical Sciences and Director of the largest Physician Associates programme in the UK, said: “We are delighted to be part of this major study. It is essential we measure the impact of Physician Associates as this workforce is set to grow to as many as 3,000 graduates by 2020.”
Vari Drennan, Professor of Health Care and Policy Research at the Faculty of Health, Social Care and Education, run jointly by Kingston University and St George’s, University of London, said: “We found that the relatively new role of Physician Associate can make a valuable and flexible contribution to medical and surgical teams in hospital, and they were found to be acceptable, appropriate and safe members of the teams by the majority of doctors, managers and nurses.
“In particular, patients responded very positively to Physician Associates; the Physician Associates were likely to be constantly present on a ward and therefore easy to approach, and would follow up items from the doctors’ ward rounds as well as explaining care plans and decisions to patients and relatives.
“The recent announcement by the Secretary of State for Health & Social Care that Physician Associates will be regulated by statute has the potential for allowing them to prescribe medicines and order ionising radiation, both of which would strongly enhance their contribution in hospital teams.”
Stephen Hammond MP, Minister of State for Health, said: “This research highlights the invaluable role Physician Associates play in the NHS, supporting doctors to deliver safe, high-quality care to patients. Our decision to regulate Physician Associates is not only a recognition of this enormous contribution but will empower them to work to their full potential and place them on a firm foundation for a long and successful career in the NHS.”
To interview Professor Jim Parle please contact Emma McKinney, Communications Manager (Health Sciences), University of Birmingham, tel: +44 (0) 121 414 6681, or contact the press office out of hours on +44 (0) 7789 921 165.
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- Vari et al (2019). ‘What is the contribution of Physician Associates in hospital care in England? A mixed methods, multiple case study.' BMJ Open.
- The study team also included academics from the University of Birmingham, University of Surrey and Royal Holloway, University of London as well as NHS managers and patient representatives.
- The study was funded by the National Institute of Health Research’s Health Service & Delivery Research programme.
- The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
- Funds, supports and delivers high quality research that benefits the NHS, public health and social care
- Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- Partners with other public funders, charities and industry to maximise the value of research to patients and the economy.
- The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.
- This report presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the Health Service & Delivery Research (HS& DR) or the Department of Health.