Workforce: ‘What can you do then?’ Integrating new roles into healthcare teams: Regional experience with physician associates

Abstract

In the context of NHS workforce shortages, providers are increasingly looking to new models of care, diversifying the workforce and introducing new roles such as physician associates (PAs) into clinical teams. The current study used qualitative methods to investigate how PAs are integrated into a workforce in a region largely unfamiliar with the profession. We conducted an observational study examining factors that facilitated and challenged PA integration.Findings suggest that the factors influencing PA integration relate to attributes of the individual, interpersonal relationships and organisational elements. From these, five key considerations have been derived which may aid organisations when planning to integrate new roles into the clinical workforce: prior to introducing PAs organisations should consider how to fully inform current staff about the PA profession; how to define the role of the PA within teams including clinical supervision arrangements; investment in educational and career development support for PAs; communication of remuneration to existing staff and conveying an organisational vision of PAs within the future workforce. Through consideration of these areas, organisations can facilitate role integration, maximising the potential of the workforce to contribute to sustainable healthcare provision.

Implementing the Safe and Effective Clinical Outcomes (SECO) simulation to prepare physician associate students for practice

“…Within the evaluation form, SPs were asked to define the PA role and it was clear that this was challenging, which backs current research findings. [4][5] This also indicates that potentially more work needs to be done on how students are introducing themselves so that this confusion can be overcome. Many of the SPs commented that they liked the realism of doing a whole consultation including a physical examination and the advantage of having plenty of time to give detailed written feedback to the student.…”

“…[2][3] Unlike medicine, however, they are not able to request certain investigations or prescribe medications and early research findings show that there is a lack of knowledge around the role in many healthcare settings and ambiguity around jurisdictional boundaries. [4][5] Higher education institutions, therefore, face considerable challenges in preparing PA students for clinical practice to overcome this uncertainty, develop diagnostic skills and generate an awareness of when to escalate to ensure patient safety is paramount.…”

Pharmacists in advanced clinical practice roles in emergency departments (PARED)

“…There is increased patient demand coupled with shortages in the number of doctors. European countries and elsewhere have dealt with the situation by restructuring the workforce and mobilising the clinical non-medical workforce [7][8][9][10][11][12][13].…”

Pharmacists in Advanced Clinical Practice Roles in Emergency Departments (PARED)

“…Assessments relate to the four pillars of ACP: clinical practice, leadership, education and training, and research and include independent prescribing. Healthcare workforce challenges in urgent and emergency care settings are recognised as a signi cant issue affecting NHS service delivery in the UK [5][6][7]. There is increased patient demand coupled with shortages in the number of doctors.…”