GP practices to train over 100 physician associates in east London

GP practices in east London will train more than 100 physician associates over the next seven years under plans to transform the primary care workforce.

Local NHS leaders recruited 24 trainees this year - with places oversubscribed by more than four times - and have already placed the first of these new recruits into GP practices.

The trainee physician associates (PAs) have now been recruited for a two-year practice-based training programme run by three east London CCGs, a major NHS trust and a medical school.

Local clinical leaders said the scheme had also been oversubscribed by practices wishing to take on the trainees.

GP Podcast: can skill mix ease GP workforce crisis?

The programme is part of a radical transformation plan for health services in three east London boroughs. GPonline revealed details of the Transforming Services Together (TST) plan earlier this year, including its forecast that GP numbers in the area will fall by a third over the next decade.

Commissioning leaders in Waltham Forest, Newham and Tower Hamlets have drawn up the plans which include recruiting more pharmacists, physician associates, and nurses to help offset the dramatic loss of GPs.

Last month Tower Hamlets CCG chair and north-east London STP clinical director Dr Sam Everington said GP numbers would fall by half over five years in the wider eight-borough area.

TST clinical leaders have told GPonline that they now intend to recruit a further 34 trainee PAs for 2018, followed by 44, 55, and 64 in subsequent years, with 111 of the total 221 trained PAs by 2023 working in primary care.

The training is being part funded by the CCGs, while the syllabus is being developed by Barts NHS trust and Queen Mary, University of London.

GP skill mix

Waltham Forest CCG clinical director Dr Ken Aswani, interviewed for the GP Podcast, said: ‘Although, quite rightly, initially GPs do have questions about physician associates, they have come on board. The fact that we can place 24 student PAs - so they'll need even more supervision - I think is testament that people are willing to give this a go and work with them.’

Dr Aswani, who has pioneered the use of GP PAs over the last 10 years in Leytonstone's Allum Medical Centre - where he is a partner - also sits on the TST physician associate steering group. He said plans to increase skill mix would help keep practices sustainable and resilient for the future and relieve workload pressure on GPs.

The plans, he said, should not be seen as an attempt to substitute for GPs or to run services ‘on the cheap’. ‘This is about saying, look we know patients need to manage, we know there's complexity. We know there is a recruitment issue. And how can we work together, and the new way of working, to manage patients.’

He stressed that the plan to recruit PAs was ‘not just about replacing GPs’.

Primary care transformation lead for the TST programme GP Dr Asma Ali added: ‘It's very important for us to develop the syllabus and the safety guidelines around safety … that there's a clear monitoring process as well as a learning process for them’.

She added: ‘One of the benefits of having it across [Waltham Forest and East London], or across the TST, across the number of stakeholders that are involved in the partnership, is that we've got these 24 as the forerunner.

'The learning from that is being used as best practice, for evidence-based best practice.' With 33 more PAs places available next year she said the programme hoped to attract even more than the 200 applicants for this year's posts. 'Hopefully it will develop into this multidisciplinary approach which actually has the right clinical skill set for the right patient at the right time.’

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