Physician assistant (PA) pilots in Sandwell in the West Midlands have been so successful that PCT managers have said they no longer intend to recruit GPs when old ones decide to retire.
‘A PA can do anything a GP can do in the context of general practice,’ said Geraint Griffiths, formerly from Sandwell but now a director at South Staffordshire PCT.
‘We haven’t yet found anything they can’t do except work independently — they can examine, diagnose, interpret and write prescriptions.’
He said the only problems they had encountered was that sometimes they had been limited by the expertise of their supervisor — who is responsible for anything they do — and that they were not in a position to sign prescriptions.
However, he said that in practice clinicians had enough confidence to sign off most prescriptions without any problems.
PAs go through a two to three year postgraduate training course before qualifying and are currently paid between £40,000 and £50,000, making it much cheaper and quicker than training and employing a GP, said Mr Griffiths.
Medical practitioner assistants are expected to undergo similar training although it will not be an exact like-for-like comparison.
But GPC chairman Dr Hamish Meldrum said medical practitioner assistants would be inadequately trained to deal with complex illnesses.
‘Skilled nurse practitioners in primary care have taken over many more of the more routine tasks from GPs.
‘I would need a lot of convincing that medical practitioner assistants would be of added benefit and would not confuse patients,’ he said.
What PAs do
Can: examine, diagnose, interpret and write prescriptions.
Cannot: sign prescriptions or work without a supervising clinician.