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The NHS Long Term Workforce Plan is seen as a once-in-a-generation opportunity to put staffing on a sustainable footing and improve patient care. Published in June 2023, the plan sets out a bold vision for the future of the NHS workforce, addressing issues in the workforce, such as staff shortages and burnout, and mentions physician associates in several key topics.

How will PA numbers compare to other professionals?

Annually, about 7,000 doctors graduate from UK medical schools every year.  And the workforce plan promises to more than double this number to 15,000 graduates. To draw comparisons – there would be about 1,500 PAs graduating a year if plans to expand PA numbers are met.

However, this has the potential to be a flashpoint for medical students. Concerns about healthcare students in training competing for limited training chances have lately erupted on #medtwitter. And discussions on social media regarding qualified PAs doing clinical skills and learning new procedures in place of doctors in training are a common cause for concern. While it is important for all professionals to be trained and to advance in their careers, the expansion of all parts of the healthcare workforce is likely to produce some tensions in the future.

In addition to boosting the number of PAs to 1,500 a year, there is also a push to fill more advanced practitioner (ACP/ANP) positions. The workforce plan pledges to recruit more than 6,300 people beginning advanced practice routes each year by 2031/32. While this may be a good career development path for existing healthcare professionals such as nurses, paramedics, and pharmacists, it raises concerns about depleting those existing pools of staff to become advanced practitioner roles. Typically, PA training brings new people into the healthcare workforce, who were previously working outside of the NHS and bring their talents and experience to the PA role.

What needs to be considered when expanding PA numbers?

It will become important to create clear job descriptions and expectations for physician associates and doctors, as well as advanced practitioners and others to ensure that physician associates are not duplicating the work of doctors or other healthcare staff, and that all professions can achieve their training objectives and acquire new skills and progress in their careers.

It will be really important to foster a collaborative and supportive work environment,  to ensure that both doctors and physician associates and ACPs all feel valued and respected, and that they are not competing with each other for opportunities to learn.

It will be difficult but necessary to allocate resources equitably,  so that all healthcare staff have access to the learning opportunities they need.

The NHS long term workforce plan notes that physician associates are seen as valuable members of the healthcare team, and they should be encouraged to participate in learning opportunities that will help them to develop their skills and knowledge. I hope that in the future, we can help to ensure that physician associates have the opportunity to learn and grow, without competing with doctors or other healthcare staff.

 

CLARIFICATION – This article has been edited on 28th November. A previous version of the article stated numbers of medical student places would treble from 7,000 to 15,000; this has been corrected to ‘more than double’. A previous version of the article also said: ‘1,500 PAs {graduating} per year will likely represent around 10% of the number of doctors graduating each year’. To clarify, physician associates are not doctors. The article has been modified to clarify the comparison in numbers of gradates does not imply equivalency of the professions.

 

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