The National Health Service (NHS) has released a summary of existing guidance on the deployment of medical associate professions (MAPs) within healthcare settings. This guidance emphasizes the importance of collaboration and clear communication within multidisciplinary teams.
The NHS guidance states that doctors are able to delegate tasks and responsibilities appropriately, following relevant regulatory guidelines. This delegation should be informed by a strong understanding of the roles and skillsets present within their teams. Physician associates must be directed and overseen by a supervising senior doctor who has delegated responsibility to the MAP in line with the standards and guidance in Good Medical Practice, Leadership and management for all doctors, and Delegation and referral.
The NHS guidance clarifies that physician associates (PAs) are not intended to replace doctors. Instead, PAs are specifically trained to work collaboratively with doctors, nurses, and other allied health professionals (ARRS) as supplementary members of the team. The NHS discourages the use of PAs to fill staffing gaps on doctor rotas.
To ensure safe and effective deployment of MAPs, the guidance outlines several key steps for NHS trusts:
- Rota Software Assessment: Trusts are encouraged to assess their current rota software capabilities to ensure it accurately reflects the multidisciplinary nature of staffing.
- Safe Staffing Levels: Each department should undertake a dedicated assessment to establish safe minimum staffing levels. This assessment should consider the skillsets and scopes of practice of various staff members, informed by a service evaluation of patient needs.
- Rota Transparency: The full name and job title of each healthcare professional, including PAs, should be clearly displayed on any rota system.
- Staff Education: As part of the induction process, all staff members should receive education on how the rota is developed, operated, and displayed. This promotes understanding and transparency within the team. The NHS says that as part of good governance processes, all staff should be aware of how to triage patients so that they are seen appropriately by a clinician working within their level of competence.
PAs are not substitutes for doctors of any grade or experience; rather, they are specifically trained to work collaboratively with doctors and others as supplementary members of a multidisciplinary team alongside nursing and other ARRS colleagues. As previously communicated, PAs should not be used as replacements for doctors on a rota.
The NHS highlight how important it is that all staff introduce themselves and their role clearly, to ensure that patients understand who is caring for them. The Faculty of Physician Associates has produced guidance to support staff which is available on their website.
To ensure the effective integration of PAs into the NHS workforce, fostering collaboration and ultimately improving patient care, it is important patients and staff understand the role of the physician associate. The NHS says that patients should be supported to understand the role of each healthcare professional they are seeing and are not led to believe that the professional they are seeing has competencies beyond their scope of practice or skills set.
The NHS state that all clinical staff, and administrative/clerical staff (for example, receptionists) must be educated on the PA role, and must make it clear to patients that they are seeing a PA.