Cut price doctor will see you now: 3,000 assistants with just two years training to work at GPs and hospitals

Cut price doctor will see you now: 3,000 assistants with just two years training to work at GPs and hospitals

  • NHS is increasing number of ‘associate physicians’ from 300 to 3,000 by 2020 
  • The medics train for just two years and earn a third of a regular doctor’s salary 
  • Government hopes it will ease staffing burden without weighing on the budget
  • But critics say they are ‘doctors on the cheap’ and will put patients at risk 

Thousands of new ‘doctors on the cheap’ are being trained to prop up the cash-strapped NHS, it emerged yesterday.

An army of ‘physician associates’ will work in GP surgeries and hospitals to diagnose patients, recommend treatments and perform minor procedures.

There are currently just 300 of the physicians – who train for just two years and earn only a third of a doctor’s salary – working in the health service.

Government plans call for the number of 'associate physicians' to be increased from 300 to more than 3,000 to reduce pressure on more highly skilled doctors

Government plans call for the number of ‘associate physicians’ to be increased from 300 to more than 3,000 to reduce pressure on more highly skilled doctors

But new figures yesterday indicated that there would now be more than 3,000 by 2020 – and at least 1,000 per year graduating after that.

The dramatic expansion in their numbers comes after the NHS urged more universities to start offering the two-year post-graduate training course, which is open to anyone with a science degree.

Proponents say they can help ease the burden on the cash-strapped NHS and overstretched GPs and can fill an important role in reducing the workload of senior staff in busy hospitals.

But critics say they are doing jobs that should really be performed by doctors and have raised concerns that patients could be put at risk due to their lack of experience and training.

Joyce Robins, director of Patient Concern, said: ‘It sounds very much to me like doctors on the cheap. I am really rather knocked back by it. Of course doctors are overrun at the moment but this is worrying and I think patients will be concerned.

‘It depends exactly on what they are doing but their role sounds quite extensive for just two years of training. My heart quakes.’

The role of physician associate, which originated as an idea in America, was first introduced into the NHS in 2013.

They train on a two-year postgraduate course that focuses on general adult medicine in hospital and general practice. It also teaches mental health, obstetrics and gynaecology and paediatrics.

Students will undergo around 1,600 hours of clinical training over two years.

Associate physicians are trained for two years on a post-graduate course available to anyone who has a science degree

Associate physicians are trained for two years on a post-graduate course available to anyone who has a science degree

As well as diagnosing patients, those that qualify are also able analyse test results as well as carry out minor operations, such as skin cancer and tumour removal and biopsies. They are able to work alongside GPs and hospital doctors.

By contrast, it typically takes around 10 years to train as a GP and 14 years to train as a surgeon. Physician associates are also much cheaper than doctors, earning between £30,000 and £40,000 a year – a third of the average annual salary of a family doctor.

Jeremy Hunt, the Health Secretary, had originally said he wanted to see 1,000 working in the NHS by 2020. But there are already around 1,000 people on one of the two-year courses currently being offered around the country.

And yesterday, the Royal College of Physicians said projected figures now indicated there would be more than 3,000 qualified physician associates by 2020 and at least 1,000 per year graduating after that.

There were two physician associate courses running in 2013. There are now 27 and there are more in the pipeline.

This week, De Montfort University in Leicester became the latest institution to announce it would be running a physician associate studies course for 2017/18.

It said it had been contacted by local healthcare providers keen to recruit physician associates.

Currently there are about 150,000 GPs, hospital doctors and junior doctors within the NHS.

Dr Louise Dunford, joint academic lead for setting up the course at De Montford University, said: ‘Local healthcare providers contacted DMU to say they were interested in recruiting PAs.

‘The idea is to develop a new sustainable workforce to help reduce waiting times for patients and provide continuity of care.’

The course will cost £9,000 a year and is open to anyone with a minimum of a 2:1 BSc Hons, or equivalent, in a life sciences or health-related subject such as anatomy, biology, biomedical science, healthcare science, medical science, medical engineering or nursing.

Proponents say using physician associates will fill gaps in NHS staffing without driving up costs, but critics say it will put patients at risk

Proponents say using physician associates will fill gaps in NHS staffing without driving up costs, but critics say it will put patients at risk

Despite the concerns, one study has found those that graduate as a physician associate are just as competent as GPs at diagnosing and managing patients who don’t have complex medical problems.

They mainly see younger patients, freeing up the GPs’ time to deal with the elderly who have a range of serious, long-term illnesses.

They are currently not able to prescribe drugs or request chest x-rays or CT scans.

There is currently a huge shortage of GPs and physician associates are one way of helping plug the gap.

But the Royal College of GPs has previously said the workers are ‘no substitute’ for family doctors.

Separately, doctors in Suffolk are hiring physician associates from America to work in surgeries.

Patrick Mitchell, Regional Director at Health Education England and Senior Reporting officer on Physician Associates, said: ‘The PA role is becoming increasingly popular and valuable in the NHS. There are currently 412 trainees who are in the second year of their training with a further 700 in their first year. Twenty seven universities are currently running PA courses.

‘HEE has been working to develop the PA profession for some time as this type of practitioner was identified as a workforce solution to address the challenges within emergency medicine to support teams in the emergency department and more recently in primary care supporting GPs.’

Jeannie Watkins, President of the Faculty of Physician Associates, added: ‘Physician associates have a 3 year undergraduate degree in biomedical or health related sciences, after which they undergo a 2 year intensive medical training programme to enable them to practice medicine.

‘Their training in addition to medical theory, includes clinical placements – where they have significant time with patients, supervised by doctors, to gain experience in preparation for professional practice.

‘Once qualified, the breadth of their responsibilities will depend on how much experience they have, and their dedicated consultant supervisor will be able to delegate this appropriately.

‘This is not about doctors on the cheap but about skill mix, redistribution of the medical workload to appropriately trained healthcare professionals, and increased access to services and continuity of care for patients.’

Last week, research suggested waiting times to see a GP could hit three weeks by 2022. Patients currently have to wait an average of 13 days for a routine appointment, according to a survey of GPs – up from ten days in 2015.

Experts claim waiting times will continue to ‘rocket’ unless general practice receives a major overhaul. If pressure continues to build at the current rate, the average waiting time will reach three weeks in five years.

The Government has pledged to hire 5,000 new GPs by 2020 to make up for an exodus of doctors from the NHS.

Although GPs benefited from a new contract ten years ago that led to average salaries soaring to more than £100,000 a year – and enabled them to give up out-of-hours work – morale is at an all-time low with two in every five GPs are planning to retire or quit within the next five years, separate studies have shown.

Doctors claim they are not being given enough funding to meet the needs of the growing and ageing population. The Conservatives have said they were investing £2.4billion more in primary care, a historic 14 per cent real-terms rise.

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