A01 - AHP An Examination of the Opinions of NHS Stakeholders on the Current and Future Role of Physician Associates

Abstract Background Globally, healthcare systems are experiencing problems recruiting and retaining healthcare workers. Like many developed countries, in the UK, shortages are exacerbated by rising healthcare costs and models have had to be developed utilising shorter training periods and a generalized skillset. One of the consequences is the development of intermediate-level practitioners including Physician Associates (PAs). By 2024 over 4,000 PAs were working in the NHS, but their myriad roles has meant that integration has been challenging. This study examines the opinions of NHS stakeholders on the current and future roles of PAs and explores approaches to improve their integration. Method This cross-sectional study at a single NHS Trust gathered views and experiences regarding PAs through a survey of consultant and junior medical staff (JDs), PAs, and patients. Patients who interacted with a PA within four weeks prior to the period of the survey were randomly selected to avoid recall bias. Surveys, initially generated by doctors and a PA, were tailored, validated by experts, and pilot-tested. Distribution was via Microsoft Forms® and ACCURX® and responses were collected electronically with weekly reminders. Data were analysed using Microsoft Excel® and SPSS®, with qualitative analysis used to identify recurring themes. Results Consultants more frequently recognised positive contributions of PAs (p=0.012) although 68.6% noted PA roles were unclear. The PA role had only been explained to 11% of JDs, just 14% fully understood their role and 75% felt PAs might negatively affect their training. Conversely most PAs felt consultants (87.5%) and JDs (81.3%) were aware of their responsibilities. While 62.5% of PAs anticipated career progression, 87.5% were satisfied with training, 56.3% were considering a career change and 75% felt the healthcare climate adversely affected their work. Only 14% of patients fully understood the PA role, but 86% comfortable being seen by them. Conclusion This study highlights the positive contributions of PAs and recognition by stakeholders. Integration however remains challenging with concerns regarding JD training, PA career progression, and job satisfaction. The main hurdles remain unclear compounded by myriad PA roles and surveys reveal significant gaps in understanding among JDs and patients. PAs overestimate understanding of their role and education of stakeholders regarding their PA roles is crucial and must involve PAs, managers, consultants, GMC, and Royal Colleges. Local trusts and consultants must define PA roles, ensure career progression, and support JD training to enhance interprofessional relationships, trust, and the quality of patient care.