Department reviewing application to recognise physician associates

The Department of Health is reviewing an application from the HSE to recognise the grade of physician associate (PA), the Medical Independent has learned.

According to the HSE, “challenges and learnings” from other jurisdictions are being considered to ensure the grade improves the overall patient experience and patient safety.

PAs are trained in the medical model and work as part of a multidisciplinary team under consultant or GP supervision. The RCSI, which commenced an MSc in Physician Associate Studies in 2016, states: “PAs support doctors and surgeons in the diagnosis and management of patients and are trained to perform several roles, including taking medical histories, performing examinations, making diagnoses, and analysing
test results.”

Commenting on 13 August, an IMO spokesperson said it had met with the HSE in relation to a guidance document on PA employment and is “currently engaged in providing submissions on the issue”.

“The IMO is strongly of the view that in order for PAs to be part of the workforce within the HSE it is critical that we learn from the UK experience along with addressing issues around governance and regulation, patient safety, impact on consultant workload, potential negative impact on NCHD training, and scope of practice for PAs.”

“Following a recommendation from the IMO, the HSE is pausing all further recruitment of PAs until the guidance document is finalised. The IMO will continue to engage with
the HSE.”

The HSE’s preparations to date include the development of a guidance document outlining clinical governance structures. According to the HSE, this document will provide guidance in relation to education and regulation, supervision requirements, and scope of practice.

“The deliberations around the future regulator for this role are still ongoing,” stated a
HSE spokesperson.

To date, 76 PAs have graduated from the RCSI’s two-year programme and most are working in hospitals in Ireland. There are also a small number of overseas-qualified PAs employed here.

Public employers include Beaumont Hospital, Dublin; Our Lady’s Hospital, Navan; Letterkenny University Hospital; and the Rotunda Hospital, Dublin. This year, the HSE has provided funding for course fees to RCSI PA students in return for a service commitment following graduation. All 29 students in first-year will provide a three-year service commitment to the HSE in return for their fees being covered for the course duration. Seven of the second years have had their fees covered for one year and will provide a service commitment of two years. See news feature.