Physician associate grade ‘will be considered’ under reforms – DoH

New grades such as physician associate (PA) will be considered in the context of “innovation” under Sláintecare, a Department of Health spokesperson has told the Medical Independent (MI).

“The reforms identified in the Sláintecare Reform Programme Workstream ‘Teams of the Future’ are centred on planning, building and supporting a health and social care workforce which can deliver on the Sláintecare reforms, as well as initiatives which promote innovation,” said the Department’s spokesperson.

“In this context of innovation, new grades, such as that of physician associates, will be considered.”

Consideration will be given to regulation “if and when a decision is taken to introduce the grade of physician associate to the Irish public health service”.

An RCSI-led small-scale pilot of PAs took place at Beaumont Hospital, Dublin, from 2015 to 2017. The Department subsequently indicated that a larger pilot was required to assess the potential benefits of PAs.

“The Department of Health needs to consider the benefits of the introduction of a further wider pilot project, which would better inform future deliberations,” commented its spokesperson in December.

In 2016, the RCSI established an MSc programme to qualify PAs. Currently, there are PAs employed in several public and private healthcare facilities.
However, PAs do not have any regulatory body in Ireland. PAs graduating from the RCSI take a national certifying exam and a voluntary register is managed by the Irish Society of Physician Associates.

Newly appointed Director of the RCSI programme, Prof Lisa Mustone Alexander, told MI it is hoped the Department will advocate for a regulatory process covering PAs.

According to the RCSI, most of its PA graduates work in the greater Dublin region, including Beaumont Hospital, the Mater Misericordiae University Hospital, Our Lady’s Hospital, Navan, and Bon Secours Health System.

Graduates work in various surgical and medical subspecialties, including gastroenterology, otolaryngology, infectious disease, emergency medicine, orthopedics, cardiology, and general practice.

As of December, some 28 PAs have graduated from the RCSI’s programme.
PAs are trained in the medical model and work under consultant or GP supervision. They support doctors in the diagnosis and management of patients and are trained to perform several roles, including taking medical histories, performing examinations and making diagnoses.

See news feature, Introducing physician associates to Ireland: The story so far – Medical Independent