NHS Grampian
The Physician Associates Handbook
&
2017, revised 2018, 2020, 2023
Contents
1. Introduction,
p2
2. Registration
p2
3. Governance Structure
p3
a. Training
b. Indemnity
c. Supervision
d. Appraisal
e. Duty and Responsibility Framework
f. Induction
4. Competencies
p5
a. Primary Care
b. Secondary Care
c. Limitations
5. Professional Development
p7
a. CPD
b. Study Budget and Leave
c. Recertification
d. General Development
6. Appendices
p9
a. Template for the Duties and Responsibilities Framework (p9)
b. Departmental Guide to Clinical Activity and Learning Objectives (p12)
c. Additional Extended Competencies (p18)
d. Continuing Professional Development (p19)
e. Further Reading (p20)
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1.
Introduction
The Faculty of Physician Associates at the Royal College of Physicians, London,
describes Physicians Associates (PAs) as healthcare professionals with a generalist
medical education who work alongside doctors, physicians, GPs and surgeons to
provide medical care as an integral part of the multidisciplinary team. A PA is able to
see a range of undifferentiated patients, and does not necessarily work to set
protocols in the manner of an extended practitioner.
The Department of Health defined a PA in 2012 as “a new healthcare professional
who, while not a doctor, works to the medical model, with the attitudes, skills and
knowledge base to deliver holistic care and treatment within the general medical
and/or general practice team under defined levels of supervision”.
In the UK the Physician Associate has a first degree in appropriate sciences (e.g.
biomedical sciences, anatomy etc) or clinical healthcare (e.g. physiology, pharmacy
etc), and then undertakes a 2 year Physician Associate Programme at University.
Aberdeen University’s PA training programme was one of the earliest in the UK, and
is a well established course. As the profession has evolved, more roles and skills are
being developed by PAs, and their roles within generalist and specialist teams
continue to grow.
There is a commitment across Grampian to grow the PA Healthcare Profession as it
is recognised that there is a requirement for this role within Healthcare to meet
increased service delivery requirements and to support junior doctors’ training in the
context of these service needs. NHS Grampian has also invested in an Intern year to
ensure that newly graduated PAs are able to develop and are supported within their
first year. This provides a platform to build their future careers, in anticipation that the
PA workforce will remain working in the Grampian area.
2. Registration
Physician Associates do not currently have a recognised regulatory body analogous
to the GMC, although active efforts are underway to establish statutory regulation for
PAs. The Faculty of Physician Associates (FPA) was established in 2015 by the
Royal College of Physicians along with other health education bodies, in conjunction
with the UK Association of Physician Associates. The FPA is a UK-wide body, and
oversees standards for professional activities, patient safety, fitness to practice, etc.
These standards will be legally backed once a regulatory body is in place.
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The FPA maintains a Managed Voluntary Register (MVR). NHS Scotland1, and NHS
Grampian, stipulate as part of the condition of employment, that PAs must be
registered on the MVR. There is a currently a £200 annual fee to maintain
registration and a requirement to undertake 50 hours Continuing Professional
Development (CPD) each year. Employers are able to check PA registration at
appointment and at yearly appraisals. The FPA notes that this will help to ensure that
only those who have been properly trained are able to practise as PAs.
3. Governance Structure
(a) Training
Currently only PAs trained in the UK or USA are permitted to work in the UK. In the
interests of public safety – and because of the lack of statutory regulation – the FPA
will not accept a PA trained in any other country to work in the UK or to be on the PA
MVR. There is currently no system for PAs from other countries to be able to
demonstrate UK-equivalent standards of education and training.
To be appointed to a post, a PA must have successfully passed the final
examinations of a recognised PA course in the UK or USA, and have successfully
sat the UK PA national examination. Evidence of this must be provided and checked
at interview. They must also be registered on the PA MVR, which will be checked
prior to appointment, and reviewed each year at appraisal by the PA tutor or line
manager. US-trained PAs are required to have, and maintain, their certification by
the National Commission on Certification of Physician Assistants (NCCPA) in order
to work in the UK.
Aberdeen University’s PA course is one of the oldest in the UK, and has close links
with NHS Grampian.
(b) Indemnity
In primary care, PAs must take out professional negligence insurance from one of
the medical defence organisations: Medical Protection Society (MPS), Medical
Defence Union (MDU) or Medical and Dental Defence Union of Scotland (MDDUS).
Alternatively, they may be covered under a group arrangement in general practice.
For secondary care, the current practice of PAs is covered by the Department of
Health 2012 Clinical Negligence Scheme for Trusts (CNST). Qualified PAs are
1 DL (2016) 15
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strongly recommended to have their own personal professional negligence
insurance, which can be arranged through bodies such as MDDUS.
(c) Supervision
The PA is described as a dependent practitioner and will always work under the
supervision of a designated doctor. Their detailed scope of practice in a given setting
is limited by that of the supervising doctor, and the level of training the PA has
received in that area. Supervision can take more than one form: it may be direct, with
the supervising doctor physically present, or indirect, where the supervising doctor is
not physically present, but they will always be readily available for consultation.
Like other healthcare professionals, the PA is responsible for their own practice,
although the supervising doctor always maintains the ultimate responsibility for the
patient’s care.
The PA will be employed as a member of the medical team in primary or secondary
care and will have a clinical supervisory relationship with a named doctor, who will
provide clinical guidance when appropriate. It is expected that the supervisory
relationship will mature over time, and while the doctor will remain in overall control
of the clinical management of patients, the need for directive supervision of the PA
will diminish. The PA will always act within a predetermined level of supervision and
within agreed guidelines.
The identity of the supervising doctor should be specified within each department/GP
practice. While there will be a named supervisor for each PA, although they may
work under the supervision of a different consultant/GP on a given shift. Clear lines
of delegation must be specified within every department or place of work, e.g., other
medical staff in senior roles within the clinical area.
Qualified PAs may develop specialist expertise that reflects the specialty of their
supervising doctor. This will be gained through experiential learning and CPD.
However, a PA is expected to maintain their broad clinical knowledge base through
regular testing of generalist knowledge and demonstrated maintenance of generalist
clinical skills. PAs are required to demonstrate general competences through a
National Recertification Assessment very 5 years. This will move to a GMC-
mandated revalidation process once GMC regulation of PAs comes into force.
(d) Appraisal
All PAs should have an annual appraisal with their supervisor. In practice, a PA is
likely to work with different consultants or members of the GP team. Therefore,
feedback from the team should inform and support the annual appraisal.
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All NHS Grampian staff members were moved in 2018 to the Turas Appraisal system
for internal performance appraisal and development purposes. This is an online
system, to support the Knowledge and Skills Framework, required for all Agenda for
Change Staff. It has been developed by NHS Education for Scotland, but is now
being adopted by wider parts of the NHS.
There are a number of forms available on the FPA website for PAs and employers to
use to supplement the NHSG’s appraisal support documentation, including forms for
collecting patient and colleague feedback, evidence/case-based discussions and
confirming direct observation of procedures. NHSG forms are available on the
Intranet.
(e) Duty and Responsibility Framework
NHS Grampian requires a duty and responsibility framework document to be
completed for each PA to allow both department and PA to understand what is
expected of them. This document should indicate hours of work, required duties,
competencies and opportunities for development. This document will be reviewed at
least on an annual basis e.g. as part of the annual appraisal.
A model template is attached in appendix A.
In addition, departments and GP practices will find it greatly beneficial to provide
documented learning objectives and a guide to opportunities and expected clinical
activities. This will help identify the broader scope within which an individual PA’s
duty and responsibility document lies. Such a departmental guide will also inform the
wider clinical structure of the department/GP practice. An example of such a guide,
currently in use in Respiraory Medicine at ARI, is attached in Appendix B.
(f) Induction
Those PAs who are commencing employment with NHS Grampian are required to
attend NHS Grampian Corporate Induction. All PAs appointed to a new specialty
should undertake a local orientation/induction meeting to identify their learning
needs, and determine how these will be addressed in the first year and beyond.
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4. Competencies
(a) Primary Care
PAs in general practice can undertake a variety of jobs. They can assess, manage
and treat patients of all ages with a variety of acute undifferentiated and chronic
conditions. They can see patients presenting with acute/same-day problems, as well
as offering rebooked appointments. PAs are able to triage patients, carry out
telephone consultations, make referrals, and review and act on laboratory results.
Many PAs also carry out home visits or visit nursing and residential homes.
If desired, PAs may offer specialised clinics following appropriate training. Some
examples listed nationally include family planning, baby checks, COPD, asthma,
diabetes and anticoagulation. PAs are also able to teach and supervise students.
The level of competence at which the PA can work will depend on their skills and
experience, and the skills and experience of their supervising GP.
All PAs must be aware of the level of their clinical competence, and to work within
their limits accordingly. As PAs become more experienced, they can become
involved in a wide range of activities including service design and development,
becoming clinical placement leads for students, undertaking minor operations and
becoming involved in practice-wide education and quality improvement projects.
Some PAs may run a minor surgery clinic if appropriately trained. However, the
responsible GP with up-to-date skills must be available on-site. As a safety issue, the
clinic should not run if the appropriate doctor is not in the building.
(b) Secondary Care
All PAs have a core set of skills that they will perform on a regular basis as part of
their working role, regardless of the specialty in which they work. Core skills include
being able to: take medical histories; conduct comprehensive physical examinations;
request and interpret certain investigations; diagnose and treat illness/injuries; and
counsel, or offer preventative healthcare.
Ward rounds will be a key activity for most PAs working in secondary care. A PA is
able to perform most tasks that a junior doctor would perform on a ward round and
can lead the clinical review without direct supervision, providing a qualified and
registered doctor is also working in the clinical area, and the supervising doctor is
happy that the required competencies are present for them to do so.
If considered appropriate within a department, PAs may be trained in a range of
extended skills over a period of time. Examples of extended skills being undertaken
by UK PAs are listed in Appendix C.
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(c) Limitations
Due to the lack of statutory regulation at present, PAs cannot currently prescribe
medications or request ionising radiation.
5. Professional Development
(a) Continuing Professional Development (CPD)
All PAs are expected to maintain their CPD, as required by the The Faculty of
Physician Associates (FPA). NHSG expects that a PA will establish a formal
educational needs plan with their supervisor, which will be reviewed on a regular
basis.
The FPA has produced a CPD Diary for PAs to record activities undertaken. There is
a requirement for 50 hours CPD to be undertaken annually for the PA to remain on
the Managed Voluntary Register (MVR). Of these 50 hours at least 25 must be
external and some examples of internal or personal, examples are listed in Appendix
D.
(b) Study Budget and Leave
As NHS Grampian require PA’s to be on the MVR. Supervisors must enable PA’s to
undertake 50 hours Continuing Professional Development (CPD) per year by
providing support, access to a study budget and study leave.
Each PA should receive a study leave allowance of 10 days per annum to allow CPD
as per national requirements, as well as CPD related to essential skills specific to
their individual role. Of note, these two sets of requirements are likely to overlap to
some degree. Attendance at routine in-house departmental CPD opportunities
should also be encouraged, if possible.
NHS Grampian has agreed a study budget of £500 per annum for each PA, funded
by the parent department.
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(c) Recertification
Every 5 years, PA’s are required to undertake an examination in order to recertify.
They will have 3 attempts to pass this examination within the year. If they do not
pass, they will need to undertake the full National Examination before they can
continue to work as a Physician Associate.
The recertification examination costs £250 and covers all core areas of practice that
a PA is required to maintain knowledge in regardless of which specialty they are
working within.
The requirement for the recertification assessment will be replaced by a new GMC
appraisal system once GMC regulation of PAs comes into force.
(d) General Development
As PAs acquire seniority and increase their skills in their area of work, they will
become experienced members of their clinical teams. They would therefore have the
potential to become valuable contributors to the NHS in areas other than direct
clinical care.
In common with other NHS staff, senior PAs will be able to use development
opportunities for themselves in various areas such as leadership, operational
management, teaching and training, quality improvement, or research. Good liaison
within teams will help interested PAs to identify their interests, and to facilitate the
appropriate development opportunities.
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Appendices
Appendix A – Template for the Duties & Responsibilities Framework
Physician Associate in NHS Grampian: Duties and Responsibilities
Name:
Department:
Place of Work:
Supervising Consultant:
In the absence of the supervising consultant, supervision will be provided by:
(e.g., duty consultant as per rota)
Operational Line Manager:
Date of Review of this Document:
Summary of Duties.
Physician Associates (PAs) provide assistance to the consultants, specialty doctors, and
senior trainees in the provision of a high quality, patient centred service. PAs can participate
in all appropriate aspects of the care pathway and will be expected to perform delegated duties
with a high degree of clinical skill and knowledge.
PAs work alongside the medical team. They assess and examine patients, present them,
initiate and interpret investigations, and recommend treatment. They liaise with other
professionals and specialities as required and complete necessary documentation relating to
their patients.
They will be supervised by a designated consultant and will also have individual mentors to
overview their career development.
Physician Associates are involved in the activities of the Department, including coordinating
patients on ambulatory pathways related to their speciality, review patients admitted to their
ward/s and providing subsequent management of their case in conjunction with the medical
team. The role is generally developed flexibly over time in accordance with the PA’s clinical
interests and in line with the needs of the service.
Physician Associates may represent the department at local and external meetings as
appropriate.
Description of Duties.
A summary of regular work may be presented in a tabular form with descriptions as necessary:
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Examples:
Monday
Tuesday
Wednesday
Thursday
Friday
A.M.
Ambulatory
Ward round
Assist in
OP clinic
Ward rounds
clinic
Theatre
Mid-day
Teaching
MDT
Grand Round
Safety &
session
Quality
meeting
P.M.
Ward work
Patient
Attend post-
Ward work
Admin/QI
follow-up
op rounds
Details of duties specific to role/department...
Core procedures:
o Venepuncture
o Cannulation
o Arterial blood gases
o Arterial line insertion
o Injections
o ECG
o Urethral catheterisation
o Nasogastric tube insertion
o Lumbar puncture
o Thoracentesis
Department specific:
o ?
Responsibilities of a PA:
To have, develop and maintain specialist medical knowledge.
To keep up to date with current guidelines and maintain best practice.
To be accountable for the care given and to comply with the Fitness to Practice and Code
of Conduct standard as established by the UK Physician Associate Register (the PA
Managed Voluntary Register) and subsequently the appropriate statutory regulating body
when in place.
To work within the framework of the scope of professional practice.
To work within the multidisciplinary team to ensure effective team working in the provision
of acute medical care to patients on a day-to-day basis
To support and contribute to timely discharge planning including completing discharge
summaries and support optimising bed capacity.
To abide by the Clinical & Corporate Governance policies of NHS Grampian.
To take part in the administration of the department and the involvement in the
management of resources.
To fully document all aspects of patient care, and complete all required paperwork.
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The Physician Associate’s role wil initially be developed in collaboration with the Clinical Lead
of the relevant Department and the Chief of Medicine. The duties and responsibilities
framework is subject to review in line with service developments.
Development.
Personal Development Plan.
Every PA must have an agreed PDP for each year. This must cover essential areas,
including maintenance of clinical skills and CPD.
Development areas may be addressed under four categories:
Clinical skills
Teaching and skills as an educator
Management skills
Research, audit and quality improvement.
Appraisal.
Every PA will have an annual appraisal, carried out by their supervising consultant. This will
cover all areas of work, including:
Knowledge and skills
Workload
Teamworking
Safety and Quality
Feedback and complaints
Health and Probity statements
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Appendix B – Example of Departmental Guide to Clinical Activity and Learning
Objectives
PHYSICIAN ASSOCIATES - RESPIRATORY
, Consultant. Version 2, August 2018.
This document describes the opportunities available during the clinical placement, training,
and patient care activities of Physician Associates in Respiratory Medicine. This guide is
designed to be used by supervising consultants and PAs jointly. Section (1) deals with PA
Interns (i.e., in the first year after qualification, AfC Band 6), and Section (2) deals with
permanent (Band 7) PAs.
(1). INTERN PLACEMENT (6 months) LEARNING OBJECTIVES AND OUTCOMES:
Learning will be achieved primarily by attachment to the ward and clinical team however a
portion of the placement will be with the Bronchoscopy/Diagnostics service. Attendance at
specialist MDTs, educational meetings and clinics during the attachment as well as formal
teaching sessions will help to attain the learning outcomes outlined below. These have been
developed based on the core clinical conditions listed by the FPARPC but are by no means
exhaustive.
By the end of the 6 month placement on Respiratory the aim is that the PA intern has
enhanced their basic clinical skills in line with the intern year aims and curriculum as well as
gained experience with a broad range of relevant respiratory conditions both in terms of
diagnosis and management. This will be planned and assessed by a designated supervisor.
PA interns should have a broad mix of evidence in terms of WPBAs, reflective practice and
attendance at teaching sessions contributing to their appraisal as applicable.
The table below divides the most common respiratory conditions according to the matrix as
well as likely areas they can be achieved and suggestions on how to record this as evidence
for appraisal. Again these are not prescriptive and it will be the responsibility of the PA and
their supervisor to agree that these aims have been met. More common or core conditions
are in bold and evidence collated should include all of these.
Suggested evidence for 6 month placement:
2 sessions in each of the specialist clinics – Sleep/ILD/CF/General
8-12 weeks on Bronchoscopy Service
3 Mini Cex
2 CbD
DOPS for all skills
Reflective practice
Attendance at relevant teaching events
QIM project
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Respiratory Conditions:
1a: Able to investigate/diagnose and commence management for following conditions: (
is
able to diagnose the following conditions in a patient who is
presenting with the problem for the first time, and will normally be able to manage it without
regular or routine referral.)
Condition
Detail/Notes
Suggested source
Evidence
Acute Bronchitis
Ward
MiniCex
Reflective
practice
Bacterial and Viral Inc CURB scoring,
Ward
MiniCex
Pneumonia
complications and
Reflective
follow up, atypical
practice
infections
Influenza
Ward
MiniCex
Reflective
practice
COPD
outpatient diagnosis
Ward
MiniCex
and acute exacerbation Clinic
Reflective
management inc
ESD
practice
discharge
Teaching
bundles/indications for
NIV/referral to Pul
Rehab
Asthma
outpatient diagnosis
Ward
MiniCex
and acute exacerbation Clinic
Reflective
inc discharge bundles
practice
and action plans
1b: Conditions identified as possible diagnosis but unable to confirm diagnosis without
specialist clinician input. Aim to prevent harm while awaiting management.(
to identify the
following conditions as possible diagnoses, may not have the knowledge or resources to
confirm the diagnosis or to manage the condition safely, but can take measures to avoid
immediate deterioration and refer appropriately.)
Condition
Detail
Suggested
Evidence
source/evidence
Acute Bronchiolitis
Ward
Pertussis/Epiglottitis
Teaching
Pleural conditions:
Including
Ward
MiniCex
- Effusion inc
Pleural clinic
Reflective
empyema
Teaching
practice
- Pneumothorax –
DOPS
primary and
secondary
PE
Ward
MiniCex
Reflective
practice
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Cor Pulmonale
Ward
MiniCex
Clinic
Reflective
practice
Bronchogenic
Including diagnostic
Ward
MiniCex
carcinoma
pathway and
MDT
Reflective
modalities, staging,
Bronchoscopy
practice
management
service
CbD
options and
metastatic disease
2a: N/A
2b: carry out management as directed by clinician
(to undertake the day-to-day management
of the patient with one of the following conditions once the diagnosis and strategic
management decisions have been made by another.)
Condition
Detail
Suggested source
Evidence
Specialist pulmonary
Teaching
MiniCex
infection –
Reflective
HIV/fungal/TB
practice
CbD
Bronchiectasis
Ward
MiniCex
Reflective
practice
CF
Acute issues and
Ward
MiniCex
chronic disease
Specialist clinic
Reflective
management
practice
CbD
Idiopathic
Cause, diagnosis,
Clinic
MiniCex
pulmonary fibrosis
current
Teaching
Reflective
management
MDT (ILD)
practice
strategy and
CbD
prognosis
Pneumoconiosis
Teaching
MiniCex
ILD MDT
Reflective
practice
Sarcoidosis
Teaching
MiniCex
Bronchoscopy
Reflective
Clinic
practice
ILD MDT
CbD
Pulmonary
Teaching
MiniCex
Hypertension
Ward
Reflective
practice
Carcinoid
Teaching
MiniCex
Lung MDT
Reflective
Bronchoscopy
practice
Pulmonary nodules
Teaching
MiniCex
Lung MDT
Reflective
practice
Skills/Experience: (in addition to generic clinical skills)
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Skill
Source
Evidence
Inhaler technique - patient
Ward pharmacy team
DOPs
education
ESD
ABG interpretation
Ward
DOPs
Teaching
Mini Cex
Basic Spirometry
Ward
DOPS
performance (PEF) and
interpretation
Involvement in ward based Ward
QIM project report
QIM/clinical audit.
QIM
Reflective practice
Pleural Aspirate
Ward
DOPs
Pleural Clinic
Mini Cex
Teaching:
Suggested formal teaching topics
(1-2 hours delivered by registrars/consultant/specialist either as tutorial or bedside/clinical
teaching. Doubles as teaching for trainees as well – often requested by previous cohorts. As
the PAs across the hospital and region are required to sit an examination every 5 years to
maintain competence there is scope to expand this in time)
NIV
Lung Cancer
ILD
Infections (specialist)
Pulmonary Vascular Disease
Suggested timetable:
Ward based activity including attendance on ward round/ involvement in ward
activities/review of new patients.
Attendance at formal teaching sessions like departmental Thursday meeting/MDTs
Attendance at specialist and general clinic (while on either Bronch/Ward placement
depending on service requirement) Sleep/ILD/CF. To be arranged by PA intern in
conjunction with consultant/registrar both for the ward and the proposed clinic.
Bronchoscopy service – 8 - 12 weeks
(integral part of the role of a PA on Chest although not necessarily entirely appropriate for
generic competency and learning ie those not likely to take up a Chest PA post.)
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2. PERMENANT PLACEMENT RESPIRATORY PHYSICIAN ASSOCIATE:
As a permanent member of the team more time can be dedicated to developing greater
depth to core knowledge as well as Respiratory specific skills. This can be guided, to a
degree by PA preference/interest.
Evidence of maintenance of basic competency (general) as well as regular up dates on core
respiratory topics is required. Efforts to be made to ensure evidence is also accumulated to
reflect less common (non bold) topics and areas not listed.
Time split between ward and diagnostic/bronchoscopy services – 3 month rotations
dependant on intern availability/service requirement.
Outcomes to work towards:
Practical Skill:
o Pleural procedures including
pleural aspirate/thoracocentesis
Intercostal chest drain insertion – Seldinger only
o Thoracic ultrasound aiming towards Level 1 competency/independence
o NIV application – indication/establishment/trouble shooting
o Oxygen assessment for ward patients (support of Oxygen team)
o EBUS needle sampling
o Consent for procedures
o Midline insertion
o Gripper Insertion
Education:
Medical student/PA teaching (including attendance on a relevant teaching
skills course) and involvement in ward nurse education and new doctor
induction.
Attendance at IMPACT/ALS/relevant RCP course eg updates from
RCPE/National meeting eg STS biannual meeting aiming for 25 hours
minimum of Type 1 CPD each year (or 75 hours in 3 years)
Desirable/Enhanced:
More detailed knowledge of physiology testing and indications – PFTs and
Somnography.
Collaboration or original research or publication
Journal club presentation/involvement in departmental education
Evidence: For annual appraisal:
Type 1 CPD - min 25 hours
Type 2 CPD – 25 hours
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Evidence of maintenance of general competency.....
Evidence of work towards higher skills/competency
3 sessions in each of the specialist clinics – Sleep/ILD/CF/General
8-12 weeks on Bronchoscopy Service
5 Mini Cex
3 CbD
DOPS for essential and new skills
Reflective practice
Attendance at relevant teaching events
QIM project
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Appendix C – Additional Extended Competencies
As part of mutual agreement between a PA and their clinical supervisor, PAs may be trained
in a range of extended skills over a period of time. Information on extended skills being
undertaken by UK PAs is collected annually by the FPA in its annual census. These
extended skills include:
ascitic drain insertion or tap
backslab application
lumbar puncture
fracture reduction
surgical first assisting
joint aspiration/injection
nerve blocks
pleural tap
incision and drainage of abscesses.
An employer wishing to train PAs in extended skills should expect the PA to acquire these
extended skills in a manner that upholds a high standard of care, and to safeguard the
patient, practitioner and employer. To be trained in extended skills, the PA should receive
training from a qualified and competent practitioner in that skill, and then undergo a period of
supervised practice. Both the initial training and supervised practice should be documented
and form part of the PA’s work-based yearly appraisal. Competence to continue practising
the extended skills should also be reviewed during this appraisal.
PAs are able to obtain verbal consent for the extended skills listed above, providing that the
verbal consent is documented in the medical notes. Please note that PAs are unable to
obtain consent from patients for operative procedures which require anaesthesia.
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Appendix D – CPD
All NHSG Staff are expected to maintain statutory and mandatory training
requirements as part of employment. Additionally, PA CPD can include items from
the following list:
Work related MSc or equivalent activity (external)
Unlisted external meetings (external)
Faculty of Physician Associates examining activities (Maximum 12 External
credits)
Internal mandatory training (internal)
Internal CPD meetings (internal)
Participating in audit meetings or morbidity and mortality meetings (internal)
Participating in seminars/workshops (internal)
Participating in grand rounds or specialty clinical meetings (internal)
Carrying our information searches (personal)
Presenting at a conference (personal)
Participating in Committees (personal)
Reading journals/articles (personal)
Refereeing articles (personal)
Undertaking a research project (personal)
Undertaking peer review (personal)
Writing examination questions (personal)
Writing articles (personal)
As each PA develops within their Career, undertaking new clinical skills, at least one
Direct Observation of Procedural Skill form should be completed per procedure. NHS
Grampian recommends that each PA completes at least one the following annually:
Mini Clinical Evaluation
Case Based Discussions
Reflection on a Learning Event
Reflection on a Clinical Event
Colleague Multi Source Feedback Questionnaire
These forms are available on the Physician Associate Intranet Page
(Intranet>Departments>M>Medical Workforce>Physician Associates)
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Appendix E – Further Reading
An Employer’s Guide to Physician Associates.
Faculty of Physician Associates, Royal College of Physicians. www.fparcp.co.uk
All Wales Physician Associate Governance Framework.
http://www.nwssp.wales.nhs.uk/document/306782
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