Physician AssociateNHS

Job summary

The postholder will provide clinical care to patients within a clearly defined scope of practice and under the overall direction and supervision of a named GP. The PA will undertake clinical assessment, history taking and examination and, where appropriately trained and authorised, establish a working diagnosis and management plan for clinically assessed patients, in accordance with agreed protocols and local governance arrangements. PAs are not doctors or independent medical practitioners and must work within their competence, seeking advice and escalating to the supervising GP when required. The PA will provide holistic, patient-centred care and may undertake home visits, Care Home Ward Rounds and booked or clinically triaged consultations. The PA will review and act appropriately on results and referrals/correspondence within their scope, with appropriate GP supervision and debriefing.

The PA will have a named GMC registered GP supervisor. All work undertaken by the PA will be subject to appropriate clinical supervision and debriefing. The level and type of supervision will reflect the PAs knowledge, skills, experience and scope of competence, with the supervising GP retaining overall responsibility for delegated clinical work in accordance with NHS England and GMC requirements.

The PA will be expected to attend and partake in arranged educational meetings.

An enhanced DBS check will be carried out for all successful candidates.

Main duties of the job

Participate in treatment/preventative healthcare services as delegated by clinical leads; support Network DES Contract for Care Homes across each PCN.Provide direct clinical care using guidelines.Consult/refer patients to physicians, specialists & other health professionals.Undertake history taking, examination and clinical assessment of triaged/booked patients; establish diagnoses within scope, explain findings/management options, with GP supervision.Recommend investigations/treatment within scope/protocols, request/interpret diagnostic results where permitted & undertake authorised procedures for which trained and competent, under supervision. PAs must not prescribeEducate patients in preventative healthcare and conduct telephone/video consultations, including investigation results and routine/emergency complaints.Document patient care and complete required legal/administrative paperwork.Participate in clinicians duty rota, including home visits, and provide clinical tasks to nursing staff/Primary Care Team.Communicate with Primary Care colleagues, hospitals, consultants, healthcare providers, insurers and community organisations to discuss/refer patients, coordinate activities, exchange information and support community services/education.In line with current NHS England guidance, PAs will not routinely see undifferentiated patients. Patients must be triaged/booked into a defined pathway before PA assessment, unless a nationally/locally agreed protocol permits otherwise.

Job description

Participate in all treatment and preventative healthcare services as delegated and agreed by clinical leads.

Provide direct clinical care using established clinical guidelines.

Consult and refer patients, in person or digitally, to physicians, medical specialists and other health professionals as indicated.

Undertake history taking, physical examination and clinical assessment of appropriately triaged/booked patients; establish working diagnoses within scope, explain findings and management options, with GP supervision.

Play an integral part in the Network DES Contract for Care Homes across each PCN.

Recommend diagnostic investigations and treatment within scope and agreed protocols; treatment decisions must be appropriately supervised and PAs must not prescribe.

Request and interpret laboratory investigation results when necessary.

Undertake diagnostic examinations and treatment procedures for which appropriately trained, competent and authorised, under clinical supervision.

Instruct and educate patients in preventative healthcare.

Conduct telephone/video consultations, including discussing laboratory investigation results and implications and dealing with routine/emergency complaints.

Request/arrange laboratory and other diagnostic investigations where permitted by local policy and within scope, with supervision.

Fully document patient care and complete required legal/administrative paperwork.

Participate in clinicians duty rota, including home visits where appropriate.

Establish working diagnoses and propose management plans within scope, seeking advice/referring to the supervising GP or appropriate clinician where required.

Provide clinical tasks to nursing staff and Primary Care Team as required.

Communicate with Primary Care colleagues and hospital specialists to discuss/refer patients, coordinate activities or exchange information to improve care.

Deal with community hospitals, consultants, healthcare providers, insurance companies and community organisations to refer/consult on cases and participate in community service/education projects.

In line with current NHS England guidance, PAs will not routinely see undifferentiated patients. Patients must be appropriately triaged/booked into a defined pathway before PA assessment, except where a nationally/locally agreed protocol permits otherwise.

Signposting

Ensure patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate period, e.g. pathology results, common/minor ailments, acute conditions and long-term condition reviews.

Audit and Risk Stratification

Participate in care planning and management of high-risk patients as part of the multidisciplinary team.

Participate in audit activities to optimise prescribing resources.

Feedback clinical audit results in agreed areas, implement recommendations and complete the audit cycle.

Make recommendations based on audit and shared learning outcomes.

Work with practices to identify and recall patients due for review, ensuring appropriate monitoring tests are performed.

Analyse, interpret and present prescribing information at practice and population level to support decision-making and evidence-based practice.

Care Quality Commission

Work with the general practice team to ensure CQC compliance.

Public Health

Support public health campaigns.

Provide specialist knowledge on public health programmes available to the public.

Collaborative Working Relationships

Recognise colleagues roles and their contribution to patient care.

Use appropriate communication to gain co-operation of stakeholders including patients, senior/peer colleagues and other NHS/private organisations.

Work as a team.

Recognise personal limitations and refer to appropriate colleagues when necessary.

Develop and maintain effective relationships within/outside the practice and locality.

Foster strong links with locality services.

Explore and initiate collaborative working opportunities.

Integrate general practice with community and hospital teams.

Liaise with stakeholders for collective patient benefit, including patients; GPs, nurses and practice staff; healthcare professionals, optometrists, dentists, health/social care teams and dieticians; locality/GP leads; locality managers; community nurses/AHPs; community/hospital pharmacy teams; hospital staff.

Knowledge, Skill and Experience Required

Completion of postgraduate medical training in Physician Associate studies (UK).

Preferably minimum 2 years PA experience, demonstrated within a practice portfolio.

Current GMC registration as a Physician Associate.

Experience/awareness of common acute and long-term conditions seen in general practice.

Recognise priorities when problem-solving, identify deviations from normal patterns and refer to seniors/GPs when appropriate.

Follow legal, ethical, professional and organisational policies/procedures and codes of conduct.

Leadership

Understand role in governance and implement appropriately.

Understand and contribute to workplace vision.

Engage with PPGs and involve them in development of the role and practices.

Improve quality within service limitations.

Review yearly progress and develop plans to achieve results within priorities set by others.

Motivate self to achieve goals.

Promote diversity and equality in people management and lead by example.

Management

Understand implications of national priorities for team/service.

Understand effective resource utilisation.

Understand and conform to relevant standards of practice.

Identify and resolve risk management issues according to policy/protocol.

Extend boundaries of service delivery within the team.

Education, Training and Development

Maintain GMC registration and comply with GMC professional practice requirements.

Maintain CPD in accordance with GMC requirements, organisational policy and PDP, keeping knowledge/skills current and within scope.

Participate in annual appraisal and GMC ongoing professional development/revalidation requirements as applicable to PAs.

Maintain evidence of CPD, learning, reflection and professional development.

Undertake mandatory and role-specific training needed to maintain competence in clinical skills/procedures.

Keep up to date with medical research, technology and evidence-based practice through education courses, professional meetings, journals etc.

Undertake research/analysis to improve clinical care, diagnosis and treatment, including audit, literature review and researching unusual symptoms/treatment options with physicians/specialists.

Provide literature reviews and review/analyse the significance of diagnostic test results.

Assist in clinical instruction/supervision of medical/nursing students and other learners, including educational development and mentoring of PA students.

Attend regular multidisciplinary meetings to discuss and learn from significant clinical events.

Attend regular educational meetings to update clinical knowledge, policy/guidelines and disseminate relevant information.

Reflect regularly on practice and record learning encounters to identify learning needs and support lifelong learning/CPD.

Demonstrate learning contributing to role performance/personal development; discuss at annual appraisal and agree courses/learning with clinical supervisor.

Support learning activities with reflective entries demonstrating application of learning to clinical scenarios.

Research and Evaluation

Critically evaluate/review literature.

Identify gaps in the evidence base supporting practice.

Generate evidence suitable for practice/local presentations.

Apply research evidence to the workplace.

Understand research governance principles.

Health and Safety/Risk Management

Comply with Practice Health and Safety policies, safe working procedures and incident reporting system.

Comply with UK GDPR, Data Protection Act 2018, Access to Health Records Act 1990 and information governance policies/procedures.

9. Infection Control

Comply with infection prevention/control policies and complete related mandatory training.

Equality and Diversity

Co-operate with equality of employment policies/procedures; treat co-workers, patients and visitors equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc.

Respect for Patient Confidentiality

Comply with UK GDPR, Data Protection Act 2018 and organisational information governance/confidentiality requirements. Information about patients, carers, colleagues, healthcare workers or organisational business may only be divulged to authorised persons in accordance with policy, information governance requirements and legislation.

Special Working Conditions

Travel independently between practice sites where applicable and attend meetings hosted by other agencies.

Contact with body fluids such as wound exudates and urine during clinical practice.

Development Review

Discuss and agree key performance objectives, development needs and PDP at Annual Appraisal Reviews.

Job Description Agreement

This job description outlines key tasks and responsibilities only. Other duties commensurate with the position may be required. It is subject to regular review and may be amended for developments within Primary Care. Staff should be prepared to take on additional or relinquish existing duties to maintain efficient primary care services.

About us

Local Primary Care works with member practices to provide excellent services to patients. Supporting practices to develop their workforce and leadership.

Our Focus Is On:

• Working with practices at scale to provides primary care services.
• Preserving personalised healthcare and improving continuity of care.
• Support practices to develop their practices, their workforce and their leadership.
• Working in partnership with other health and care organisations in promoting new collaborations.

Our Values

In order to achieve the best care outcomes for patients, Local Primary Care believes we must all work towards our core values.

Our Core Values Are:

• Caring
• Excellence
• Ethical
• Transparency
• Trust