Physician associate ‘not a recognised grade’ – DoH

Physician associate (PA) is “not a recognised grade in the Irish public healthcare system” and therefore no bodies have been contacted in regards to regulation, a Department of Health spokesperson has told the Medical Independent (MI).

In 2015 a two-year pilot involving four PAs was commenced by the RCSI in four surgical directorates at Beaumont Hospital, Dublin.

“As this pilot was limited to four PAs, it was not possible to draw enough from the results to make a quality or informed national level determination,” said the Department’s spokesperson.

Beaumont Hospital currently employs 10 PAs, four of whom were recruited during the Covid-19 pandemic.

“Each physician associate reports directly to a named consultant to whom they have been assigned. They are accountable to and fully supervised by their assigned consultant,” said Beaumont’s spokesperson.

“The engagement of physician associates by Beaumont Hospital has been a very successful initiative.”

The hospital said key benefits arising from their deployment included improved continuity of service allowing for “constant understanding and knowledge of speciality systems and processes to be carried through medical rotations”; process and systematic developments that have been sustained with emphasis and direct ownership from PA deployment; continuity of care for patients thereby ensuring patient safety and quality; and “strong adherence to protocols and clinical pathways”.

The RCSI and the RCSI Hospitals Group have formally identified these benefits to the HSE and the Department of Health, added Beaumont’s spokesperson.

RCSI commenced a two-year Masters programme in PA Studies in 2016. It is understood there are now 25 RCSI-trained PAs working in Irish public and private healthcare.

Medical Director of the RCSI’s PA programme Prof James Paul O’Neill told MI the flexibility and impact of PAs had been underlined during the Covid-19 crisis.

A spokesperson for the Irish Nurses and Midwives Organisation said a PA is a medical assistant grade. “If medical professionals are seeking to introduce grades to assist them, the governance of such a patient-facing role must be in keeping with the Medical Practitioners Act.”