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The role of physician associates in secondary care: the PA-SCER mixed-methods study · References

References

CC BY 4.0 · NIHR Journals Library · approximately 19 min read

  1. Ross N, Parle J, Begg P, Kuhns D. The case for the physician assistant. Clin Med 2012;12:200–6. 10.7861/clinmedicine.12-3-200
  2. Royal College of Physicians. Hospitals on the Edge? The Time for Action. London: RCP; 2012. URL: www.rcplondon.ac.uk/guidelines-policy/hospitals-edge-time-action (accessed 31 August 2017).
  3. Future Hospital Commission. Future Hospital: Caring for Medical Patients. A Report from the Future Hospital Commission to the Royal College of Physicians. London: RCP; 2013. URL: www.rcplondon.ac.uk/projects/outputs/future-hospital-commission (accessed 31 August 2017).
  4. Royal College of Emergency Medicine. Emergency Medicine Taskforce Interim Report. 2012. URL: CEM6723-EM-Taskforce---Interim-Report-2012-(Final)%20(1).pdf (accessed 31 August 2017).
  5. Centre for Workforce Intelligence. Big Picture Challenges: The Context. 2013. URL: www.gov.uk/government/uploads/system/uploads/attachment_data/file/507359/CfWI_Big_picture_challenges_context.pdf (accessed 31 August 2017).
  6. BBC News. NHS Plans Rapid Expansion of ‘Doctor’s Assistant’ Jobs. BBC News, 22 August 2014. URL: www.bbc.co.uk/news/health-28902132 (accessed 31 August 2017).
  7. Rawlinson K. NHS Patient Groups Warn More Doctor Assistants may be ‘Healthcare On Cheap’. The Guardian, 22 August 2014. URL: www.theguardian.com/society/2014/aug/22/fears-nhs-doctors-assistant-recruitment-healthcare-cheap (accessed 31 August 2017).
  8. Health Education England. Emergency Medicine: Background to HEE Proposals to Address Workforce Shortages. Leeds: Health Education England; 2013. URL: http://hee.nhs.uk/our-work/developing-our-workforce/emergency-medicine (accessed 31 August 2017).
  9. Reid W. Plenary Paper Presented at Conference on Physician Associates in the NHS Workforce. Birmingham: University of Birmingham; 2014.
  10. Nicoll P, MacVicar R. NHS Education for Scotland: Supporting Scottish Remote and Rural Healthcare. 2013. URL: www.rrheal.scot.nhs.uk/media/185252/remote%20and%20rural%20healthcare%20updated.pdf (accessed 31 August 2017).
  11. Royal College of Physicians, Faculty of Physician Associates. Why Did the Royal College of Physicians Agree to Establish the FPA? URL: www.rcplondon.ac.uk/news/faculty-physician-associates (accessed 31 August 2017).
  12. UK Association of Physician Associates. Physician Associates Locations. 2014. URL: www.ukapa.co.uk/general-public/pa-locations/index.html (accessed 30 October 2014).
  13. Great Britain. The Working Time Regulations Statutory Instrument 1998, No 1833. London: The Stationery Office; 1998. URL: www.legislation.gov.uk/uksi/1998/1833/made (accessed 31 August 2017).
  14. Department of Health. Liberating the NHS: Developing the Healthcare Workforce. London: Department of Health; 2012. URL: www.gov.uk/government/publications/developing-the-healthcare-workforce-from-design-to-delivery (accessed 31 August 2017).
  15. World Health Organization. Task Shifting: Rational Redistribution Of Tasks Among Health Workforce Teams – Global Recommendations and Guidelines. Geneva: World Health Organization; 2008. URL: www.who.int/healthsystems/task_shifting/en (accessed 31 August 2017).
  16. Department of Health, Public Health England and Health Education England. A Strategic Review of the Future Healthcare Workforce: Informing the Nursing Workforce. London: Centre for Workforce Intelligence; 2013. URL: www.gov.uk/government/publications/strategic-review-of-the-future-nursing-workforce (accessed 31 August 2017).
  17. Drennan VM, Halter M, Brearley S, Carneiro W, Gabe J, Gage H, et al. Investigating the contribution of physician assistants to primary care in England: a mixed methods study. Health Serv Deliv Res 2014;2(16).
  18. Drennan VM, Gabe J, Halter M, de Lusignan S, Levenson R. Physician associates in primary health care in England: a challenge to professional boundaries? Soc Sci Med 2017;181:9–16. 10.1016/j.socscimed.2017.03.04528364578
  19. Halter M, Drennan VM, Joly LM, Gabe J, Gage H, de Lusignan S. Patients’ experiences of consultations with physician associates in primary care in England: a qualitative study. Health Expect 2017;20:1011–19. 10.1111/hex.1254228429886
  20. Department of Health. The Competence and Curriculum Framework for the Physician Assistant. London: Department of Health; 2006. URL: http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4139317 (accessed 31 August 2017).
  21. Physician Associate Managed Voluntary Register. The Revised Competence and Curriculum Framework for the Physician Assistant. 2012. URL: www.fparcp.co.uk/about-fpa/Who-are-physician-associates (accessed 31 August 2017).
  22. Cawley JF, Hooker RS. Physician assistants in American medicine: the half-century mark. Am J Manag Care 2013;19:e333–41.24304180
  23. Bureau of Labor Statistics, US Department of Labor. Occupational Outlook Handbook, 2016–17 Edition, Physician Assistants. URL: www.bls.gov/ooh/healthcare/physician-assistants.htm (accessed 31 August 2017).
  24. American Academy of Physician Assistants. PAs Practice Medicine Infographic. URL: www.aapa.org/what-is-a-pa/#tabs-2-get-information-on-pas (accessed 31 August 2017).
  25. Mullan F, Frehywot S. Non-physician clinicians in 47 Sub-Saharan African countries. Lancet 2007;370:2158–63. 10.1016/S0140-6736(07)60785-517574662
  26. van den Driesschen Q, de Roo F. Physician assistants in the Netherlands. JAAPA 2014;27:10–11. 10.1097/01.JAA.0000453240.00098.83
  27. Jones IW, Hooker RS. Physician assistants in Canada. Can Fam Physician 2011;57:e83–8.21402955
  28. Frossard LA, Liebich G, Hooker RS, Brooks PM, Robinson L. Introducing physician assistants into new roles: international experiences. Med J Aust 2008;188:199–201.18279123
  29. Buchan J, O’May F, Ball J. New role, new country: introducing US physician assistants to Scotland. Hum Resour Health 2007;5:13. 10.1186/1478-4491-5-1317480211
  30. Laurant M, Harmsen M, Wollersheim H, Grol R, Faber M, Sibbald B. The impact of nonphysician clinicians: do they improve the quality and cost-effectiveness of health care services? Med Care Res Rev 2009;66(Suppl. 6):36–89. 10.1177/1077558709346277
  31. Halter M, Drennan V, Chattopadhyay K, Carneiro W, Yiallouros J, de Lusignan S, et al. The contribution of physician assistants in primary care: a systematic review. BMC Health Serv Res 2013;13:223. 10.1186/1472-6963-13-22323773235
  32. Althausen PL, Shannon S, Owens B, Coll D, Cvitash M, Lu M, et al. Impact of hospital-employed physician assistants on a level II community-based orthopaedic trauma system. J Orthop Trauma 2013;27:e87–91. 10.1097/BOT.0b013e3182647f2922732868
  33. Jeanmonod R, Delcollo J, Jeanmonod D, Dombchewsky O, Reiter M. Comparison of resident and mid-level provider productivity and patient satisfaction in an emergency department fast track. Emerg Med J 2013;30:e12. 10.1136/emermed-2011-20057222411596
  34. Hamden K, Jeanmonod D, Gualtieri D, Jeanmonod R. Comparison of resident and mid-level provider productivity in a high-acuity emergency department setting. Emerg Med J 2014;31:216–19. 10.1136/emermed-2012-20190423360904
  35. Stahlfeld KR, Robinson JM, Burton EC. What do physician extenders in a general surgery residency really do? J Surg Educ 2008;65:354–8. 10.1016/j.jsurg.2008.06.00218809165
  36. Timmermans MJ, van Vught AJ, Wensing M, Laurant MG. The effectiveness of substitution of hospital ward care from medical doctors to physician assistants: a study protocol. BMC Health Serv Res 2014;14:43. 10.1186/1472-6963-14-4324472112
  37. Cabinet Office, Northern Ireland Office, Scotland Office and Office of the Secretary of State for Wales. Devolution of Powers to Scotland, Wales and Northern Ireland. GOV.UK; 2013. URL: www.gov.uk/guidance/devolution-of-powers-to-scotland-wales-and-northern-ireland (accessed 31 August 2017).
  38. NHS Choices. NHS Trusts. NHS Choices; 2017. URL: www.nhs.uk/servicedirectories/pages/nhstrustlisting.aspx#TrS (accessed 31 August 2017).
  39. NHS Digital. NHS Hospital & Community Health Service (HCHS) Monthly Workforce Statistics – Provisional Statistics: HCHS Doctors by Grade and Specialty in Trusts and CCGs – Full Time Equivalent May 2017. Leeds: NHS Digital; 2017. URL: http://digital.nhs.uk/catalogue/PUB30042 (accessed 31 August 2017).
  40. NHS Digital. National Health Service Occupation Code Manual. Version 14.0. Leeds: NHS Digital; 2016. URL: content.digital.nhs.uk/article/2268/NHS-Occupation-Codes (accessed 31 August 2017).
  41. Parle JV, Ross NM, Doe WF. The medical care practitioner: developing a physician assistant equivalent for the United Kingdom. Med J Aust 2006;185:13–17.16813540
  42. Woodin J, McLeod H, McManus R, Jelphs K. The Introduction of US-trained Physician Assistants to Primary Care and Accident and Emergency Departments in Sandwell and Birmingham. Final Report. Birmingham: University of Birmingham; 2005. URL: www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/2005/Evaluation-of-US-trained-Physician-Assistants.pdf (accessed 31 August 2017).
  43. Farmer J, Currie M, Hyman J, West C, Arnott N. Evaluation of physician assistants in National Health Service Scotland. Scott Med J 2011;56:130–4. 10.1258/smj.2011.01110921873716
  44. White H, Round JE. Introducing physician assistants into an intensive care unit: process, problems, impact and recommendations. Clin Med 2013;13:15–18. 10.7861/clinmedicine.13-1-15
  45. Williams LE, Ritsema TS. Satisfaction of doctors with the role of physician associates. Clin Med 2014;14:113–16. 10.7861/clinmedicine.14-2-113
  46. Royal College of Physicians, Faculty of Physician Associates. Where Are We With Regulation? URL: www.rcplondon.ac.uk/news/faculty-physician-associates (accessed 31 August 2017).
  47. Department of Health. Open Consultation. The Regulation of Medical Associate Professions in the UK. London: Department of Health; 2017. URL: www.gov.uk/government/consultations/regulating-medical-associate-professions-in-the-uk (accessed 18 October 2017).
  48. Ritsema TS, Paterson KE. Results of the Second Annual UK Physician Assistant Census. London: 2012. URL: www.ukapa.co.uk (accessed 30 October 2014).
  49. Donabedian A. The quality of care. How can it be assessed? JAMA 1988;260:1743–8. 10.1001/jama.1988.034101200890333045356
  50. Maxwell RJ. Dimensions of quality revisited: from thought to action. Qual Health Care 1992;1:171–7. 10.1136/qshc.1.3.17110136859
  51. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004;82:581–629. 10.1111/j.0887-378X.2004.00325.x15595944
  52. Nancarrow SA, Borthwick AM. Dynamic professional boundaries in the healthcare workforce. Sociol Health Illn 2005;27:897–919. 10.1111/j.1467-9566.2005.00463.x16313522
  53. Abbott A. The System of Professions – a Study of the Division of Expert Labour. London: University of Chicago Press; 1988.
  54. Creswell JW, Clark VL. Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage Publications Ltd; 2007.
  55. NIHR INVOLVE. Payment and Recognition for Public Involvement. URL: www.invo.org.uk/resource-centre/payment-and-recognition-for-public-involvement/ (accessed October 2017).
  56. Bowling A. Research Methods in Health. 3rd edn. Maidenhead: Open University Press; 2009.
  57. Binley’s. Database of Hospital Doctors. URL: www.binleys.com/Product/Hospital_Doctors/ (accessed 17 October 2017).
  58. Drennan VM, Chattopadhyay K, Halter M, Brearley S, de Lusignan S, Gabe J, Gage H. Physician assistants in English primary care teams: a survey. J Interprof Care 2012;26:416–18. 10.3109/13561820.2012.68653822574762
  59. Ritsema TS. Faculty of Physician Associates Census Results. 2016. URL: www.fparcp.co.uk/about-fpa/fpa-census (accessed 10 September 2017).
  60. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62:1006–12. 10.1016/j.jclinepi.2009.06.00519631508
  61. Halter M, Wheeler C, Drennan V, Pelone F. Evidence of Impact of Physician Associates in Secondary Care: A Systematic Mixed Studies Review. CRD42016032895. PROSPERO. 2016. URL: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016032895 (accessed September 2017).
  62. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ 2005;331:1064–5. 10.1136/bmj.38636.593461.6816230312
  63. International Monetary Fund. Table B1. Advanced Economies: Unemployment, Employment, and Real GDP per Capita. URL: www.imf.org/external/pubs/ft/weo/2015/01/pdf/tblpartb.pdf (accessed December 2015).
  64. Kmet LM, Lee RC, Cook LS. Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Alberta Herit Found Med Res 2004;13:1–11. URL: www.files.deslibris.ca/cppc/200/200548.pdf (accessed November 2015).
  65. Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annu Rev Public Health 2014;35:29–45. 10.1146/annurev-publhealth-032013-18244024188053
  66. Centre for Reviews and Dissemination, University of York. Systematic Reviews. CRD’s Guidance for Undertaking Reviews in Healthcare. York: Centre for Reviews and Dissemination, University of York; 2009.
  67. Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. ESRC Research Methods Programme. Lancaster: Lancaster University; 2006.
  68. Walt G, Shiffman J, Schneider H, Murray SF, Brugha R, Gilson L. ‘Doing’ health policy analysis: methodological and conceptual reflections and challenges. Health Policy Plan 2008;23:308–17. 10.1093/heapol/czn02418701552
  69. Silverman D. Interpreting Qualitative Data. Methods for Analysing Talk, Text and Interaction. 5th edn. London: Sage Publications; 2014.
  70. Yin RK. Case Study Research: Design and Methods. 6th edn. Thousand Oaks, CA: Sage Publications; 2018.
  71. Kessler I, Heron P, Dopson S, Magee H, Swain D. Nature and Consequences of Support Workers in a Hospital Setting. Final Report. NIHR Service Delivery and Organisation programme. 2010. URL: www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1619-155_V01.pdf (accessed October 2017).
  72. Spilsbury K, Adamson J, Atkin K, Bartlett C, Bloor K, Borglin G et al. Evaluation of the Development and Impact of Assistant Practitioners Supporting the Work of Ward-based Registered Nurses in Acute NHS (Hospital) Trusts in England. NIHR Service Delivery and Organisation programme. 2010. URL: www.nets.nihr.ac.uk/projects/hsdr/081619159 (accessed October 2017).
  73. Department for Environment, Food & Rural Affairs. Official Statistics 2011. Rural–Urban Classification of Local Authorities and Other Geographies. 2014. URL: www.gov.uk/government/statistics/2011-rural-urban-classification-of-local-authority-and-other-higher-level-geographies-for-statistical-purposes (accessed October 2017).
  74. NHS Digital. NHS Hospital & Community Health Service (HCHS): HCHS Doctors, by Grade and Organisation, in NHS Trusts and CCGs in England, as at 31 January to 31 December 2016, Average Full Time Equivalent. URL: https://digital.nhs.uk/catalogue/PUB23470 (accessed October 2017).
  75. Kvale S. Doing Interviews. London: Sage Publications; 2007. 10.4135/9781849208963
  76. Boyatzis RE. Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks, CA: Sage; 1998.
  77. Pope C, Mays N. Observational Methods. In Pope C, Mays N, editors. Qualitative Research in Health Care. 4th edn. Chichester: John Wiley & Sons; 2008. pp. 32–42.
  78. McCann, L, Granter E, Hyde P, Hassard, J Still blue-collar after all these years? An ethnography of the professionalization of emergency ambulance work. Journal of Management Studies 2013;50:750–76. 10.1111/joms.12009
  79. Department of Health and Social Care Urgent and Emergency Care Review Team. Safer, Faster, Better: Good Practice in Delivering Urgent and Emergency Care. URL: https://improvement.nhs.uk/resources/safer-faster-better-transforming-urgent-and-emergency/ (accessed 7 March 2019).
  80. Gipsen K. Working in the ED. Presentation at the Physician Assistant in the Workforce Conference. Birmingham: University of Birmingham; 2014.
  81. Sakr M, Angus J, Perrin J, Nixon C, Nicholl J, Wardrope J. Care of minor injuries by emergency nurse practitioners or junior doctors: a randomised controlled trial. Lancet 1999;354:1321–6. 10.1016/S0140-6736(99)02447-210533859
  82. Cooper MA, Lindsay GM, Kinn S, Swann IJ. Evaluating emergency nurse practitioner services: a randomized controlled trial. J Adv Nurs 2002;40:721–30. 10.1046/j.1365-2648.2002.02431.x12473052
  83. Department of Health. A&E Clinical Quality Indicators Data Definition and Implementation Guidance. London: Department of Health; 2010. URL: http://webarchive.nationalarchives.gov.uk/20130104115320/https://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_122868 (accessed 7 March 2019).
  84. NHS Digital. Provisional Accident and Emergency Quality Indicators – England, by Provider for December 2014. Leeds: NHS Digital; 2015. URL: https://digital.nhs.uk/catalogue/PUB17191 (accessed October 2017).
  85. Gardner MJ, Altman DG. Confidence intervals rather than P values: estimation rather than hypothesis testing. Br Med J 1986;292:746–50. 10.1136/bmj.292.6522.7463082422
  86. Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 2007;165:710–18. 10.1093/aje/kwk05217182981
  87. Mackway-Jones K, Marsden J, Windle J. Emergency Triage: Manchester Triage Group. 3rd edn. London: John Wiley & Sons; 2013. 10.1002/9781118299029
  88. Royal College of Physicians. National Early Warning Score (NEWS): Standardising the Assessment of Acute Illness Severity in the NHS. London: RCP; 2012.
  89. Curtis L, Burns A. Unit Costs of Health and Social Care 2017. Canterbury: Personal Social Services Research Unit, University of Kent; 2017. URL: 10.22024/UniKent/01.02/65559 (accessed 15 April 2019).
  90. Department of Health. NHS Reference Costs 2016. London: Department of Health; 2016. URL: www.gov.uk/government/collections/nhs-reference-costs#published-reference-costs/ (accessed January 2018).
  91. Mauskopf JA, Paul JE, Grant DM, Stergachis A. The role of cost-consequence analysis in healthcare decision-making. PharmacoEconomics 1998;13:277–88. 10.2165/00019053-199813030-0000210178653
  92. Medical Research Council. Good Research Practice: Principles and Guidelines. Medical Research Council; 2012. URL: www.mrc.ac.uk/research/policies-and-guidance-for-researchers/good-research-practice/ (accessed October 2017).
  93. Great Britain. Data Protection Act 1998. London: The Stationery Office; 1998.
  94. Arnopolin SL, Smithline HA. Patient care by physician assistants and by physicians in an emergency department. JAAPA 2000;13:39–40, 49–50, 53–4 passim.
  95. Ducharme J, Alder RJ, Pelletier C, Murray D, Tepper J. The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments. CJEM 2009;11:455–61. 10.1017/S148180350001165919788790
  96. Hooker RS, Cipher DJ, Cawley JF, Herrmann D, Melson J. Emergency medicine services: interprofessional care trends. J Interprof Care 2008;22:167–78. 10.1080/1356182070175146818320451
  97. Kozlowski MJ, Wiater JG, Pasqual RG, Compton S, Swor RA, Jackson RE. Painful discrimination: the differential use of analgesia in isolated lower limb injuries. Am J Emerg Med 2002;20:502–5. 10.1053/ajem.2002.3496512369020
  98. Pavlik D, Sacchetti A, Seymour A, Blass B. Physician assistant management of pediatric patients in a general community emergency department: a real-world analysis. Pediatr Emerg Care 2017;33:26–30. 10.1097/PEC.000000000000094927798540
  99. Ritsema TS, Kelen GD, Pronovost PJ, Pham JC. The national trend in quality of emergency department pain management for long bone fractures. Acad Emerg Med 2007;14:163–9. 10.1197/j.aem.2006.08.01517192448
  100. Singer AJ, Hollander JE, Cassara G, Valentine SM, Thode HC, Henry MC. Level of training, wound care practices, and infection rates. Am J Emerg Med 1995;13:265–8. 10.1016/0735-6757(95)90197-37755815
  101. Bohm ER, Dunbar M, Pitman D, Rhule C, Araneta J. Experience with physician assistants in a Canadian arthroplasty program. Can J Surg 2010;53:103–8.20334742
  102. Garrison S, Eismann EA, Cornwall R. Does using PAs in the closed treatment of pediatric forearm fractures increase malunion risk? JAAPA 2017;30:41–5. 10.1097/01.JAA.0000526777.00101.b929210908
  103. Hepp SL, Suter E, Nagy D, Knorren T, Bergman JW. Utilizing the physician assistant role: case study in an upper-extremity orthopedic surgical program. Can J Surg 2017;60:115–21. 10.1503/cjs.00271628234216
  104. Mains C, Scarborough K, Bar-Or R, Hawkes A, Huber J, Bourg P, Bar-Or D. Staff commitment to trauma care improves mortality and length of stay at a level I trauma center. J Trauma 2009;66:1315–20. 10.1097/TA.0b013e31819d96d819430233
  105. Oswanski MF, Sharma OP, Raj SS. Comparative review of use of physician assistants in a level I trauma center. Am Surg 2004;70:272–9.15055854
  106. Capstack TM, Seguija C, Vollono LM, Moser JD, Meisenberg BR, Michtalik HJ. A comparison of conventional and expanded physician assistant hospitalist staffing models at a community hospital. J Clin Outcomes 2016;23:455–61.
  107. Van Rhee J, Ritchie J, Eward AM. Resource use by physician assistant services versus teaching services. JAAPA 2002;15:33–8, 40, 42.11845630
  108. McCutchen B, Patel S, Copeland D. Expanding the role of PAs in the treatment of severe and persistent mental illness. JAAPA 2017;30:36–7. 10.1097/01.JAA.0000521138.61409.04
  109. Halter M, Wheeler C, Pelone F, Gage H, de Lusignan S, Parle J, et al. Contribution of physician assistants/associates to secondary care: a systematic review. BMJ Open 2018;8:e019573. 10.1136/bmjopen-2017-019573
  110. Timmermans MJC, van Vught AJAH, Peters YAS, Meermans G, Peute JGM, Postma CT, et al. The impact of the implementation of physician assistants in inpatient care: a multicenter matched-controlled study. PLOS ONE 2017;12:e0178212. 10.1371/journal.pone.017821228793317
  111. Timmermans MJC, van den Brink GT, van Vught AJAH, Adang E, van Berlo CLH, Boxtel KV, et al. The involvement of physician assistants in inpatient care in hospitals in the Netherlands: a cost-effectiveness analysis. BMJ Open 2017;7:e016405. 10.1136/bmjopen-2017-016405
  112. Department of Health, Hunt J. New Deal for General Practice. GOV.UK; 2015. URL: www.gov.uk/government/speeches/new-deal-for-general-practice (accessed November 2017).
  113. Department of Health, Hunt J. NHS Providers Annual Conference Keynote Speech 30-11-2016. GOV.UK; 2016. URL: www.gov.uk/government/speeches/nhs-providers-annual-conference-keynote-speech (accessed November 2017).
  114. Department of Health, Hunt J. Jeremy Hunt Speech to the Royal College of General Practitioners 12-10-2017. GOV.UK; 2017. URL: www.gov.uk/government/news/jeremy-hunt-announces-salary-supplement-for-trainee-gps (accessed November 2017).
  115. House of Commons. Health Select Committee Report on Primary Care. HC408. 2016. URL: https://publications.parliament.uk/pa/cm201516/cmselect/cmhealth/408/40802.htm (accessed November 2017).
  116. Department of Health. The Regulation of Medical Associate Professions in the UK: Open Consultation 2017. URL: www.gov.uk/government/consultations/regulating-medical-associate-professions-in-the-uk (accessed November 2017).
  117. NHS England. General Practice Forward View. NHS England. 2016. URL: www.england.nhs.uk/gp/gpfv/ (accessed November 2017).
  118. NHS England. The Forward View into Action: Planning for 2015/16. NHS England. 2014. URL: www.england.nhs.uk/publication/the-forward-view-into-action-planning-for-201516/ (accessed March 2018).
  119. NHS England. Next Steps in the Five Year Plan. NHS England. 2017. URL: www.england.nhs.uk/five-year-forward-view/next-steps-on-the-nhs-five-year-forward-view/ (accessed November 2017).
  120. Health Education England. Workforce Plan 2014–2015. HEE. 2014. URL: https://hee.nhs.uk/our-work/planning-commissioning/workforce-planning (accessed November 2017).
  121. Health Education England. Workforce Plan 2015–2016. HEE. 2015. URL: https://hee.nhs.uk/our-work/planning-commissioning/workforce-planning (accessed November 2017).
  122. Health Education England. Workforce Plan 2016–2017. HEE. 2016. URL: https://hee.nhs.uk/our-work/planning-commissioning/workforce-planning (accessed November 2017).
  123. Health Education England. Business Plan 2015. HEE. URL: https://hee.nhs.uk/our-work/planning-commissioning/our-business-plan (accessed November 2017).
  124. Health Education England. Response to the Primary Care Workforce Commission Report. HEE. 2016. URL: https://hee.nhs.uk/our-work/hospitals-primary-community-care/primary-community-care/primary-care-workforce-commission (accessed November 2017).
  125. Health Education England. General Practice Nursing Workforce Development Plan. HEE. 2017. URL: https://hee.nhs.uk/our-work/hospitals-primary-community-care/primary-community-care/general-practice-nursing (accessed November 2017).
  126. Health Education England. Regulation Consultation Risk Profiles for the Medical Associate Professions. HEE. 2017. URL: www.gov.uk/government/consultations/regulating-medical-associate-professions-in-the-uk (accessed November 2017).
  127. NHS England, Health Education England, British Medical Association, Royal College of General Practitioners. Building the Workforce: The New Deal for General Practice. NHS England. 2015. URL: www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/01/building-the-workforce-new-deal-gp.pdf (accessed November 2017).
  128. Aiello M, Roberts KA. Development of the United Kingdom physician associate profession. JAAPA 2017;30:1–8. 10.1097/01.JAA.0000513357.68395.12
  129. NHS England. Delivering the Forward View: NHS Planning Guidance 2016/17–2020/21. NHS England. 2019. URL: www.england.nhs.uk/wp-content/uploads/2015/12/planning-guid-16-17-20-21.pdf (accessed November 2017).
  130. NHS England. Local Sustainability and Transformation Partnerships. URL: www.england.nhs.uk/stps/view-stps/ (accessed 5 February 2019).
  131. Department of Health, Hunt J. NHS 7 Day Services and the Junior Doctors’ Strike. London: Department of Health; 2016. URL: www.gov.uk/government/speeches/nhs-7-day-services-and-the-junior-doctors-strike (accessed November 2017).
  132. Monitor, NHS Trust Development Authority. Supporting the Role of the Medical Director. 2014. URL: www.gov.uk/government/publications/supporting-the-role-of-the-medical-director (accessed November 2017).
  133. Moote M, Krsek C, Kleinpell R, Todd B. Physician assistant and nurse practitioner utilization in academic medical centers. Am J Med Qual 2011;26:452–60. 10.1177/106286061140298421555487
  134. Halter M, Wheeler C, Drennan VM, de Lusignan S, Grant R, Gabe J, et al. Physician associates in England’s hospitals: a survey of medical directors exploring current usage and factors affecting recruitment. Clin Med 2017;17:126–31. 10.7861/clinmedicine.17-2-126
  135. Wheeler C, Halter M, Drennan VM, de Lusignan S, Grant R, Gabe J, et al. Physician associates working in secondary care teams in England: interprofessional implications from a national survey. J Interprof Care 2017;31:774–6. 10.1080/13561820.2017.134139028876145
  136. Nagurney JT, Brown DF, Sane S, Weiner JB, Wang AC, Chang Y. The accuracy and completeness of data collected by prospective and retrospective methods. Acad Emerg Med 2005;12:884–95. 10.1197/j.aem.2005.04.02116141025
  137. Ratnapalan S, Brown K, Cieslak P, Cohen-Silver J, Jarvis A, Mounstephen W. Charting errors in a teaching hospital. Pediatr Emerg Care 2012;28:268–71. 10.1097/PEC.0b013e3182494fb822344217
  138. Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull 1971;5:378–82. 10.1037/h0031619
  139. Altman D. Practical Statistics for Medical Research. London: Chapman & Hall; 1991.
  140. NHS Health Careers. Physician Associates: Pay and Conditions. 2018. URL: www.healthcareers.nhs.uk/explore-roles/medical-associate-professions/roles-medical-associate-professions/physician-associate (accessed January 2018).
  141. NHS Digital. NHS Staff Earnings Estimates, December 2017, Provisional Statistics 2009–2017. NHS Digital. 2018. URL: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-staff-earnings-estimates/nhs-staff-earnings-estimates-december-2017-provisional-statistics (accessed 15 April 2019).
  142. NHS Employers. Pay and Conditions Circular (Medical & Dental staff) 1/2017. NHS Employers. 2018. URL: www.nhsemployers.org/case-studies-and-resources/2018/03/pay-and-conditions-circular-md-1-2017 (accessed 2 August 2018).
  143. van Vught AJ, van den Brink GT, Wobbes T. Implementation of the physician assistant in Dutch health care organizations: primary motives and outcomes. Health Care Manag 2014;33:149–53. 10.1097/01.HCM.0000440621.39514.9f
  144. Fréchette D, Shrichand A. Insights into the physician assistant profession in Canada. JAAPA 2016;29:35–9. 10.1097/01.JAA.0000484302.35696.cd
  145. Health Education England. Facing the Facts, Shaping the Future. A Draft Health and Care Workforce Strategy for England to 2027. HEE. 2017. URL: https://hee.nhs.uk/our-work/workforce-strategy (accessed 15 April 2019).
  146. Kartha A, Restuccia JD, Burgess JF, Benzer J, Glasgow J, Hockenberry J, et al. Nurse practitioner and physician assistant scope of practice in 118 acute care hospitals. J Hosp Med 2014;9:615–20. 10.1002/jhm.223125224593
  147. Timmermans MJ, van Vught AJ, Van den Berg M, Ponfoort ED, Riemens F, van Unen J, et al. Physician assistants in medical ward care: a descriptive study of the situation in the Netherlands. J Eval Clin Pract 2016;22:395–402. 10.1111/jep.1249926695837
  148. Timmermans MJ, van Vught AJ, Maassen IT, Draaijer L, Hoofwijk AG, Spanier M, et al. Determinants of the sustained employment of physician assistants in hospitals: a qualitative study. BMJ Open 2016;6:e011949. 10.1136/bmjopen-2016-011949
  149. Ten Cate O. Nuts and bolts of entrustable professional activities. J Grad Med Educ 2013;5:157–8. 10.4300/JGME-D-12-00380.124404246
  150. NHS Health Careers. Course Finder Physician Associates Studies. NHS Health Careers. URL: www.healthcareers.nhs.uk/career-planning/course-finder (accessed January 2018).
  151. Department of Health and Social Care. The Regulation of Medical Associate Professionals in the UK. Consultation Response; 2019. URL: www.gov.uk/government/consultations/regulating-medical-associate-professions-in-the-uk#history (accessed 4 April 2019).
  152. Gershengorn HB, Johnson MP, Factor P. The use of nonphysician providers in adult intensive care units. Am J Respir Crit Care Med 2012;185:600–5. 10.1164/rccm.201107-1261CP22135345
  153. Johal J, Dodd A. Physician extenders on surgical services: a systematic review. Can J Surg 2017;60:172–8. 10.1503/cjs.00151628327274
  154. Iles V, Sutherland K. Organisational Change. A Review for Health Care Managers, Professionals and Researchers. NIHR Service Delivery & Organisation Programme; 2001. URL: www.netscc.ac.uk/hsdr/files/adhoc/change-management-review.pdf (accessed January 2018).
  155. Jones IW, Hooker RS. Physician assistants in Canada: update on health policy initiatives. Can Fam Physician 2011;57:e83–8.21402955
  156. Ballweg R, Metzler K. Physician Assistant Staffing in a Rural New Zealand Hospital. 14th National Rural Health Conference A World of Rural Health, Cairns, QLD, 26–29 April 2017. URL: www.ruralhealth.org.au/14nrhc/sites/default/files/Ballweg%2C%20Ruth_E2.pdf (accessed January 2018).
  157. Netherlands Association of Physician Assistants. Independency of Physician Assistants (PA) and Nurse Practitioners (NP) Regulated in the Netherlands. Netherlands Association of Physician Assistants; 2017. URL: www.napa.nl/english/ (accessed December 2017).
  158. Ritsema TS, Roberts KA. Job satisfaction among British physician associates. Clin Med 2016;16:511–13. 10.7861/clinmedicine.16-6-511
  159. Royal College of Physicians. Census of Consultant Physicians and Higher Specialty Trainees in the UK 2014–15 Executive Summary. RCP; 2016. URL: www.rcplondon.ac.uk/news/one-fifth-consultants-state-rota-gaps-are-causing-significant-problems-patient-safety (accessed January 2018).
  160. General Medical Council. GMC Urges Doctors in Training to Share Their Experiences of Rota Gaps. General Medical Council; 2017. URL: www.gmc-uk.org/news/29301.asp (accessed January 2018).
  161. NHS Improvement. Reducing Expenditure on NHS Agency Staff: Rules and Price Caps. URL: https://improvement.nhs.uk/resources/reducing-expenditure-on-nhs-agency-staff-rules-and-price-caps/ (accessed January 2018).
  162. Royal College of Physicians. Being a Junior Doctor: Experiences from the Front Line of the NHS. RCP; 2016. URL: www.rcplondon.ac.uk/guidelines-policy/being-junior-doctor (accessed January 2018).
  163. Tipping MD, Forth VE, Magill DB, Englert K, Williams MV. Systematic review of time studies evaluating physicians in the hospital setting. J Hosp Med 2010;5:353–9. 10.1002/jhm.64720803675
  164. Newton R, Panchal M, Ahmed N, Yuen S, Thalava R, Puttha R. Safety and health care professionals: satisfaction of the task based role of physician associates, supplementing doctors, in a paediatric unit. Arch Dis Child 2017;102(Suppl. 1):A1–A218.
  165. Department of Health. Operational Productivity and Performance in English NHS Acute Hospitals: Unwarranted Variations. GOV.UK; 2015. URL: www.gov.uk/government/publications/productivity-in-nhs-hospitals (accessed January 2018).
  166. BBC News. NHS Agency Pay Caps Breached More Than 50,000 Times a Week. BBC News, 23 May 2016. URL: www.bbc.co.uk/news/uk-england-36341285 (accessed January 2018).
  167. Liaison. Taking the Temperature: Review of NHS Agency Spending 2017/2018-Q3. Liaison; 2018. URL: http://liaison.co.uk/taking-the-temperature-update-2017-18-q3/ (accessed March 2018).
  168. Schadewaldt V, McInnes E, Hiller JE, Gardner A. Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review. BMC Fam Pract 2013;14:132. 10.1186/1471-2296-14-13224007269
  169. Organisation for Economic Co-operation and Development (OECD). Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places. OECD; 2016. URL: www.oecd.org/health/health-systems/health-workforce-policies-in-oecd-countries-9789264239517-en.htm (accessed January 2018).
  170. McNally S, Huber J. Award-winning new doctors’ assistants freeing time in acute NHS hospitals; pilot reduces doctor overtime and improves efficiency. Health Management 2018;1:56–9. URL: https://healthmanagement.org/c/healthmanagement/issuearticle/award-winning-new-doctors-assistants-freeing-time-in-acute-nhs-hospitals (accessed January 2018).
  171. Grover A, Orlowski JM, Erikson CE. The nation’s physician workforce and future challenges. Am J Med Sci 2016;351:11–19. 10.1016/j.amjms.2015.10.00926802753
  172. Department of Health. Up to 1,500 Extra Medical Training Places Announced. GOV.UK; 2016. URL: www.gov.uk/government/news/up-to-1500-extra-medical-training-places-announced (accessed January 2018).
  173. General Medical Council. The State of Medical Education and Practice in the UK. General Medical Council; 2017. URL: www.gmc-uk.org/publications/somep.asp (accessed January 2018).
  174. Rivett G. From Cradle to Grave: Fifty Years of the NHS. London: The King’s Fund; 1998.
  175. Department of Health, Monitor. NHS Providers Urged to Take More Action to Counter Pressures. GOV.UK; 2016. URL: www.gov.uk/government/news/nhs-providers-urged-to-take-more-action-to-counter-pressures (accessed January 2018).
  176. BBC News. Junior Doctors’ Strike: All-out Stoppage ‘A Bleak Day’. BBC News, 26 April 2016. URL: www.bbc.co.uk/news/health-36134103 (accessed January 2018).
  177. House of Commons. NHS Winter Pressures: 2016/17 Summary Commons Briefing Papers SN07057. House of Commons; 2017. URL: https://researchbriefings.parliament.uk/ResearchBriefing/Summary/SN07057 (accessed January 2018).
  178. House of Commons. NHS Winter Pressures: 2017/18 Summary Commons Briefing Papers. Commons Briefing papers CBP-8210. House of Commons; 2018. URL: https://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-8210 (accessed January 2018).
  179. BBC News. Thousands of NHS Nursing and Doctor Posts Lie Vacant. BBC News, 29 February 2016. URL: www.bbc.co.uk/news/health-35667939 (accessed January 2018).
  180. Hemming K, Haines TP, Chilton PJ, Girling AJ, Lilford RJ. The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting. BMJ 2015;350:h391. 10.1136/bmj.h39125662947
← Discussion and conclusionsAcknowledgements →

Attribution. Vari M Drennan; Mary Halter; Carly Wheeler; Laura Nice; Sally Brearley; James Ennis et al. (2019). The role of physician associates in secondary care: the PA-SCER mixed-methods study. NIHR Journals Library. Copyright © Queen’s Printer and Controller of HMSO 2019. This work was produced by Drennan et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK. Licensed under CC BY 4.0. NCBI Bookshelf NBK541749. CC BY 4.0. Original source ↗. Text reproduced from the Bookshelf XML without changing wording; figures, images and supplements are not reproduced.

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