Scottish Developments for NonMedically Qualified Practitioners in Surgery

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Scottish Developments for Non-Medically Qualified
Practitioners in Surgery

• Dorothy Armstrong
• Programme Director
• NHS Education for Scotland

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Scotland famous for
Simpson - Chloroform
Lister antiseptics
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Scotland famous for?
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NHS Scotland

• Health is devolved
• 15 Health Boards
• 6 Special Health Boards
• NHS Education is 1 of the Special Health Boards

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NHS Education for Scotland

• Our Vision Improved patient care by empowering
  Scotlands healthcare workforce through
  education, training and lifelong learning
• Nurses, Midwives Allied Health Professions
• Doctors
• Psychologists
• Pharmacy
• Chaplains
• Admin Clerical

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Key messages

• NHS is changing because the world is changing
• Over 85s
• Drugs bills
• Lifestyle diseases
• Consumer expectation
• New and developed roles is part of the change
• Embrace the opportunities that change can offer

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Care, Capability and Capacity

• Delivering for Health in Scotland. (2006)
  Scottish Executive.

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Care

• Care is the key to our work and good health care
  is about caring for people, whether that is
  within the community or the operating theatre.

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Capability

• Capability refers to the health challenges we
  face
• ageing population
• long term conditions
• reducing health inequalities
• vulnerable population

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Capacity

• Getting the right number of healthcare
  professionals, educated to the right level and
  performing the right roles to meet the needs of
  the people we serve.

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Peri-operative Career Framework
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The clinical team

• Anaesthetic Assistants
• Advanced Scrub Practitioners
• Physician Assistants Surgery and Anaesthesia

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Advanced surgical roles

• Advancing current roles or develop new ones?

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Advanced Scrub Practitioner

• Scotland wide approach
• Partnership approach
• RCSE
• RCPSG
• SEHD
• Funded by NES
• Commissioned to NAASP

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What is a Physician Assistant (PA)?
A PA is a health care professional licensed to
practice medicine with physician
supervision PAs are dependant but autonomous
practitioners delivering care in partnership with
a supervising physician
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PA Role
What the PA does in any particular setting
depends on- The type of medical practice The
working relationship with their supervising
physician State law PAs are trained to perform
a wide range of duties from primary care to
specialist areas. They work in every specialty
that doctors practise in.
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The Physician Assistant in Scotland

• Multiple potential roles
• Major group in the USA
• Successful sites in England
• Pilot recruitment to Scotland
• Significant service interest
• Detailed evaluation

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The evidence base

• Evaluation of US trained PAs working in
  Birmingham
• Increasing capacity
• Key roles in assessment and diagnosis
• Positive response from colleagues
• Strong interpersonal, communication skills team
  work
• Improved access times

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Physician Assistant - Anaesthesia

• PAs already making a very positive contribution
  to healthcare in certain regions of England
• PA Project started in Scotland start Oct 06
• Recognition of the PA profession and regulation /
  prescribing issues
• External evaluation

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Summary

• Sustainability
• Career progression
• Professional support and leadership
• Appropriate educational preparation fitness for
  practice
• Reward and recognition (A4C)
• Multi professional context
• Regulation outcome of Foster

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We often find out what will do, by finding out
what will not do and probably he who never made
a mistake never made a discovery! Samuel Smiles
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References

• Woodin J, McLeod H, McManus R (2004) Evaluation
  of US-trained PAs working in the NHS in England.
  Interim Report The introduction of US-trained
  physician assistants to primary care in Tipton
  first impressions. Health Services Management
  Centre, Department of Primary Care and General
  Practice, University of Birmingham.
• http//www.hsmc.bham.ac.uk/publications/pdf-repor
  ts/Physician20Assistant20interim20report.pdf
• Buchan I, Ball J, OMay F (2006) Physician
  Assistants in NHS Scotland Revewing the Issus.
  Queen Margaret University College, unpublished.