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Healthcare profession Supply and administration Prescribing Patient-specific direction Patient-group direction Exemptions Supplementary prescribing Independent prescribing (post-registration training) Independent prescribing (from qualification) Art therapist7 ✓ × × × × × Biomedical scientist7 ✓ × × × × × Dentist3,8 N/A N/A N/A N/A N/A ✓ Physician3,9 N/A N/A N/A N/A N/A ✓ Chiropodist/podiatrist3,7 ✓ ✓ ✓ ✓ ✓ (including controlled drugs) × Clinical scientist7 ✓ × × × × × Dietitian7 ✓ ✓ × ✓ × × Hearing aid dispenser7 ✓ × × × × × Nursing associate10 ✓ × × × × × Occupational therapist7 ✓ ✓ × × × × Orthoptist7 ✓ ✓ ✓ × × × Operating department practitioner7 ✓ × × × × × Paramedic3,7 ✓ ✓ ✓ ✓ ✓ × Pharmacist3,11 ✓ ✓ × ✓ ✓ (including controlled drugs) × Physician associate12 ✓ × × × × × Physiotherapist3,7 ✓ ✓ × ✓ ✓ (including controlled drugs) × Practitioner psychologist7 ✓ × × × × × Prosthetist7 ✓ ✓ × × × × Radiographer (diagnostic)7 ✓ ✓ × ✓ × × Radiographer (therapeutic)7 ✓ ✓ × ✓ ✓ × Registered nurse3,13 ✓ ✓ × ✓ ✓ (including controlled drugs) × Registered midwife3,13 ✓ ✓ ✓ ✓ ✓ × Speech and language therapist7 ✓ ✓ × × × × N/A = not applicable.
- Table 2.
Comparison of physician associate scope of practice to that of three other healthcare professions
Element Profession Physician associate17,18 Registered medical practitioner14 Registered paramedic19 Registered pharmacist11 Domain: inflexible boundaries: education, regulation and certification Regulation Managed Voluntary Register General Medical Council Health and Care Professions Council General Pharmaceutical Council Educational requirement PGDip or MSc MBChB/MBBS DipHE/FdSc or BSc MPharm QAA level of registration qualification Level 7 Level 7 Level 5 (pre-2018) or 6 Level 7 Certification examination Yes: must be completed before entry to Managed Voluntary Register No No Yes: at end of pre-registration year Pre-registration year No Yes No Yes Engagement with CPD and/or CE 100 h over 2 years. Annual engagement; must be tailored to scope of practice and needs of individual; annual personal development plan CPD requirement is outcomes based and, as such, does not have set number of hours Annual CPD requirement for continued registration, tailored to scope of practice and needs of individual Recertification examination/assessment National Recertification Examination every 6 years Annual Review of Competence Progression for physicians in training No No Prescription-only medication status None Independent prescriber Exemptions PGD, emergency supplies of medication Domain: inflexible boundaries: core competencies Patient assessment: history taking Yes Yes Yes Yes Patient assessment: physical examination Yes Yes Yes Yes Patient assessment: requests diagnostic investigations Yes Yes Yes Yes Patient assessment: interpreting diagnostic investigations Yes Yes Yes Yes Patient assessment: makes a diagnosis Yes Yes Yes Yes Patient management: develops a management plan Yes Yes Yes Yes Patient management: undertakes therapeutic interventions Yes Yes Yes Yes Domain: flexible boundaries Professional experience of clinician Yes, and agreed with supervising physician; might change with roles in new clinical specialities Developed through formal exams with Medical Royal Colleges and Foundation, Core and Speciality training schemes Can develop, recognising that paramedic might become more specialised/focused in their practice over time or with change in roles Formally developed, with Foundation year leading to full registration; develop through post-registration education and research; some roles are very specialised Patient population All All All All Supervision/collaboration Named supervisor(s) who must be contactable during working hours Consultant or GP named as an educational supervisor; none at consultant/GP level Autonomous practice, knowing when to refer on appropriately Autonomous practice, knowing when to seek help or refer on appropriately; to provide leadership in pharmacy practice Practice guidelines Aware of, and work with, guidelines, but not restricted by protocols Aware of, and work with, guidelines, but not restricted by protocols Aware of, and work with, guidelines, but not restricted by protocols Be aware of, and take a critical view of, national and local policies and guidelines, without being restricted by them BSc = Batchelor of science; CE = continuing education; CPD = continuing professional development; DipHE = Diploma of Higher Education; FdSc = Foundation degree in science; MBChB/MBBS = Batchelor of Medicine and Surgery; MPharm = Master of Pharmacy; MSc = Master of science; PGDip = Postgraduate Diploma; PGD = Patient group direction; QAA = Quality Assurance Agency for Higher Education.
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