Over 30 Physician Associates currently work in Mental Health Trusts, University Health Boards and Health and Social Care Trusts across the UK.
Physician Associates play a crucial role in multidisciplinary mental health teams to deliver effective care across the whole spectrum of patients.
Physician Associates always practise under the supervision of a consultant psychiatrist. The level of responsibility agreed will be subject to on-going audit and evaluation. A ‘Scope of Practice’ document can be agreed between the supervising consultant and the Physician Associate on appointment, to be amended over time according to increasing experience and competence.
Responsibilities of the role
Assessments, clinical examinations and investigations
- take medical and psychiatric histories from patients
- conduct mental state examinations and cognitive and initial psychiatric assessments
- perform general medicine, physical assessments and basic procedures (liaising with acute hospital services as needed).
If needed, they can organise medical investigations and/or requesting diagnostic studies and medical diagnostic tests (undertaken within applicable guidelines).
Interpretation of results, diagnostic process and formulation of management plans
- assimilate and interpret the clinical information collected in order to formulate a list of differential diagnoses based on a range of options – often the clinical information will be multi-dimensional with different possible outcomes/conclusions
- discuss diagnoses with the consultant psychiatrist supervising them or the MDT
- recommend appropriate management and treatment plans under supervision of their Consultant Psychiatrist, escalating as appropriate.
The Physician Associate and Consultant Psychiatrist will keep this plan under review as more clinical information is forthcoming.
Procedures, treatment provision and therapeutic interventions
Within their scope of practice and working as part of the MDT, Physician Associates perform therapeutic procedures, including ECG, venepuncture, IV cannulation, collection and interpretation of blood investigations, initiation of basic/advanced life support.
In addition, they can:
- carry out psychiatric observations
- administer and review medication
- record and act upon the side effects of medication
- provide continual analysis of clinical information to ensure that the treatment plan is still applicable.
In emergency situations, Physician Associates can administer hospital life support to support life-saving procedures. Procedures include defibrillation, oxygen and medications. Currently, Physician Associates are not able to prescribe medication nor request ionising radiation (e.g. chest x-ray or CT scan).
Management of caseloads of patients and ward rounds
Physician Associates attend and participate in consultant psychiatrist and registrar-led ward rounds or multi-disciplinary meetings as appropriate. This will include the day to day management of clinical caseloads. They can also manage or take responsibility for a dedicated caseload of patients as determined by the consultant psychiatrist.
Management of referrals and discharge processes
Physician Associates participate in the management of the whole patient’s care pathway, including arrangements for community care, as well as admission, discharge, follow-up and after-care of patients in the acute in-patient unit, with other health professionals and assisting in the MDT planning as required, including relevant paperwork and letters to GP and referring services.
Communication with patients and families
Once psychiatry management/rehabilitation plans are determined, Physician Associates may have to inform and counsel patients and relatives/carers regarding explanation of treatment, diagnosis and rehabilitation of mental health disorders. Sometimes this information will be multi-factorial and must be presented with empathy and reassurance.
Team working and liaison with other services
Physician Associates will attend and contribute to weekly clinical team meetings, team formulation meetings and group supervision. The Physician Associate’s role will compliment roles already developed within the service and strengthen the multi-professional team.
It is often the Physician Associate’s job to liaise with the GP for the service and delivery of effective healthcare for the management of acute and chronic physical conditions.
Health promotion and disease prevention
- provide health promotion and disease prevention advice for patients, including those relating to smoking, drugs and alcohol
- provide psycho-educational support as well as proactive screening and interventions with regard to the physical health of patients.
Research, audit, service development and Quality Improvement (QI)
In conjunction with clinical colleagues, Physician Associates participate in all aspects of clinical governance, including undertaking clinical audits, (quality assessment and process improvement) and risk management.
Education, teaching and training activities
Like other clinicians, Physician Associates keep up to date with medical research technology and related issues, maintaining knowledge and proficiency in medical practices through continuing education, staff meetings, workshops and ensure such training and development meets clinical governance guidelines for Continuing Professional Development and their Personal Development Plan.
When agreed with their supervising consultant, Physician Associates provide mentorship and support to trainee and newly qualified Physician Associates and medical undergraduates, as well as contributing to the development and delivery of formal and informal teaching sessions and seminars for Physician Associates, medical students, junior doctors and members of the wider health care team.
Documentation and administrative duties
- carry out administrative duties in relation to the care of patient
- assist the consultant psychiatrist by, for example, writing letters, chasing referrals/treatments and preparing hardcopy for medical notes
- complete any other paperwork required for legal or administrative purposes.