American-trained physician assistants are to be recruited for a pilot of the role at Counties Manukau District Health Board in early 2010.
Physician assistants will be the first of the “innovative” health role trials being supported by the new Clinical Training Agency board as it investigates ways to recruit the predicted 800 extra staff needed to boost elective surgery.
The physician assistant role can involve diagnosis, treatment and prescribing but unlike a nurse practitioner they cannot practice autonomously. Don Mackie, Counties Manukau DHB chief medical officer, said ongoing staffing issues and the planned elective surgery increase had prompted the four northern region district health boards to support a pilot of the physician assistant role.
Chief nurse Mark Jones said it was a role worth testing and was clearly different to any nursing role because a physician assistant had to work under the designated authority of a medical practitioner.But he said it was important that the role was not considered in isolation of advanced practice nursing roles like the nurse practitioner.
Nursing is involved in the pilot with Denise Kivell, Counties-Manukau director of nursing, a member of the local pilot steering group and Auckland DHB’s Taima Campbell on the regional steering group. Kivell said the concept was still in its evolutionary stages in New Zealand and it was quite a different pathway to the strong nursing career pathway.
With physician assistants long-established in the United States, Mackie said the pilot planned to recruit probably two US-trained PAs to work at Counties-Manukau to see how they could fit into the New Zealand health system.
He said it seemed to be sensible to “test the fit” of such a position before embarking on a training programme for New Zealand. The Medical Council earlier this year sought feedback on whether New Zealand should train a physician assistant workforce for New Zealand and whether it needed to be regulated. Mackie said current advice was that the pilot physician assistants did not need to be registered in New Zealand and instead would work under delegated responsibility from a physician.
He was aware of several tertiary education providers interested in developing PA programmes and that they would be keenly watching the pilot. It would involve a rigorous evaluation process, with the first report released about three months into the pilot. Meanwhile, the northern boards were working with the Clinical Training Agency to finalise funding of the pilot which it hoped to have under way by March next year. Mackie said at this stage elective surgery was a focus but it had not decided in which areas the physician assistant would be placed and, dependent on who was recruited, might include operating theatres,
out-patients or a range of other
related roles.
