What are the barriers and facilitators to the integration of Physician Associates into the General Practice workforce?

Talk Code: 
Dr Ben Jackson
Michelle Marshall
Author institutions: 
Dr Ben Jackson - Academic Unit of Primary Medical Care - University of Sheffield, Dr Michelle Marshall - Academic Unit of Medical Education - University of Sheffield


The NHS is under unprecedented pressure and problems with workforce capacity leading to difficulties in accessing people accessing help when they need it (Appleby & Robertson 2016; Health Education England 2015; Hawkes 2014). The role of Physician Associate to support primary care has been suggested as a potential solution (NHS England 2016). In response to these proposals a large number of new courses are being developed across the UK but there is currently limited evidence of the potential value of this new role to the primary care workforce and how well new graduates will be able to successfully integrate into general practice teams (Drennan et al. 2014). More research is needed on how new roles can be incorporated into primary care teams in a way that preserves the core function of General Practice teams in supporting the NHS as a whole.


An investigation is undertaken using grounded theory methodology into the barriers and facilitators to the integration of Physician Associates to general practice teams in a region unfamiliar with the role. A theoretical framework developed from fieldwork with stakeholders and a scoping review is tested in focus groups with general practitioners, advanced nurse practitioners and patients to develop a conceptual model


Qualitative data is described from focus groups that illustrate the barriers and facilitators from which a conceptual model is generated summarising the main barriers and facilitators to the integration of this new role into the workforce. This model allows reflection on how some of the barriers be addressed e.g. through adaptation in curriculum delivery, through regulation or through professional leadership.


The model constructed may provide a useful framework for examining the potential other professional roles currently suggested as potential solutions for the workforce and access problems in general practice and how prepared they are to contribute to ‘generalist’ teams.

Submitted by: 
Benjamin Jackson
Funding acknowledgement: 
Innovation Funds from University of Sheffield Medical School