Ugly… that’s the first word that came into my mind.
A story on the BBC news website.
A bio-tale about a woman called Julia, working in the NHS, as a physician’s associate.
It tells of her joy at starting her work and how it’s since become toxic, as she is ostracised in the workplace by doctors.
Not because of who she is, or how she behaves but because of what she is. How it’s perceived she presents a challenge and the potential for PAs to undermine doctoring.
The story is compounded with an allegation that two young women died after seeing PAs.
As catastrophic as this is, may I point out there are about 8,000 complaints against doctors every year with about 200 cases ending in some form of sanction or warning against the doctor…
… this includes actions like suspension, conditions on practice, or removal from the medical register.
The question is, do PAs make more mistakes than doctors… those pivotal numbers are not yet in the public domain.
The article quotes the United Medical Associate Professionals, a body which represents PAs…
‘… there are countless examples [of PAs] facing bullying and being sidelined.’
PA’s have been around the NHS for 10 years. Their numbers are planned to grow (including anaesthetist associates) to 12,000 by 2036.
I don’t want to believe the BBC. I want to believe Julia is a fabricated person and the story made-up…
… but we both know it’s true and very likely, the tip of an iceberg. We know the NHS can be a toxic place to work.
I can’t imagine what it must be like to study hard and join the NHS with great optimism, to be of service to people. Only to be rebuffed and abused in what is little more than the name of name of protectionism…
… compounded by the fact there are unemployed doctors that the NHS cannot or will not afford to bring into the workplace.
Is there room, or even sense, in having qualified assistants working with doctors, to shoulder some of the routine workload.
Of course there is.
That said, it is highly likely in the future the drudge of admin will fall into the bailiwick of machines and the day-to-day of diagnostics onto the screens of intelligent-machines.
What has gone wrong here? Why is this such a venomous and destructive mess?
Simple. Implementation has been botched.
PAs have been drip-fed into the system since 2015. No one noticed. Now, they’re seen as a torrent that will drown out safety and careers.
There are basic steps to implementing any new policy. Not difficult but ignore them, particularly when controversy, is involved and you end up with a mess like this.
How should it be done?
Define the goals, articulate the objectives. What exactly are we trying to achieve… apart from hacking everyone off.
Are we worried about a future global-shortage of doctors…
… then say so.
If we expect a near future where much of the day-to-day routine of the NHS is to be carried out by AI, supporting PA decisions…
… then say so.
With the doctor in an overarching, consultative supervising role…
… then say so.
Involve people.
Talk to the doctors we have now, explain how you see the future and prepare the ground.
Don’t try and smuggle a whole new workforce into the NHS and hope they won’t notice.
Identify the resources.
If we can’t afford the doctors we’ve already invested in, how can we afford PAs, to support the doctors we can’t afford… if you follow that!
Ensure the policy is comprehensive and aligned with organisational goals or legal requirements.
Just what can PAs do? Spell it out. No porous boundaries. Create a new regulator. Not the old one, with one foot in the grave.
Announce the Policy.
Tell everyone what to expect, when and why. Don’t try and smuggle people into the workforce disguised as doctors and hope the public don’t notice.
Define the roles.
Specific responsibilities, properly resourced. Road test the policies. Understand if PAs are a ‘cheap alternative’, hard pressed employers up against it to balance the books, will employ them.
Establish feedback channels for stakeholders, to share their experiences and challenges.
Be ready to refine or adjust the policy.
Evaluation and Sustainability.
Review and share outcomes, with lessons learned and revise the policy as needed. Do not stumble-on in the hope everything will come right. It never does.
All this requires only basic management skills. Civility in the workplace. Courtesy and good manners.
Do you think we can do that?
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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