Background UK hospice medical teams usually consist of consultants, SAS doctors and junior doctors on rotation. Throughout medicine, rotation changes can disrupt patient and staff continuity. Physician Associates (PAs) are medical professionals working alongside doctors in multidisciplinary teams to provide continuity, and are well established within primary and secondary care. However, there are no recorded palliative PAs. In 2020 St Raphael’s Hospice appointed the first UK hospice PA. This service evaluation aims to qualitatively review the impact of a PA and share information on the role in palliative care.
Methods Anonymised questionnaires were completed at 3-weeks and 6-months following introduction of the hospice inpatient unit (IPU) PA to obtain clinical staff perspectives on the contributions of the role. A prospective 3-week workplace diary was completed to illustrate clinical tasks undertaken by the PA.
Results 16 participants completed the 3-week survey and 9 participants completed the 6-month survey. The main themes identified were: understanding of the PA role, the impact on clinical staff workloads, and future considerations for palliative PAs. Opinion improved at 6 months, with 100% reporting benefit to clinical work and care of patients and families. Feedback showed enhanced interdisciplinary communication alongside increased support to the medical team, especially around admitting patients to the IPU and overall day to day clinical efficiency.
Conclusion Incorporating the PA role in a hospice can optimise the multidisciplinary approach to continuity of care for the specialist palliative population. The role has been well received within the hospice IPU, with the PA viewed as an invaluable team member, bringing knowledge, skill and continuity of care. Inclusion of information about the PA role as part of Hospice induction may facilitate future integration into the Hospice workforce. This service evaluation supports expansion of the palliative medicine workforce through the introduction of PA posts within UK hospices.
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