Operose PA job advert leads to ‘confusion’ over prescribing rights

A recent job advert for an Operose GP practice suggested physician associates (PAs) are able to prescribe medication, despite laws against this.

Under job responsibilities, Operose stipulated that the senior PA must ‘adhere to the practice prescribing formulary’ and ‘ensure’ the electronic prescription rate (EPS) is ‘maximised’. 

The advert has now closed, but Operose Health told Pulse they will ‘revise’ this wording for future job adverts, as they recognise it ‘caused some confusion’. 

The GP chain, which runs nearly 60 practices across the UK, sought to clarify that its PAs ‘do not prescribe medication to patients’. 

PAs and anaesthesia associates (AA) cannot currently prescribe, either in GP practices or in secondary care, as there is no legislation in place to allow it. 

Operose’s senior PA job advert, for a GP practice in London, said the successful candidate will ‘demonstrate safe, clinical decision making and expert care, including assessment and diagnostic skills’. 

It also highlighted that the PA works ‘under supervision of the GP in the practice’.

The responsibilities relating to prescribing were as follows:

• Be able to justify choice of medication. Able to understand the impact of comorbidities and other medications (poly-pharmacy) on agent choice and prognosis;
• Adhere to the practice prescribing formulary, local and national guidelines;
• Ensure the practice EPS (electronic prescription rate, paperless prescription generation) is maximised.

Doctors’ Association UK (DAUK) GP spokesperson Dr Steve Taylor told Pulse that the ‘confusion’ over the PA role ‘is not confined to patients’. 

He said: ‘There have now been a number of adverts for roles where prescribing has been linked to the role. This shows that employers and some senior managers are unsure of what role Physician Associates can undertake. 

‘It is concerning that if these are the expectations of employers, then it will put Physician Associates and supervisors in an unlawful position, and create unsafe environments.’

Yesterday, the BMA published a ‘first of its kind’ guide to a physician associate’s ‘scope of practice’ – Dr Taylor said this piece of work provides the ‘clarity’ that DAUK thinks is needed.

The scope of practice argued that PAs should never see ‘undifferentiated’ patients in a GP setting, and that they must not use any ‘workarounds’ to gain access to prescribing credentials.

An Operose Health spokesperson told Pulse: ‘We are aware that the job description in question has caused some confusion and we have already begun to revise the wording in this for the future.

‘For clarification, and as per UK legislation – our PAs do not prescribe medication to patients.’

Following a controversial parliamentary process, PAs will be brought under GMC regulation towards the end of this year – but this will not include prescribing rights.

When consulting on the draft regulations last year, the Government suggested that PAs and AAs could get prescribing rights under separate legislation in future. 

It said a working group had been set up to examine how prescribing responsibilities could ‘potentially operate’ once PAs are regulated. 

However, following responses to this consultation, the Government emphasised in December that any decision to extend prescribing rights ‘would need further consultation’. 

At the end of last year, HRCG Care Group – formerly known as Virgin Care – agreed to buy Operose Health’s GP practices from US medical giant Centene.