Physician Associates in Mental Health Services (PAMHS): An Evaluation
Research type
Research Study
Full title
Physician Associates in Mental Health Services (PAMHS): A realist evaluation of the feasibility, sustainability and effectiveness of deploying physician associates across English mental health services
IRAS ID
324741
Contact name
Paul Tiffin
Contact email
Sponsor organisation
University of York
Duration of Study in the UK
1 years, 2 months, 30 days
Research summary
"Research Summary"
There is a workforce crisis in English NHS mental health services with vacancy rates of approximately 10% for doctors, and around 20% for nurses; this harms the delivery of care. One suggested solution is the use of Physician Associates in mental health settings. Physician Associates should be skilled in medical history taking, physical examination, diagnosis and relevant procedures, allowing them to work in roles that support doctors.Prior research in primary care and acute secondary care has found that Physician Associates are acceptable to patients and are likely to be cost-effective, increasing the capacity and continuity of care in these settings. Thus, there is the potential for Physician Associates to contribute positively and play a key role in easing the psychiatric staffing crisis. However, there is virtually no evidence regarding the feasibility of employing Physician Associates in mental health settings.
This study aims to obtain early evidence regarding the feasibility, sustainability and effectiveness of deploying Physician Associates in mental health services. To meet the study aims and objectives, we plan to conduct a series of focus groups and interviews across three participating NHS Trust sites. Interviews will be conducted with Physician Associates who are currently working, or have recently worked in mental health services. Focus groups will be conducted with key stakeholders including clinical team members working alongside Physician Associates in mental health settings. In addition, we plan to conduct interviews with the three Trust leads that are responsible for implementing the Physician Associate role. We will also conduct interviews with patients, and carers, that have recently had contact with mental health services, and ideally may have had input from a Physician Associate. Our findings will shape national practice and policy in this area, helping to realise the potential of this new role to support the delivery of mental health services.
"Summary of Results"
What we did and why Physician Associates (PAs) are a type of healthcare professional introduced to help with staff shortages and improve patient care in the NHS. At the moment we don't know to what extent they could help deliver care in mental health services though. Our study looked at how PAs can best contribute in this setting, what makes them effective, and whether it's realistic to hire and keep them in these roles.
How we did it
We reviewed existing research, held group discussions, conducted interviews with staff, and surveyed PA students. This helped us develop and test a theory about what may make the PA role successful in NHS mental health services, and some of the barriers to this.
What we found
PAs can improve patient health and satisfaction in mental health services. This is likely because they focus on managing patients' physical health needs and provide consistent care by seeing the same people regularly. They seem to be most helpful in hospital settings where patients have both mental and physical health problems. While about 40% of PA students would consider working in mental health, there are challenges. There is still some confusion about their exact duties, and they need more access to support from specialist, senior medical doctors for the physical care they provide.
What this means
Using PAs in mental health services is a workable idea that could lead to better patient care. However, more research is needed to confirm the role is safe for patients, clinically effective, and a good use of resources.REC name
Wales REC 7
REC reference
23/WA/0231
Date of REC Opinion
29 Aug 2023
REC opinion
Favourable Opinion