Comparison of the scope of practice of physician associates with that of healthcare professions with prescribing responsibility from point of registration.

Physician associates (PAs) have been practising in the UK since the mid-2000s and are due to be regulated by the General Medical Council (GMC) after summer 2024. Presently, PAs are not able to prescribe prescription-only medication (POM), but this is anticipated to change following GMC regulation. This research compared the scope of practice (SoP) of PAs with other healthcare professionals who have some level of prescribing authority from the point of registration, to establish the need for PAs to prescribe POM and to explore which of the prescribing authority options would fit the PA role. The comparison demonstrates that PA SoP would suggest the need to prescribe POM, and that any prescribing authority should not be limited to a set clinical speciality or patient population. Additional research is needed to explore PA clinical practice further and identify the range of POM for which PAs need prescribing authority.

Social prescribing: Exploring general practitioners' and healthcare professionals' perceptions of, and engagement with, the NHS model.

Social prescribing (SP) has rapidly expanded over recent years. Previously a bottom-up, community-led phenomenon, SP is now a formal part of structured NHS policy and practice. This study was designed to ascertain how general practitioners and other primary healthcare professionals (HCPs) within one clinical commissioning group (CCG) perceive and engage with this new NHS model. The research comprised an online survey distributed to HCPs within a predominately rural, English CCG between June and August 2021. Qualitative data were gathered and analysed using reflexive thematic analysis. Positive portrayals of SP were found, although definitions and perceptions varied greatly. Many HCPs reported high levels of engagement with SP services; yet referral rates appeared to remain significantly lower than the previously estimated 20% of primary care attendees referred for social reasons. Moreover, 96% of HCPs reported signposting patients directly to community or external services, rather than referring them to SP. This signposting, which has been positioned as a model of SP, reflects engagement with SP in practice, which is likely to have pre-dated the introduction of the fuller NHS model. HCPs may be unaware that this could be classed as a social prescription, and this type of SP remains uncaptured within NHS statistics. These results indicate an underuse of the national system set up to deliver one particular model of SP, rather than that SP does not occur. Additionally, despite national guidance issued to accompany the NHS model, practices such as referral and feedback processes, and link worker presence within practices, were not uniform even within this single CCG. Nevertheless, understanding is increasing as SP becomes embedded within primary care. The lack of consistency in referrals between practices warrants further examination in terms of equity of service choices to patients, as does the very low self-reported referral rate to SP.