My name is Louise Maude, and I am a Physician Associate (PA), working in Care of the Elderly at Warrington Hospital.
This week is National Physician Associate week. The purpose of this is to showcase the PA profession and to recognize the contribution PAs make in many different areas of primary and secondary care as they work alongside other members of the health care team, particularly doctors.
One of the things I love most about being a PA is that I am not tied down to a career path working in a single specialty but can change jobs to work in different specialties. This is because PAs are intentionally trained as ‘generalists’ so that they can switch into different types of work either for their own growth and satisfaction, or for the benefit of the community or hospital they work in.
10 years ago, I started my PA career in primary care, working in a large GP practice in Massachusetts, USA. In 2016 I returned to the UK as part of the National Physician Associate Expansion Programme which brought a number of PAs from the USA to England to work in Trusts that had no experience of a PA. At that time many Trusts were unfamiliar with the way PAs worked and how a PA could benefit them. With 4 other PAs I came to Warrington A and E department for 2 years where we worked alongside the doctors and NPs in all the various different A and E departments. PA students trained alongside us and it is lovely to see that some of them have returned after graduation to work in A and E, as well as other departments at Warrington Hospital.
In 2018 Warrington Hospital opened a Frailty Assessment Day Unit (FAU) and I was recruited to be a part of the team. It has been such a rewarding 4 years working as part of a multidisciplinary team assessing and caring for frail elderly patients referred from the community by their GP, community matron or paramedics, or from A and E or AMU. The team has grown as the unit has expanded its work and I work alongside a Nurse Consultant, NPs, ACPs, OTs, PTs, Pharmacist, APs and other support staff, as well as trainee GPs who have started to rotate through the unit as part of their training. The unit is headed by a Consultant Geriatrician who visits throughout the day to lead the MDT.
During my time on FAU, I was seconded to Halton B wards during the early months of the pandemic to support the work of the locum doctors. Later, during the winter pressures of 2021/2 an older person’s short stay unit was opened in Halton. A team of us worked with patients sent from FAU or A and E who needed a day or two (or sometimes more) in hospital for medical treatment and therapy before being discharged back home or to a Care home.
I have just completed a 3-month trial on A4 (surgical) in ‘Perioperative management of older persons undergoing surgery’, known as POPS. I identify patients 65 and older under the care of the surgeons and assess them using a shortened version of the comprehensive geriatric assessment which is the gold standard for assessment of frail elderly people. Later the Consultant Geriatrician and I see the patient together and medical and holistic recommendations are made to the surgical team regarding each patient. POPS service is found in many NHS hospitals: it has been shown to improve outcomes in the frail elderly patient undergoing surgery by decreasing length of stay as well as decreasing morbidities and mortality which makes it a valuable service not only to patients but also to the Trust.
Thank you for taking the time to read my story. My hope is that you now have a greater understanding of who PAs are and what they can do. To all my PA colleagues here in Warrington: thank you for all that you do each day in caring for patients and supporting colleagues throughout the hospital. Happy PA week!
