The physician associate (PA) role is gaining momentum as a healthcare professional who supports medical workload in primary care, yet there is a lack of clinical literature around how best to clinically supervise this new role. This seems especially pertinent amid the recent funding initiatives that encourage employment of PAs to aid the increasing demands in primary care, especially with the added stressors of the COVID-19 pandemic. There is a need for clinical supervisors to be aware of what their responsibilities are when employing and supervising a PA. Qualitative feedback from a cohort of primary care PAs in Sheffield alongside the authors' own expertise have been collated to produce recommendations to supplement existing documentation from the Faculty of Physician Associates. The paper seeks to rapidly initiate a starting point in clinical literature around the breadth of considerations within PA supervision. These recommendations include, but are not limited to, a discussion at the onset of PA employment of mutual needs and a specified supervisory schedule, alongside named clinicians who generally address clinical and pastoral components periodically. This accompanies an induction into the practice and general clinical support that is initially more intensive but otherwise remains available when the PA feels it is required.

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The advent of the COVID-19 pandemic necessitated a dramatic shift in the traditional general practice (GP) model of consultation. General practice was forced to deliver care remotely and this workforce included physician associates (PAs), who may not have been previously exposed to remote consultations prior to the pandemic. A qualitative online questionnaire explored how a cohort of primary care PAs in Sheffield adapted to the use of remote consultations, how clinically safe they felt in utilising this method, supervision arrangements in their practices and how they would manage three clinical scenarios. Recommendations are limited by the small sample size, but based upon this feedback we recommend inclusion of remote consultation as part of the student experience in higher educational institutions (HEIs) that do not currently utilise it; discussion of the PAs' previous experience of remote consultation at their induction in order to decide how to most effectively use their skillset while they transition into remote consultations, appreciating that they may have a lower threshold to invite patients in for a face-to-face appointment if newly qualified; on-demand supervision for remote consultations where possible; and reinforcement of clinical and pastoral review from the employer to manage the increasing scope of the PA.

Objectives: Despite a long-standing declaration of educational need in the area of paediatrics in primary care, there is little in the way of strategy for delivering high-quality learning relevant to the specific needs of the primary care team. This article seeks to explore various models for delivering primary care centred paediatric education to inform discussion about how to meet this need. Methods: As well as considering various educational modalities, we share the lessons learned from setting up a novel educational model for practitioners working in a primary care setting. We consider the importance of education for those working where they may be operating from a position of uncertainty, which may lead to unnecessary referrals or unsafe practice. We explore the complexities of the interface which occurs between primary and secondary care in designing and delivering education. Results: There are various barriers to the setting up of a programme of education designed specifically for primary care, including time needed, funding and uncertainty of success. While the needs of the whole primary care team needs to be considered, there is a growing number of advanced clinical practitioners and physician associates who are likely to engage with paediatric-specific professional development opportunities, at least as much as the traditional medical workforce. Conclusion: The lack of adequate paediatric education for those working in primary care poses a risk which should not be ignored. In the absence of a coherent strategy in the United Kingdom to identify and meet the learning needs of practicing primary care clinicians, one possible solution is for health regions to develop bespoke initiatives based on an understanding of the local workforce, their learning needs and the local resources available. We explore the various modalities through which this can be achieved and share the lessons learned from the development of a multifaceted programme of paediatric learning for primary care clinicians.