Physician Associate

Apprenticeships are work-based training programmes. An apprentice is an employee with a paid job, contract of employment and holiday leave. They learn and gain on the job experience. Apprentices must spend at least an average of 6 hours per week of their working hours ‘off-the-job’*, completing classroom-based learning, which leads to a nationally recognised qualification. For degree apprenticeships the off-the-job learning is typically around 40%.

*The off the job minimum requirement for a part-time apprentice is 20% of their normal working hours.

The apprenticeship standard and end point assessment have been developed, with approval from The Institute for Apprenticeships and Technical Education (Department for Education).

Health Education England are leading on activities designed to support employers to access PA apprenticeship programmes. Health Education England are hosting PA Apprenticeship Implementation Network meetings (next date 19th April). Contact maps@hee.nhs.uk to receive network updates.

Employers interested in offering PA Apprenticeships are strongly encouraged to undertake workforce planning without delay and identify providers (see details and resources below).

1.Who will be funding these apprenticeships?

The amount of government funding varies depending on whether the employer is a levy payer or non-levy payer. You can find more information on our Funding and Levy page.

If a primary care employer is unable to secure a levy transfer for example, the government will fund 95% of the tuition costs, leaving the employer to contribute the remaining 5%.

2.How can employers access apprenticeship funding?

All employers with a pay bill of over £3 million each year pay the apprenticeship levy which can only be spent on apprenticeship training. Apprenticeship leads, who normally work within their organisations training or HR department, will be able to help employers access the apprenticeship levy. Primary Care employers can access support from their local training hub.

3.If an employing organisation does not pay the apprenticeship levy, how can they access funding?

Organisations can still access government funding for apprenticeships by either:

• Reserve government co-investment: Organisations can reserve funding, where the government pays 95% of the training costs and the employer pays the remaining 5%.

• Levy transfers: Levy paying employers can transfer some of their annual levy to other employers. These transfers cover 100% of the training costs of the apprenticeship.

4.Is the apprenticeship levy different between primary and secondary care?

Primary care employers are not generally large enough to have a levy pot. They can either pay a 5% contribution to the costs, where the government pays the other 95%, or they can receive a levy transfer from a larger organisation (although this can’t be guaranteed). Health Education England (HEE) can facilitate this process. Please contact talentforcare@hee.nhs.uk

5.Can employers use apprenticeship levy funding to pay for their apprentice’s salary?

No. The apprenticeship levy, reservations of funds and levy transfers do not cover salary costs.

6.Is the levy funding guaranteed once employers employ an apprentice?

Levy paying organisations can use their available levy funds to pay for apprenticeships.

If you work for a non-levy paying organisation, you will need to either arrange for a levy transfer or government co-investment for each apprentice you intend to support. This must be in place before the apprenticeship begins. There are apprenticeship relationship managers in each region whose contact details can be accessed here. They can support non-levy paying organisations to apply for levy transfers or set up co-investment.

7.What can the apprenticeship levy be used for and who is it paid to?

Only the cost of the apprenticeship training and assessment up to the maximum allocated funding band. Apprentice salary or any other costs such as travel and accommodation, expenses or other training are not included in the apprenticeship levy and cannot be paid for using this funding. Where placements are required by the apprenticeship standard, these are not covered by the levy cost. Employers are responsible for making sure their apprentices gain the right on-the-job experience. This will require strong partnerships between employers at a local level, supported by the university.

Levy payments are made only to the university or apprenticeship training provider in equal monthly instalments over the duration of the apprenticeship, via a digital account.

8.How is the funding band of an apprenticeship decided and assigned?

Each apprenticeship is allocated one of 30 funding bands. The Physician Associate apprenticeship funding band will be different to the cost of the direct entry route.

Apprenticeship training providers will need to deliver everything required by the apprenticeship standard and end point assessment within the maximum funding available, including any mandatory qualifications. Universities can charge for any additional costs not covered by the apprenticeship standard, and these would need to be negotiated with the employer.

9.How much levy funding can employers access?

The amount of levy funding that can be used to pay for the apprenticeship standard and end point assessment is the maximum funding band amount of £17,000. If an employer negotiates a price with an apprenticeship provider that is more than the funding band, the employer must pay anything over £17,000. It may be possible for an employer to negotiate a price less than the funding band maximum, particularly where at-scale cohorts are being assembled by consortiums of employers. The apprentice can make no financial contribution to the cost of the apprenticeship training or end point assessment.

10.If someone is on an apprenticeship, can they access other student loans?

No. Apprentices are not eligible for student loans as they are employed, and the apprenticeship levy only covers the training and assessment costs of the programme.

11.Is there likely to be any Health Education England (HEE) funding support for employers who employ physician associate apprentices?

A HEE proposal has been made to provide a significant apprenticeship employment grant to trusts/PCNs employing PA Apprentices, in support of the development of educational infrastructure. HEE will update on this by April 2023.

12.Could an apprenticeship be funded as part of the Primary Care Additional Roles Reimbursement Scheme (ARRS)?

From April 2023 the Physician Associate apprentice role will be introduced into the Additional Roles Reimbursement Scheme, the ARRS.

Therefore a PCN can claim reimbursement for salary costs (plus some on-costs) up to a maximum reimbursable amount equivalent to Band 5 on the  Agenda for Change payscale. Staff will need to be enrolled on an approved apprenticeship programme in line with the Network Contract DES.  As set out in Investment and Evolution: Update to the GP contract agreement 2020/21 – 2023/24, staff employed through ARRS will be considered as part of the core general practice cost base beyond 2023/24.

13.Will Health Education England (HEE) cover placement costs for those on an apprenticeship route?

Currently apprenticeship placements do not attract placement tariff. Placements for apprentices should not be paid for by the university or employer. The recommendation is for local employers to work together, supported by the university, to offer reciprocal placement arrangements that help support all apprentices. This has been included in the tender specification for HEI (Higher Education Institutions) programmes and is being factored into their programme development.

14.Will there be funding from Health Education England (HEE) tariff for supervision requirements, as there is for medics?

Apprenticeships do not attract placement or supervision tariffs.

15.How will an apprentice in secondary care, complete the primary care part of physician associate training?

Apprentices will have to complete placements in other sectors and specialties to meet curriculum requirements. This will require strong partnerships between employers at a local level, supported by the university. Apprenticeships are not covered by placement tariff, so Health Education England will not be able to fund placements.

Physician Associate FAQ: Primary Care Resources

Access our Physician Associate (PA) FAQ which have been collated to support Primary Care Networks (PCNs), Training Hubs, GP practices and other primary care colleagues.

This section shows further resources and guidance for employers in Primary Care including:

• General enquiries

• The PA apprentice role

• Apprentice programme

• Funding

• Support

Access the Physician Associate FAQ: Primary Care Resources page.

The PA Apprenticeship in Primary Care Pathway factsheet shows the steps to employ a Physician Associate in Primary Care.

The PA Apprenticeship Primary Care infographic is a quick guide to introducing a Physician Associate(PA) Apprentice into Primary Care.

1.Who will be providing PA apprenticeship programmes and where do they deliver?

The following higher education institutions (HEIs) have been approved to deliver the Physician Associate Degree Apprenticeship in collaboration with employers, following a national procurement process. These providers have been quality assured by Salisbury NHS Foundation Trust and an expert panel.

2. Can employers choose which university they want to deliver the apprenticeship standard?

Yes. Employers will be able to choose a university from the ‘Salisbury’ list outlined above. This gives some assurance that these universities have been through a rigorous quality assessment process. It means that employers won’t need to run individual procurement exercises and ensures the correct service contract is in place. Employers will still be able to select an apprenticeship provider who is not part of this procurement, but that will require undertaking a procurement exercise without the benefit of receiving any of the provisions that have already been secured.

3.Will I have to wait for set dates for an apprentice to start?

HEI’s have given us planned start dates, please see the programme providers course and contact details below.

As apprenticeships are employer led, we would always recommend a discussion with the HEI to decide on intake/cohort start date.

4.Is there any support for apprentices who may have additional needs and learning difficulties?

Universities can support learners with additional needs or learning difficulties and have access to a specific budget to fund any necessary support. The university will be able to advise – see programme details below.

For those with an education, health and care plan (EHCP) or a legacy statement, the English and Maths minimum requirement is Entry Level 3. British Sign Language qualifications are an alternative to English qualifications for whom this is their primary language.

5.How does the recognition of prior learning (RPL) process work?

Recognising prior learning is an essential part of the apprenticeship learner eligibility assessment. Apprenticeships must provide new and significant learning as funding cannot be used to pay for skills, knowledge and behaviours already attained by the apprentice. Universities will have to account for this and consider, for example, any previous work experience, education, training, and qualifications.

Before a learner starts an apprenticeship, the university must carry out an initial assessment to see if a candidate can meet the knowledge, skills and behaviours set out in the apprenticeship standard. Where an individual has the necessary skill level to achieve occupational competence, the content, length and cost of the apprenticeship may be reduced. You will find more detail on the government website.

Universities are likely to have an accreditation of prior experiential learning (APEL) policy in place to support accreditation.  See programme details below.

6.Does the recognition of prior learning mean that the programme would be individual for each apprentice?

Yes. It allows for qualifications and experience to be taken into account when conducting the initial skills scan against the knowledge, skills, and behaviours of the apprenticeship standard. It’s likely that each apprentice will have different outcomes and starting points with individual learning plans on the apprenticeship.

Each of the programme providers are listed below. Click on each link to access contact and course details:

• Edge Hill University

• Keele University

• Queen Mary, University of London

• Sheffield Hallam University

• University of Central Lancashire

• University Of Derby

• University of East London

• University of Greenwich

• University of Plymouth

• University of Worcester

1. How do I begin the process of taking on an apprentice?

The best place to navigate apprenticeships and technical education in the health sector is the HASO (healthcare apprenticeship standards online) website.  Aimed at employers and front-line managers (but also valued by training providers and end point assessment organisations). Here you can:

• Plan how you will deliver apprenticeships for your team or across your organisation

• Consider ways to prepare staff for apprenticeships

• Plan recruitment into apprenticeship posts or create apprenticeship pathways for career progression

There will also be an apprenticeship lead within your organisation who will be an expert in these areas as well as your regional HEE Apprenticeship Relationship Manager who can provide support.

You may need to develop a business case or investment proposal to support your plans to recruit Physician Associate Apprentices.  HEE have developed a template for this – click here to access this template.

2.Where do I find a job description for the Physician Associate Apprentice role?

Health Education England have developed a template job description for employers – click here to access this template.

3.How much will a Physician Associate apprentice be paid?

 Apprentices must be employed and paid at least the apprenticeship minimum wage, specified in the apprenticeship funding rules. Employers are encouraged to consider the entry requirements, role expectations and organisational policy when considering salary reimbursement.

4.Can employers recruit part time apprentices?

 The Education and Skills Funding Agency (ESFA) are clear that part-time working should not be a barrier to anyone undertaking an apprenticeship. However, employers wanting to recruit an apprentice for less than 30 hours a week will need to be aware that the programme duration will need to be extended to accommodate the required teaching and assessment, and that not all universities will offer this option. Please contact your preferred programme provider to discuss this in detail.

5.Are apprentices expected to work during their training?

Apprentices are employees within an organisation during their apprenticeship. There will be a certain amount of ‘off-the-job’ training including protected study time and placements. For a degree apprenticeship this is typically around 40%. Outside of this time, apprentices will be in their employed role as they undertake ‘on-the-job’ learning. The job role should provide an apprentice with the opportunity to gain the knowledge, skills and behaviours needed to achieve their apprenticeship. Employers should allow the apprentice time to complete their programme of study and access to opportunities that enables them to develop through their job role.

6.What happens if an apprentice leaves before the end of their apprenticeship?

 If they move to a different employer in a suitable role that allows them to complete the apprenticeship and the new employer is happy to support them to complete, then the apprentice can continue and levy paying responsibility transferred to the new employer. If an apprentice does not wish to complete their programme or if the new employer is unable to support them then the apprenticeship will stop and any levy payments to the apprenticeship provider will cease.

7.Will this apprenticeship route better support those already working in the NHS, rather than anyone coming in new?

 Apprenticeships can be used to support both the upskilling of existing members of staff as well as for providing an external pipeline of individuals directly into the workforce. Typically, most apprenticeships in the NHS are used to develop existing staff, but it does depend on available candidates and employer choice.

8.What is the benefit of having an apprentice over employing a self–funding graduate?

 Apprenticeships give an employer the opportunity to invest in ‘growing their own’ workforce, invest in local communities by widening access to professions and creating more diversity across their organisations. Apprenticeships provide opportunities for people of all ages and backgrounds to gain credible knowledge and skills that may not otherwise be accessible them, for example, local people who are unable to take time off work to study.

9.Do apprentices have to work for the employing organisation who have supported them once they complete their apprenticeship?

 There will be no legal obligation for either party at the end of the apprenticeship. An employer does not have to provide a role for the apprentice to move into, and the apprentice does not have to stay once they have finished the programme.

10.What are the current requirements for this apprenticeship in terms of who can be their Supervisor/Assessors?

 The level of supervision required will mirror the requirements of the postgraduate programme. With regards to assessors, this would be the role of the training provider.

You can access the Level 7 Physician Associate (degree) apprenticeship standard here. The standard document sets out the knowledge, skills and behaviours which must be learned during the apprenticeship to complete an award of Postgraduate Diploma (PGDip) or Master of Science (MSc) in PA studies, Masters in PA studies (MPAS), or MSc Physician Associate.

The apprenticeship has parity with traditional routes and includes the same mandatory degree qualification and the same occupational competence and outcome. Apprentices will be subject to the same National Examination as a requirement to practice. The main difference to the traditional route is that apprentices are employed whilst they train, and education and assessment costs are covered by the apprenticeship levy.

1. What plans are there to update the apprenticeship standard and reflect any changes that come with statutory regulation?

The trailblazer group will be reconvened once the General Medical Council publish the new curriculum standards. The apprenticeship standard and end point assessment will need to be rewritten to ensure alignment with the revised Physician Associate curriculum and GMC (General Medical Council) generic outcomes. The new GMC PA Registration Assessment (PARA) will still be separate to the MSc, therefore the end-point assessment will not be integrated. The GMC plan to subcontract it to the RCP (Royal College of Physicians)/ FPA (Faculty of Physician Associates) who will have to be the EPAO. The Institute for Apprenticeships and Technical Education must approve all changes. Regulation updates are published on the Faculty of Physician Associates (FPA) website.

All providers will support apprentices to achieve GMC registration by the end of the programme including passing the Physician Associate National Exam, and will ensure their apprenticeship delivery plans meet GMC’s standards for education providers, including delivering the outcomes specified in the revised PA curriculum.

2. What are the entry requirements?

Universities specify their entry criteria for the Physician Associate apprenticeship programme (see detailed summary here). These must be set in conjunction with employers, demonstrate a student’s ability to study at a master’s degree level and consider experience along with qualifications.

The apprenticeship standard suggests that entry requirements may be a Bioscience-related First Degree, a Nursing and Midwifery Council Registered Nurse or Midwife, or a Health and Care Professions Council (HCPC) registered Allied Health Professional.  Evidence of English or Maths at Level 2 or equivalent functional skills is also required.  Universities set out their approach to assessing/supporting these in their criteria, alongside the requirements for non-UK graduates.

Click here to find out about free functional skills resources.

3. Can employers reduce the number of physician associate student placements on the non-apprenticeship route and increase the number of apprentices in the workforce?

The aim of the apprenticeship scheme is to increase the number of students in the workforce, through additional routes to train, not prioritise apprenticeships over traditional learners.

4. Will it be mandatory for universities to offer this apprenticeship?

No, the decision to offer an apprenticeship training route sits with the university.

5. Will there be any flexibility in the apprenticeship start date?

Universities can choose to start their programmes on any date in agreement with an employer, based on their need. This does not necessarily have to be the same start date as direct entry programmes. Please contact the providers listed above to discuss these requirements in detail.

6. Where will apprentices be sent on their training placements?

As Physician Associate is a generalist role, apprentices will be required to undertake placements and gain experience across a range of specialties in primary and secondary care. This will require strong partnerships between employers at a local level, supported by the university.

Placements will need to be a suitable duration, covering a broad range of clinical settings that will enable apprentices to develop the required capabilities and meet the curriculum requirements. The focus will be on general medicine (general practice, acute and emergency medicine, general medical specialties) as well as other specialty areas such as care of older people, paediatric, surgical, and mental health services. Please contact the providers listed above to discuss this process in detail.

7. Will apprentices still need to cover all the different specialties that current physician associate students complete?

Yes. Apprentices will need to complete the same assessments and qualify in the same way as traditional route PAs.

8. It’s already difficult for employers to manage placement capacity in clinical practice for physician associate students. How do we manage to fit in apprentice learners too?

Apprenticeship placements will be managed differently to student placements. Nursing apprenticeships are an example of how two placement models can co-exist in practice. We advise that employers engage with their local Health Education England (HEE) clinical placement teams and Integrated Care System (ICS) colleagues to support the development of regional placement strategies in the longer term.

HEE understand the general challenges around placement capacity and are currently scoping the issue collaboratively to identify innovative solutions.

9. How long will these apprenticeships take to complete?

The apprenticeship standard states a typical duration of 30 months. This timeframe was designed by the trailblazer group to make sure the PA National Exam (PANE) could be incorporated. It is possible for the duration to be shorter if it can be showed that all values behaviours and outcomes have been delivered.

Universities will need to design a delivery model covering the apprenticeship standard that works for themselves and employers. Consideration will need to be given to on-the-job versus off-the-job allowances, which may differ from the direct entry programme delivery model.

10. Will universities have to run two separate programmes?

It will be up to each university to decide. Some may choose to run two separate programmes others may combine the direct entry and apprenticeship programmes. If a university decides to combine the apprenticeship route with the direct entry programme, they will need to ensure that the apprenticeship programme is delivered in line with the funding rules and meet all Ofsted and Education and Skills Funding Agency (ESFA) requirements. It is important that apprentices are recognised as employees and processes are in place to support the tri-partite nature of apprenticeships with significant employer involvement.

11. Could apprentices be perceived as cheap labour and their qualification not as good as the more traditional diploma or master’s route?

Apprentices will undertake the same mandatory qualification (diploma or master’s) required to practice as a PA. They will achieve the same occupational competence and outcome as they study, it’s only the delivery model that may differ. They will also have to pass the Physician Associate National Examination to complete their apprenticeship.

The benefit of this additional apprenticeship route will help widen access to the Physician Associate profession and is an effective way for employers to invest in ‘growing their own’ workforce. There is a growing body of evidence to suggest that employers experience greater retention of apprentices than students who may have undertaken placements.

What is the end point assessment (EPA)?

The Physician Associate National Examination (PANE) is the end point assessment for this apprenticeship standard. The Faculty of Physician Associates (FPA) have the Institute for Apprenticeships and Technical Education approval as an end-point-assessment organisation in principle. The Faculty of Physician Associates currently run the national certification exam (PANE) and therefore the PANE is the end-point-assessment. On successful completion of the PANE, providing they are a member of the FPA, Physician Associates can be registered on the Physician Associate Managed Voluntary Register (PAMVR).

What is the difference between the Level 7 Physician Associate (degree) and Level 7 Advanced Clinical Practitioner apprenticeship (integrated degree)?

The two apprenticeships deliver different knowledge and competencies relevant to their unique occupation and skillsets.