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Wednesday, 05 October 2022

"I feel very privileged to be the Lead PA"

Posted in Blog

This week (3-7 October) we are celebrating Physician Associate Awareness Week. Physician associates (PAs) are medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team.

Francis Leach is one of three PAs working across the Trust. Here she tells us more about her role.

I qualified as a Physician Associate (PA) in 2014 from St George’s, University of London. After qualifying I worked in primary care for four years where I put everything I learnt at university into practice, developing my history taking and examinations skills. During my clinics I would see a wide variety of presenting complaints from acutely unwell patients to chronic illness reviews in patients of all ages, from newborn babies to older adults. After that I worked for 18 months in oncology at Guy’s Hospital as I wanted to develop more acute medicine knowledge to complement my primary care skills.

14909 012 GraingePhotographyIn April 2020 I joined SWLStG and was subsequently appointed as Lead PA in the Trust’s Acute and Urgent Care service in June 2021. Being the first PA in the Trust was hard to navigate at first (mostly raising awareness of the role and the duties undertaken by a PA) but I was welcomed into the team and quickly found my place in the multidisciplinary team (MDT). When starting in mental health I was offered an amazing opportunity to work in the Orchid Mental Health Emergency Service Unit which was set up during the pandemic to create a mental health alternative to acute hospital emergency departments. Whilst it was very much a baptism by fire it helped me to broaden my learning across all aspects of mental health and how best I could contribute to the MDT to provide holistic care to our patients. We would see everything from first time presentations to chronic frequent attenders. Initially we were seeing children which, although sometimes harrowing, was great experience in understanding childhood mental illness.

I now work across the Trust’s Coral Crisis Hub and Lotus Assessment Suite which both support people experiencing a mental health crisis. My primary role is to provide physical healthcare for our patients. I utilise my primary care skills to assess any symptoms patients may report and have supported in medical emergencies when needed.

As the physical health lead in my team my duties include reviewing patients’ physical health, forming management plans that include medication reviews, providing teaching to the team and performing monthly audits to improve patient care and outcomes. This has provided me with the opportunity to develop my psychiatric assessment skills. I also carry out the necessary investigations prior to initiating medications such as ECG and blood tests. Prior to having a PA on the team patients would have needed to go to14909 055 GraingePhotography their GP or local hospital for these tests to be done, which would not only delay commencing treatment but could be challenging for services to navigate for patients in crisis. This simple step has helped to improve the experience of our patients.

I really enjoy working in mental health. The team have fully embraced having a PA on the team and understand where my skill set lies, all while helping me to develop my psychiatric assessment skills.

The Faculty of Physican Associates did a spotlight series to feature PAs working in mental health and I had the pleasure of being interviewed to tell my story. Read it here: Faculty of Physician Associates - quality health care across the NHS (

Last year, I was asked to work on developing the PA framework with the Royal College of Psychiatrists that launched in April this year. This is a piece of work I was proud to be involved in. I was interviewed by the RCPsych Insight about how this framework can help support both PAs and our supervisors. The interview is available to read here: rcpsych-insight-20---summer-2022.pdf

I feel very privileged to be the Lead PA to help pave the way for future PAs to work and excel in mental health. I am very passionate about the role and how we can support the MDT in providing the best holistic care to patients.