A day in the life: Working as a Physician Associate at Alder Hey

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By Gabriella Tait, Paediatric Physician Associate at Alder Hey Children’s NHS Foundation Trust

I was the first paediatric Physician Associate (PA) to be employed by Alder Hey Children’s Hospital in April 2019 and the first PA in the country to work in paediatric safeguarding.

A year later, Alder Hey now has the largest cohort of paediatric PAs in the country and is the only trust pioneering a paediatric PA training scheme of this size and calibre. The cohort is set to establish core paediatric skills for 12 months before entering sub-specialist roles in tertiary services.

I am the lead PA at Alder Hey and this entails championing and developing the PA role, facilitating personal and professional development, overseeing a journal club and a newsletter, pioneering health promotion and quality improvement projects; all whilst continuing with my role in safeguarding.

I completely fell for paediatrics from my first lecture at university and again for safeguarding during my elective placement at Alder Hey Children’s Hospital. I now work alongside the consultant who actually gave that lecture, who is now my educational supervisor and PA programme lead for the hospital.

My undergraduate degree is in physiology, after which I spent five years working in law, always seeking out the more medical and detective elements of defending cases. My career choices thus far have proved translatable and beneficial for my dream job in paediatric safeguarding.

Here’s my week in the life as a paediatric Safeguarding PA:

Mondays start with prepping notes on my completed child protection medical assessments from the previous week to present to the medical team in our weekly peer review meeting. This is my favourite part of my week and I love the debate and demonstrations of expert knowledge that working in our department entails. This is followed by protected teaching time, then implementing agreed actions from peer review. The afternoon typically involves arranged reflective practice, prepping time for teaching, writing reports and providing supervision and pastoral support for the PAs.

Tuesdays are often spent on the first on-call rota. I see any child protection referral that comes in on this day and I can see up to five cases in a day. These range from cases of neglect and physical assault to child sexual assault; assisting with STI testing and forensic swabs to abusive head trauma. I perform a top to toe medical as well as systems examination, take detailed histories. I interpret the findings from examination and formulate an opinion on the injuries to make recommendations with social care, as part of the medical team, including support from the safeguarding on call consultant. Following this, I write a comprehensive report for use by social care, police and presented as evidence to the courts.

Wednesdays I can be found reviewing and formulating an opinion on any medical contraindications on Adult Health Reports for fostering applications and converting Initial Health Assessments for adoption processes. Although not seeing these children face to face, I am able to provide detailed healthcare plans for these children who are often deprived of resources by reviewing and including all relevant information. I also attend lunchtime teaching to keep up with my general paediatric knowledge and skills.

Thursdays are clinic days where I see children for an Initial Health Assessment. These are set clinics for children who are new into the care system. Similar to the assessments above, I perform a top to toe health check and take a detailed life history before writing the reports within a tight deadline and making referrals for any identified health concerns. Examining neonates with their foster carers is a highlight of my working week and something which I continue to look forward to.

Fridays I am back on the first on-call rota for one of the busier days of child protection medical assessments. If time allows, I assist the on-call Consultant with ward cases, taking referrals and on one occasion attending the mortuary. Due to my heavy presence on the on-call rota, I can often see a crossover of children and their families with my work with foster carer applications and new into care medicals as inevitably some of these children become looked after by the Local Authority. I therefore am able to provide continuity of care in my department not just to the rotating junior medical team, but also the families and children I see.

Working with children is a privilege and to do so in Alder Hey – a world leading centre, is my dream role. Our PA programme is going from strength to strength and is paving the way for paediatric careers development across the country.

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