Canada In Canada there are four "allied primary health practitioners" identified under the
National Occupational Classification (NOC) section 3124:
physician assistant,
nurse practitioner,
midwife, and
anesthesiologist assistant. Nurse practitioners are permitted to provide several, but not all, of the health care services physicians provide.
India In 2016, a new mid-level healthcare provider role was introduced in India(Dealing With modern Medicine), known as Community Health Officer (CHO) or Nurse Practitioner, Physician Associate/Assistant. The role was intended to support the community-level Health and Wellness Centres in India.
Community Health Officers (CHOs) and Physician Associate/Assistant (PA), also called
Mid Level Health Providers (MLHPs) and
non-physician practitioners(Physician Associate/Assistant), are trained in Health Sciences model who have a defined scope of modern medicine practice. In
India,
Nursing,
AYUSH and Healthcare Professionals (Healthcare profession like Physiotherapy, Physician Assistant/Associate, Optometrist Etc. prescribed in NCAHP ACT 2021, NCAHP,MOHFW, Government of India)are eligible for this cadre. This means that they are trained in Modern Health Sciences model and legally permitted to provide healthcare in fewer situations than physicians but more than other
health professionals. In India, Community Health Officer or Nurse practitioner, Physician Associate/Assistant are other names for mid-level practitioner. Apart from doctor and nurses there was a list of Healthcare providers as recently
NCAHP,Ministry of Health and Family Welfare published Guideline in Ayusman Bharat digital Health Mission control of health related cases in rural areas of India. According to these guidelines, symptomatic cases can be triaged at village level by tele-consultation with a Physician Associate/Assistant or a Community Health Officer (CHO).
South Africa In 2008, a new mid-level practitioner role was introduced in South Africa, known as
clinical associates. The role was intended to support the district hospital workforce.
United Kingdom Mid-level practitioners in the UK are known as
Advanced Clinical Practitioners (ACP) or
Advanced Practitioners (AP) and occurred as an evolution of many differing professions which use various titles such as 'Extended Scope Practitioner'. Historically there has been debate over the consistency of quality in these senior clinicians and therefore it became necessary to generate a distinguished definition of the ACP role. The ACP: • Is a registered healthcare practitioner with a minimum of 5 years clinical experience (2 years in a senior clinical role) • Has acquired expert knowledge and complex decision-making skills which may be an extension of their traditional scope of practice • Will undertake a two-year level 7 (
Master's degree) training course in Advanced Practice • Will maintain training and CPD requirements ACPs may practice in the acute setting (ED, critical care, etc.) or community
General Practice / Family Medicine. The majority can independently assess, investigate (through blood tests / imaging etc.), diagnose and formulate a treatment plan including prescribing medications or referring to specialist care. The deployment of ACPs is considered to be part of a Value Based Recruitment framework driven by Health Education England (HEE). This seeks to appoint clinicians based upon their competencies, values and behaviours in support of collaborative working and delivering excellent patient care. Some health professionals considered mid-level practitioners by the United States DEA include: •
Ambulance services •
Animal shelters • Certified
chiropractors •
Doctors of Oriental Medicine •
Euthanasia technicians •
Homeopathic physicians •
Medical psychologists •
Naturopathic physicians •
Nurse practitioners (including
nurse midwives,
nurse anesthetists, and
clinical nurse specialists) •
Optometrists •
Physician assistants • Registered
pharmacists ==See also==