Introduction

St Mary’s Hospital (SMH), Manchester, is home to one of the busiest neonatal units in the UK, with 69 cots providing all levels of neonatal care. As a tertiary referral centre for surgical, cardiac and specialist medical babies in the North West, there is a wide range of activity with many babies requiring complex care. There is therefore a need for a comprehensive and consistent workforce providing high-quality care.

This neonatal intensive care unit (NICU) has benefited from having a blended workforce of what would traditionally have been considered medical rotas, with trainee and locally appointed doctors working on tiers 1 and 2, advanced neonatal nurse practitioners working on tier 1 and band 6 enhanced neonatal nurse practitioners working in high-dependency unit (HDU) and special care (SCBU). However, rota gaps, less than full-time training and recruitment challenges led to understaffed rotas, while nurses choosing to become nurse practitioners meant losing experienced cot-side neonatal nurses.

We are aware that not many neonatal units are familiar with how physician associates (PAs) may complement the workforce. This paper sets out to describe the benefits, limitations and practical tips for those wishing to expand their workforce similarly.