with Community Health Officer (CHO), and cases with comorbidity or low oxygen saturation should be sent to higher centres. Mid-level practitioner in 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. Mid-level practitioner in 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 This is an emerging role and is showing a good deal of promise in meeting the demands of the UK's rapidly evolving healthcare 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. Physician Associates Physician Associates (PAs) practising in the United Kingdom is the equivalent title to physician assistant, these clinicians are described as "dependent practitioners", meaning that they require supervision at all times by a physician. They cannot prescribe medications. Mid-level practitioner in United States In the United States, mid-level practitioners are health care workers with training less than that of a physician but greater than that of nurses or medical assistants. The term mid-level practitioner or mid-level provider is related to the occupational closure of healthcare. This concept centered around physicians as the ultimate professional responsible for healthcare. As healthcare demands have increased in the United States due to an aging