More than 250 physician associates (PAs) and anaesthesia associates (AAs) have now been granted a registration by the General Medical Council (GMC), with a further 3,000 applications in progress.
The news, announced by the GMC, comes as a High Court challenge from the BMA over its regulation approach began today.
A hearing was held at the Royal Courts of Justice on the Strand in London, where lawyers for the BMA argued that the GMC’s approach to the regulation is ‘unlawful’, ‘undermining’ its statutory functions and ‘contravening’ requirements imposed by legislation.
The BMA is also challenging the GMC over its use of the term ‘medical professionals’ in relation to PAs and AAs, arguing that it should be used ‘only to refer to qualified doctors’.
The BMA has argued that this risks ‘blurring the line’ between doctors and non-doctors.
Today’s hearing will determine whether the BMA should be granted permission to apply for judicial review and, if such permission is granted, to allow for substantive determination of the claim.
BMA lawyers argued that PAs and AAs are ‘neither doctors nor medically qualified’, with the distinction ‘crucial’ to patient safety, and that a refusal to make a ‘clear’ distinction between associates and doctors will ‘undermine’ public confidence in the NHS.
BMA council chair Professor Phil Banfield said that the description of PAs as ‘medical professionals’ is not just ‘a semantic disagreement’ between the union and the GMC.
He said: ‘It goes to the core of its failure as a regulator. Its job is to reassure the public that there is a clear difference between who is and who is not a doctor.
‘Now that it is a regulator both of doctors and non-doctors, that job has become even more crucial, and its failure to distinguish between them even less forgivable.
‘Put simply, associates are not medical professionals. Doctors are. The NHS is a complex enough system as it is and if the GMC’s regulatory approach is to further confuse patients by blurring the lines between the two, it only undermines public confidence in the healthcare they receive.’
The hearing will continue tomorrow and Pulse understands that the ruling is expected to take several weeks.
The GMC said that term ‘medical professionals’ is not a ‘protected’ title, and it is an ‘appropriate way’ to describe all the professional groups regulated by them.
A GMC spokesperson said: ‘We have made it very clear we will recognise and regulate doctors, PAs and AAs as three distinct professions.
‘We have been consistent in saying that PAs and AAs must clearly communicate who they are, and their role in the team. We also expect them to always work under supervision and to practise within their competence.
‘The registers on our website are clearly marked, so as to distinguish between the three professions we regulate.
‘A prefix is used for PA and AA reference numbers, which provides a clear distinction between those two professions and doctors.
‘In addition, each profession type is prominently labelled on our public-facing registers, and in search functions. This means that when patients search our registers it will be very clear whether an individual is a doctor, a PA or an AA.
‘In preparedness for regulating PAs and AAs, we extensively and formally consulted with the BMA. From as early as 2021 we made the BMA and others aware of our intention to apply our core professional standards to doctors, PAs and AAs, and received no objections from them at all.
‘The term ‘medical professionals’ is not a protected title, and it is an appropriate way to describe all the professional groups we now regulate.’
It will become an offence to practise as a PA or AA in the UK without GMC registration from December 2026.
The GMC has invited PAs and AAs who are on the voluntary registers to apply for formal registration in a phased approach throughout December and January, and the GMC is also taking applications from newly-qualified PAs.
GMC director of registration and revalidation Una Lane said: ‘For many PAs and AAs, regulation coming into effect in December was a long-awaited milestone. For us too, it was an important landmark that we had been working towards for a long time.
‘We’re pleased to have reached this point, and that many of the first regulated PAs and AAs have given us positive feedback about their experience of the process. We look forward to helping many more achieve registration in the months to come.’
Alongside the BMA, Anaesthetists United, an independent group of grassroots anaesthetists, are planning separate but ‘complementary’ legal action, relating to the lack of any national regulation of scope of practice for PAs and AAs.
A High Court judge granted the group ‘permission’ to proceed to judicial review last month, and also ruled that the case should be ‘expedited’, with a hearing taking place on 13 May.
A Government-commissioned review into the safety of physician associates is currently looking at scope of practice, including if and when an ‘enhanced’ scope might be appropriate.
Last month, the RCGP declared that there is ‘no role’ for PAs in general practice, in its evidence to the review.
Obviously the GMC are not interested in patient safety. Like the CQC, a government controlled body tasked with punching down on GPs while dancing to the DoH tune.
I didnt know Alcoholics Anonymous worked in NHS
The key line in this article is GMC asked doctors years ago for comments and absolutely no objections. That’s why PAs have been trained at great expense to them for years now. We, doctors , will be seen by the public as conservative, self interested, arrogant naysayers. Turn on the BBC and look at the patients on corridors,most elderly , then think who is going to look after them in future if not PAs and nurse practitioners helping doctors. That is the reality and BMA have been hijacked by some younger doctors and cooler heads need to surface now to defuse and seek compromise.
Shortened sub-standard training and we need to cover them and take the legal risks? No thanks.
Shaun Meehan, the ‘key line’ you reference is entirely disingenuous.
All it says is “we made the BMA and others aware of our intention to apply our core professional standards to doctors, PAs and AAs,”
core
standards
For doctors to object to minimum accepted standards of behaviour would seem to be a nonsense, being neither in the interests of patients nor doctors.
This comment by the GMC is an irrelevance that strikingly addresses nothing of the substance of the BMA’s actual present day case (see Banfield), and should be taken for what it is: evasive drivel so as to distract from the GMC’s inability to produce a well reasoned defence of the GMCs fundamentally flawed internal logic that the BMA are challenging.
Just a GP- …
But doctor our organisations ( BMA/ RCGP and RCP if you a member) contributed and agreed Physician Associate university training outcomes and working limits from before 2016 without any objections-that is the key plus their refusal to complain in 2021. The U- turn came when the much delayed GMC regulation became imminent and junior doctors were striking- coincidence- I think not. So lots of PAs have been trained at their own cost( not a student loan) and committed to helping patients as fellow health professionals. Perhaps you can respond to my key point-who will look after me when I am 80 please and the other massive numbers of over 80s ahead? The public will see through this awful scapegoating as doctor mistakes- there are so many as you know- are highlighted in defence of PAs who may make far fewer in proportion. Then doctors will have to face the same unbearable scrutiny that PAs face today. Do you want that pressure in your career? Calmer more experienced heads should see this and keep Pandora’s box closed. Doctors, nurses, PAs and others must find the way to work in harmony or we become USA where lawyers thrive and healthcare costs twice as much with half the population having no care at all.