The GMC has confirmed that regulation of physician associates (PAs) will begin on 13 December, but registration will not be legally required for another two years.
Chief executive Charlie Massey wrote to royal colleges and NHS organisations yesterday to lay out ‘key upcoming milestones’, confirming that the regulator will publish responses to its consultation on PA regulation, which ran until May this year, ‘before the start of regulation’ in December.
PAs and anaesthesia associates (AAs) will be able to register from 16 December, with a ‘small number’ invited to do so by the end of 2024, and the remaining PAs from the voluntary register invited by the end of January 2025.
The legislation for PA regulation sets out a ‘two-year transition period’ during which registration with the GMC is optional, in order to ‘allow PAs and AAs to complete the necessary steps for registration while continuing to work’, according to the letter.
‘While PAs and AAs aren’t legally required to register until December 2026, we’ll encourage everyone currently practising in the UK to apply as soon as possible and we’ll work directly with employers to promote early registration,’ Mr Massey said.
Since mandatory registration does not come into force until the end of 2026, if a concern is raised about a PA who is not yet registered, the GMC will be unable to investigate.
Mr Massey said: ‘During the initial phase of regulation, we’re aware that we may receive concerns about PAs and AAs who are not yet registered with us.
‘While we can’t take action in those cases, we’ll log the information for future reference and, where appropriate, refer concerns to employers or relevant bodies who may be able to take action in the interim.’
From December this year, the GMC will set the standards for education and training of PAs, and will ‘approve courses and curricula’ to ensure PAs ‘work safely’ once they qualify.
This means the regulator will carry out ‘quality assurance checks’ of PA courses, and is also in the process of finalising course standards and curricula for PAs with the Royal College of Physicians and the Faculty of Physician Associates.
The letter also stated that PAs who are registered with the GMC will be required to follow Good Medical Practice, the same set of standards doctors are required to meet.
On revalidation, Mr Massey said the regulator is ‘developing’ a model and will need to ‘consult’ on the rules before revalidation dates are set.
Earlier this year, the GMC ran a public consultation on the proposed rules and standards for PA regulation, but stressed that it will not determine a ‘scope of practice’ for how PAs work beyond initial qualification competencies.
Mr Massey said the regulator is ‘analysing the responses’ and will publish a ‘detailed report’ in December.
He added: ‘The report will include quantitative data for each question we asked, showing the range of responses to our proposals.
‘It’ll explain how the feedback, along with insights from research we conducted with members of the public, has shaped our final rules, standards, and guidance. We’ll publish these once they’ve been approved by our governing Council in December.’
The GMC is currently facing the threat of legal challenge from doctors’ groups over its regulation of PAs, with Anaesthetists United fundraising for a case which calls for ‘clear and enforceable guidance’ on what PAs ‘can and cannot do’.
This week, the BMA – which is also bringing a separate judicial review claim against the GMC over PAs – confirmed that it will financially support Anaesthetists United’s legal case.
On Wednesday, the RCGP set out a clear scope for PAs which severely limits their current practice by stipulating that they must not see un-triaged patients, and are best suited for seeing the same seven minor illnesses captured by Pharmacy First.
The RCGP cannot enforce this guidance, but they advised GPs that it could be taken into account by NHS Resolution and the medical defence organisations in any case of alleged negligence.
What an extraordinary and entirely avoidable mess this has become – due mostly to woolly-thinking and poor leadership.
The Colleges have colluded in all this, then eventually remembered what they are for when it is far too late.
The GMC has lost its organisational mind, and needs a complete re-boot.
PAs should have their own regulator, and their roles restricted to supervised positions in hospitals (and not filling any gaps in the doctors’ rotas, especially not at middle grade). If any one of them wants to practice as a doctor (including prescribing rights), that’s great, they should be encouraged to train as a doctor. Perhaps they should receive preferential entry onto graduate schemes – perhaps even with funding.
Agree with Darren Tymens.
So, little or nothing for patient safety and unclear on scope for another 2yrs?
Following the death of Emily Chesterton and coroners’ cases, it is currently clear that there is no accountability for PA errors short of recourse to the legal system.
“…where appropriate, refer concerns to employers or relevant bodies who may be able to take action in the interim.’”
Which “relevant bodies” and to what effect? Or do we just cross our fingers, ignore the dangers, and pretend that the gulf of risks to patients that we now know exists continues to dissemble by the likes of Lords Bethell and (?)Darzi?
Uk healthcare is ridiculous. Working overseas it becomes increasingly easier to see the political destruction of doctors. I’ll not be coming back to work in UK ever.
The only person at risk are the GP partners or the Clinical directors of the PCN who employ them. They carry all the risk when things go wrong, now more so with the need to supervise every patient before they leave room. Employ them at your peril.
As stated in other comments, the GMC is wholly inappropriate as the regulator of PAs in my view as the HCPC already exists.
The common factor binding the GMC and PCNs/ PCN CDs is of course greed in my view and PA money tree whether it be by subscriptions or increased profits for PCN CDs and practices employing them despite all the concerns being raised.
The GMC is of course expert at producing moral codes and preaching about probity etc. but perhaps it should take a protracted hard look at its own moral compass as should PCN CDs.
@CC I think you have a serious misunderstanding about the role of a PCN CD and the functions of PCN’s generally, and it’s quite embarrassing to hear you repeating ad nauseam something which bears no relation to the real world. One of the biggest reasons why General Practice is currently in such a mess is because a lot of funding has been put into PCN’s and has to be spent and accounted for by the PCN, instead of going directly into practices. There’s no vast profits, only extra work for very little real money, most of the money being spent in completely the wrong areas. It’s NHS micro-management on a grand scale and the only people making money are NHS managers. I’m not defending PCN’s per se, only saying that they were and are currently the only game in town.
As a former CD for five years I can confirm I was paid a fixed salary, laid down in the regulations, and made zero profits. And did far more work than I was paid for….
If most of the money is being spent in completely the wrong areas then someone or some enabling vehicle must be choosing or allowing this to happen and PCNs and PCN CDs are not forced to do so and could choose to decline which has in fact happened. There are obviously consequences and that is also a choice or not. I do of course however fully accept the point that many PCNs work well and many PCN CDs also work well in the same way that many do not as there has always been a greater problem in certain areas or certain demographics even prior to PCNs.
Start again -ask the HCPC to regulate PAs with their own framework -which they apparantly were happy to do. This would create a clear divide and give them professional independance from doctors.
Also agree with Darren. This timescale is extraordinarily long!
I had to register within I think 6 weeks.
This deadline is not THIS year, it is not even NEXT year, it is the very end of the year AFTER.
That is far too long to leave any healthcare practitioner unregulated !