GMC to Regulate Physician & Anaesthesia Associates

Nicky Broyd

July 18, 2019

The four UK government health departments have agreed to ask the General Medical Council (GMC) to regulate physician associates (PAs) and anaesthesia associates (AAs).

Some see it as an important milestone, others are opposed to the plan.

'Important Professions'

The role of physician associate is defined as medically trained, generalist healthcare professionals, who work alongside doctors as part of a multidisciplinary team. PAs can work autonomously with support but have dedicated medical supervisors.  

The role was created to help with doctors' workloads in hospitals and general practice.

Anaesthesia associates used to be known as physicians' assistant (anaesthesia) (PA(A)s). Highly trained, they work as part of anaesthesia teams supervised by a consultant anaesthetist.

England's Health Minister, Stephen Hammond said in a statement: "This is a much needed, positive step forward for these important professions and we have worked closely with our counterparts in Scotland, Wales and Northern Ireland to reach this decision. Professional regulation from the GMC will give associates renewed support to thrive in diverse clinical teams, helping them provide the highest quality care for patients, and to reach their full career potential."

The new regulation framework will still require secondary legislation to be put in place, and work is due to begin with stakeholders.

'Significant Milestone'

GMC Chief Executive Charlie Massey said: "We are pleased the four UK governments have made a decision about who should take this important work forward. We look forward to supporting physician associates and anaesthesia associates to maximise their contribution to the workforce, while ensuring high standards are maintained to meet the needs of patients.

"We are now working closely with the Department of Health and Social Care to determine timescales and costs. We have been clear that costs should not be borne by doctors. In accepting responsibility for regulating these professions, we will also make sure excellence is maintained in education for both doctors and medical associate professionals, so that all trainees receive the time and support they need to learn and provide safe care."

Responding to the announcement, the President of Faculty of Physician Associates (FPA), Jeannie Watkins said: "Today sees another significant milestone for the profession as we learn that the General Medical Council has been chosen as the regulator for physician associates.

"We are delighted the voices of the FPA, the RCP (Royal College of Physicians) and those of our members have been heard. We look forward to working with the GMC, the Department of Health and Social Care and the governments in Wales, Scotland and Northern Ireland and await a final timetable for the regulation process. The road to regulation has been long - now we can focus on ensuring that PAs work to the full scope of their practice, with professional credibility and the corresponding confidence that will give the public."

Professor Donal O'Donoghue, RCP Registrar also "wholeheartedly" welcomed the decision: "Achieving statutory regulation for PAs has been an important policy priority for the RCP and the Faculty of Physician Associates. This will allow PAs to fulfil their potential and continue to support the wider NHS workforce and maintain high standards of patient care. Once regulation has been officially introduced, the next priority for the government should be consulting on prescribing rights for the profession."

The Royal College of Anaesthetists welcomed the announcement regarding anaesthesia associates and said it had been calling for statutory regulation for some years: "We believe this announcement is a very important step towards ensuring anaesthesia associates continue to provide high quality, safe care as part of a multi-professional team, led by a consultant anaesthetist."

Its joint statement with the Association of Anaesthetists, and the Association of Anaesthesia Associates, continued: "We will work to ensure that this role enhancement is undertaken in a structured manner, ensuring patient safety and the highest standards."


Against the Proposal

The British Medical Association is unhappy with the plan. Whilst it supports the decision to regulate PAs and AAs it says it is "fundamentally opposed to the position that the GMC is the right organisation to be their regulator".

BMA Council Chair, Dr Chaand Napgaul, said in a statement: "Given the significant scope of work the GMC currently undertakes in overseeing doctors’ medical education and training, setting professional standards, and acting on concerns, it is vital it should not be diverted from its efforts in this regard. We remain steadfast in our belief that public interest is best served by the continued regulation of doctors through a separate medical regulator.

"In view of today’s announcement however, easily accessible guidance for patients, so that they can understand the different staff roles within the NHS, must now urgently be prepared to ensure they are aware which health care professional is providing their care. The BMA will continue in its efforts with other organisations to produce joint guidance for doctors on how best to work with the other members of the multi-disciplinary medical and clinical team.

"We will now work hard to ensure that the regulation of PAs and AAs is introduced in a way that will not be detrimental to doctors, especially doctors in training. The Government and the GMC must work with doctors to properly assess the educational impact on trainees and supervisors in all care settings where PAs and AAs work."

Editor's Note: This article was updated to include comment from The Royal College of Anaesthetists.


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