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BMA to take legal action against GMC over PA regulation

BMA to take legal action against GMC over PA regulation

The BMA has announced it is taking legal action against the GMC over the way in which it plans to regulate physician associates (PAs).

The union said that the plans will mean ‘dangerous blurring of lines’ for patients between ‘highly-skilled and experienced’ doctors and assistant roles.

It also added that the GMC has been using the term ‘medical professionals’ in its materials to ‘describe all of its future registrants’, including both doctors and associates.

​Now the BMA is launching a judicial review claim against the GMC over its use of this term, which it said ‘should only ever be used to refer to qualified doctors’.

BMA council chair Professor Philip Banfield announced the legal action at the union’s Annual Representative Meeting (ARM) in Belfast this morning.

He said: ‘PAs are not doctors, and we have seen the tragic consequences of what happens when this is not made clear to patients.

‘Everyone has the right to know who the healthcare professional they are seeing is and what they are qualified to do – and crucially, not to do.

​’Doctors are “the medical profession”. To describe any other staff as medical professionals not only undermines doctors and the rigorous training journey they have been on, but also confuses patients, who rightly associate the two terms as one and the same.

​’The central and solemn responsibility of the GMC is to protect the public from those who are not registered qualified doctors, pretending to be doctors.’

The BMA also added that the GMC is ‘not the right organisation’ to regulate PAs and that by choosing the GMC as the regulator for PAs and anaesthesia associates (AAs), the Government is ‘undermining and devaluing the medical profession’ and ‘confusing patients’.

A letter sent to the GMC as part of the pre-action protocol mentioned the case of Emily Chesterton, who died in November 2022 after suffering a pulmonary embolism and who had been seen by a PA on two occasions but ‘believed the person diagnosing her was a GP’.

It also mentioned the marketing campaign ‘It’s a GP Practice Thing’ as an example of the ‘current lack of understanding within the NHS’ around the associate roles.

The campaign was criticised by doctors as it used ‘dangerous’ posters which referred to PAs working in GP practices as ‘physicians’. 

The letter pointed out that the use of the professional title ‘physician’ is amongst those ‘protected’ by section 49(1) of the Medical Act 1983, and that ‘its misuse can constitute a criminal offence’.

Details of the legal action

  • The BMA seeks to challenge the GMC’s decision to apply its long-established central guidance for doctors – Good Medical Practice (GMP) (the most recent version of which was published on 22 August 2023 and came into effect on 30 January 2024) – equally to PAs/AAs once they are regulated by the GMC as of 13 December 2024.
  • The BMA also challenges the continued use of the term “medical professionals” by the GMC in this context as a collective description for doctors and PAs/ AAs – and, specifically, repeatedly within the GMP text – on the basis that inclusion of PAs and AAs within the term “medical professionals” is liable to confuse patients and the broader public and blur the important distinction between medical practitioners (i.e. doctors) and associate professionals which, in turn, gives rise to serious public protection concerns.
  • Both of these issues are particularly concerning against the backdrop of: a continued absence of any nationally agreed scope of practice guidance for PAs/AAs; continuing public safety concerns connected with the same; and the broad nature of the standards for education and training for PAs/ AAs drawn up by the GMC in its latest consultation launched on 26 March 2024 Regulating anaesthesia associates and physician associates – consultation on our proposed rules, standards and guidance.

Source: BMA letter to the GMC

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.

Anaesthetists United co-founder Dr Richard Marks said: ‘Doctors and their patients are united over their opposition to the outgoing government’s plans for replacing doctors with Associates. Taking legal action seems to be the only way forward.’

A GMC spokesperson said: ‘In 2019 the General Medical Council was asked by the four UK governments to take on regulation of PAs and AAs.

‘Earlier this year legislation introducing the regulation of PAs and AAs was passed by the UK and Scottish Parliaments. This means that we will start to regulate PAs and AAs from the end of the year. Regulation will help to assure patients, colleagues and employers that PAs and AAs are safe to practise and can be held to account if serious concerns are raised.

‘As a multi-professional regulator, we will recognise and regulate doctors, PAs and AAs as three distinct professions. PAs and AAs don’t have the same knowledge, skills and expertise as doctors. They are not doctors but they can, and do, play important roles within multidisciplinary teams when appropriate and effective clinical governance and supervision are in place.

‘We know from several years of ongoing engagement with patients and the public, doctors and stakeholders that they do expect PAs and AAs will, like doctors, work to high professional standards. We will continue to work with patients, professionals, Royal Colleges, the BMA and others towards the delivery of safe and effective regulation for these groups.

‘We note the BMA’s correspondence on a range of issues and further note that no legal proceedings have been issued at this stage.’ 

Earlier this year, Pulse reported that the DAUK was also considering a legal challenge of the PA regulation plans.

It comes after the RCGP urged GP practices across the UK to ‘halt’ recruitment of PAs until the profession is regulated later this year.

Last week, the shadow health secretary said that GP concerns around the role of physician associates (PAs) need to be ‘seriously’ addressed.

And Pulse’s major investigation on the rise of PAs found evidence that practices are in part recruiting PAs instead of GPs, with cost being the driving factor. 



Please note, only GPs are permitted to add comments to articles

SUBHASH BHATT 24 June, 2024 12:53 pm

Pointless legal expense. So far as it is made clear that they are not doctors and are health care professionals , it is ok.

Nick Mann 24 June, 2024 12:56 pm

That we’ve come to this is a genuinely scary example of political policy having corrupted the professsions. Following legal action, I think there needs to be a very deep dive into the why and the how. The disregard for patient safety is stark, obvious, but pursued through the looking glass nevertheless.

David Tulloch 24 June, 2024 1:31 pm

Sad that it has come to this. It is in my mind appropriate. My only regret is that the GMC will fund their defence by utilising their members’subscritions which is more than ironic!

Mark Howson 24 June, 2024 4:17 pm

The legally protected term is registered medical practitioner. The GMC has replied in the BMJ explaining it considers medical professional ok to use. Unfortunately legally if you call yourself a doctor or a medical professional and the patient thinks you are a registered medical practitioner you have committed a criminal offence. Chiropractors use this confusion all the time. It is dishonest of the GMC and the confusion it leads reflects on the GMC acting criminal under the laws it is supposed to uphold to protect patients. They do have a prima facie case to answer.

Monkey Typing 24 June, 2024 6:18 pm

Go for it. The GMC is a national institution of importance to the well being of whole population. Over a considerable period if time it has become corrupted by political interference. In a democracy the primary protector of the population from political corruption is the law. That is what the law is for and this is a good example of where it should be used.

Krishna Malladi 24 June, 2024 10:33 pm

“In 2019 the General Medical Council was asked by the four UK governments to take on regulation of PAs and AAs.”
You could have said no. You were asked, not forced.

Alexis Alexis 25 June, 2024 3:16 pm

The GMC’s fundamental role is to protect the public from unqualified people offering medical treatment. Ironic that they are instead facilitating it.

M A A Khan 27 June, 2024 9:04 am

The Faculty of Physician Associates website states that the term Physician Associate/ Assistant is NOT a protected title- phlebotomists etc can be called PAs. They also state if IMG doctors ( or GP locums) want to do a PA job, they must retrain to do so. Also they state a PA is NOT an allied health professional or advanced care practioner ie they are medical associates health professionals .

Saibal De 27 June, 2024 12:52 pm

Tomato, potato. The GMC are not naive enough to presume that playing around with the form of words is going to make it crystal clear to the public that medical professionals are not doctors simply because they aren’t using the protected title of registered medical practitioner. If I wasn’t in the industry myself I would not be aware of this either. It’s deeply disingenuous snd an obvious exampke of trying to be seen to follow the law in letter and not spirit. Shame on the bastards led by Charlie.