High Court dismisses PA union’s legal challenge over Leng recommendations

A legal challenge against the Government’s implementation of the Leng review into the role of physician associates (PAs) has been dismissed by the High Court.

PA trade union United Medical Associate Professionals (UMAPs) was refused permission on all grounds to apply for a judicial review into the legal basis for implementing the Leng review.

The review, published a year ago, found that PAs should be renamed ‘assistants’, should not see undifferentiated patients outside of clearly determined protocols, and that they should have at least two years’ training in secondary care before being allowed to practise in primary care. Its recommendations were accepted in full by the Government.

Mr Justice MacDonald said in his decision that it was ‘clear’ the Leng review had been ‘produced as the result of a sophisticated and independent exercise of judgement’.

Among the arguments for a judicial review, which were dismissed, he said the contention that Professor Leng made her recommendations ‘primarily driven by, or for, the purpose of appeasing or addressing grievances of specific groups’ including the BMA was ‘a bare allegation of bad faith that is unevidenced’.

NHS England, the health secretary, and Professor Gillian Leng herself had been named as defendants in the case, while the BMA was an ‘interested party’.

BMA deputy chair of council Dr Emma Runswick said: ‘Every ground UMAPs brought was found to be unarguable. Importantly, the allegation that the Leng Review was somehow designed to appease the BMA and its resident doctor members was rightly found to be baseless.

‘The recommendations, while limited, were an attempt to protect patient safety. Trying to stop the implementation of safety measures on unevidenced accusations was always going to fail.

‘Government must now go further and faster to make sure patients are seen by the right staff, and specifically that physician assistants are prohibited from seeing undifferentiated patients. We will continue to ensure that the steps taken to implement the Leng recommendations are rooted in patient safety.’

UMAPs general secretary Stephen Nash said: ‘This High Court decision was taken on the papers, without a hearing or oral argument and without our members ever having their case put in open court without full consideration of all available evidence.

‘Together with our legal team, we are exploring the options available to apply for reconsideration of the decision.

‘The decision, if allowed to stand, makes clear that it will be employers, in the employment courts, that will be left carrying the burden of the decision to adopt Leng’s recommendations.’

A Department of Health and Social Care spokesperson told Pulse: ‘We welcome the Court’s decision. Our focus remains on implementing the Leng Review’s recommendations in partnership with stakeholders, ensuring the best possible outcomes for patients.’

Earlier this year, the chairs of the BMA’s national councils wrote to their respective Governments criticising inaction on implementing the Leng review.

The Government is currently consulting the public on draft legislation which would formally rename the ‘associate’ role to ‘assistant’ and make it a protected title in law.