BMA criticises slow Leng implementation and calls for immediate PA scope restrictions
The chairs of the BMA’s national councils have written to their respective Governments criticising inaction on implementing changes around physician associates (PAs) recommended in last year’s Leng Review.
In the letter addressed to each UK nation’s health secretary, the council chairs called for ‘immediate adoption’ of the BMA’s PA scope of practice while measures like name changes are being developed.
The letter noted that despite Professor Gillian Leng publishing her review into the safety and effectiveness of the role last July, ‘most of her recommendations remain unfulfilled’.
The Leng review did not set a scope of practice for PAs, although it did suggest suitable tasks for newly-qualified PAs and it backed BMA and RCGP scopes which had said PAs should not see undifferentiated patients.
The BMA’s letter said patients will ‘find it hard to know whether they have seen a doctor or not’.
And it added: ‘The BMA response to Prof. Leng’s Review last July noted that it failed to capture the urgency of the moment, and we are sorely disappointed to have been found correct.
‘There has been no production of national scopes of practice, no protections for patients to ensure that PAs and AAs are not seeing undifferentiated patients, and no move to ensure that local employers can no longer choose to employ their assistants in unsafe ways. Today, like back in July 2025, parents like those of Emily Chesterton have no new guarantee that their loved one is seeing a qualified doctor when they should be.’
‘We are once again calling for the immediate adoption of the BMA’s safe scope of practice guidance as an interim measure whilst any Royal College scopes are produced, and while other changes, such as the name changes, uniform changes, and formal certification and credentialing programmes are developed.’
Both the BMA and RCGP published scopes of practice for PAs in 2024 which severely limited their roles, including that they should never see ‘undifferentiated’ patients.
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.
Pulse has contacted the Department of Health and Social Care for comment.
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READERS' COMMENTS [3]
Please note, only GPs are permitted to add comments to articles
Really! PAs and nurses are seeing patients now as doctors are on strike. Dr’s are waving scapegoating placards outside a pitiful few hospitals for an hour or so then sunning themselves or working a locum at triple rates. Our patients are at huge risk as a result are they not? Did Professor Leng ask doctors organisations to peruse/amend the review findings before publishing but did not ask PAs as recently reported?( UMAPs website). If true then Leng review is not independent and legally built on sand. Mr Streeting should be thanking our PAs and nurses who are keeping our NHS going today and the BMA committees should all resign- they are ruining doctors reputations forever when compromise and cool heads are needed.
Really Shaun? Don’t really follow your argument here. talking about the impending strike is not relevant to the point. Drs are going on strike for pay restoration (we may agree or disagree about the timing of this) and NHS managers are trying to replace Drs with cheaper, less safe alternatives. Asking for the Leng review recommendations to be implemented after a year is hardly unreasonable. how long should you wait?
The argument is the Leng review is really the BMAs review if reports are correct…so it is invalid and I suspect the NHS is delaying any implementation because legally they will be taken to the cleaners. Your comments about ‘cheaper, less safe alternatives’ is also invalid. Despite the rush to find out how awful PAs care is there was no evidence to substantiate this despite Professor Leng searching high and BMA low ( ‘Physician Associates are not unsafe’- so they are safe then). Perhaps we should now look at how unsafe early years resident doctors are for fairness?- I know I made mistakes, fortunately I had experienced NHS colleagues( doctors, nurses and others) supporting me through the early years learning.