GMC can keep calling physician associates ‘medical professionals’, appeals court rules

The BMA has lost in the highest appeals court in its attempt to challenge the GMC’s use of the term ‘medical professionals’ to describe physician associates (PAs). 

A Court of Appeal decision said the term is not defined by or protected in law, and that the GMC’s Good Medical Practice guidance does not encourage PAs to describe themselves as members of the ‘medical profession’.

The court had been considering the High Court’s decision last April to dismiss the BMA’s judicial review claim over the GMC’s use of the ‘medical professionals’ term.

Lord Justice Coulson’s ruling, published last week (20 February), disagreed with the BMA’s argument that using the term as a collective descriptor was a ‘misdirection in law’. 

He identified a ‘number of flaws’ in the union’s argument and asserted that the original High Court judge ‘was right to conclude that the use of that expression in GMP was not a statement of law’. 

Further, Lord Coulson said: ‘There is nothing in GMP that would encourage an associate to say that they were a member of the “medical profession”. … Documents emanating from the GMC make clear that an associate is not and should not be referred to as a member of the “medical profession”.’ 

Having dismissed all parts of ground one of the BMA’s appeal, which had focused on the ‘medical professionals’ term itself, the judge then dismissed ground two, which argued the GMC’s reasoning for using the term was ‘irrational’; and ground three, which argued the BMA were not given sufficient time to submit a judicial review claim form. 

Lord Coulson said in summary: ‘Was the use of the term “medical professionals” by the GMC, accompanied as it was with a clear explanation of what the term encompassed, actionable by the BMA on public law grounds? In my judgment, the instinctive answer to that question is No.’ 

He said the appeal was ‘all about a label’ and that the label was used in guidance that would be ‘read primarily by doctors and associates, who know very well whether they are doctors or associates, and the differences between them’. 

It comes as the future of the PA role continues to be debated following the publication of a major review into the safety and effectiveness of the role last year.

The Leng review, endorsed by the Government, called for actions including revising Good Medical Practice to provide distinct categories for PAs and AAs, updating curricula and training, and formally changing the role names from ‘associate’ to ‘assistant’. 

BMA council chair Dr Tom Dolphin told Pulse the appeal had been the union’s ‘attempt to make the GMC see sense’, describing the ruling as ‘disappointing’. 

He said the continued use of ‘medical professionals’ to cover doctors, PAs and anaesthesia associates (AAs) ‘will still confuse patients and blur the lines between uniquely qualified doctors and their non-medically qualified assistants’. 

‘Last year our legal challenge was rejected on public law grounds – this appeal was our attempt to make the GMC see sense after our other approaches had failed. 

‘The Leng Review has already recommended that the GMC should amend its guidance, Good Medical Practice, to present the standards for assistant roles and doctors separately to reinforce and clarify the differences between them. We urge it to now listen to the overwhelming views of doctors and remove the unnecessary ‘medical professionals’ term when implementing these changes. 

Going forward, Dr Dolphin said the union would ‘continue to push employers, the regulator and system leaders for proper distinctions to be made between the two roles’. 

A spokesperson for the GMC said: ‘We welcome the Court of Appeal judgment, which dismissed in its entirety the BMA’s appeal in respect of our use of the term medical professionals within our core professional standards – Good Medical Practice. 

‘We regret the matter came to this and are grateful for the clarity the court has provided on the issue. We hope today’s judgment brings finality to the matter.’ 

GMC chief executive Charlie Massey told MPs last month he was ‘absolutely confident’ the regulator would deliver all the Leng review’s recommendations by the end of 2026. 

One of Professor Leng’s recommendations for the GMC is to ‘revise the text in Good Medical Practice to provide distinct categories for PAs and AAs. 

Last year, the BMA supported a separate legal case against the GMC over the regulator’s refusal to set an official scope of practice for PAs, but this was also dismissed on all grounds.