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GMC seeks views on plans to regulate physician associates

GMC seeks views on plans to regulate physician associates

The GMC has today launched a consultation seeking views on how it will regulate physician associates (PAs).

The proposed rules and standards, which need to be implemented for PAs from December this year, will also feed into future reform of the rules for doctors.

The regulator has asserted that this consultation will not ‘reopen decisions’ that have already been made, such as whether PAs and anaesthesia associates (AAs) should be regulated by the GMC or whether they have the correct professional title. 

This consultation also excludes any proposals on PAs’ scope of practice.

The GMC said: ‘We won’t determine scope of practice for AAs and PAs beyond initial qualification competencies, just as we don’t determine it for doctors. 

‘We know that NHS England, employer bodies and royal colleges have begun looking at how AA and PA scope of practice may develop over time.’

The consultation covers: 

  • the standards for PA curricula and how the GMC will quality assure education providers;
  • the requirements for inclusion on the GMC register;
  • how concerns will be dealt with;
  • how the GMC will handle appeals and revise decisions; 
  • the process for setting PA registration fees.

Legislation which recently passed through Parliament gives the GMC power to set these standards, and this will ‘act as the basis for reforming the existing legislative framework for doctors’ in the future. 

‘For this reason, we expect that the rules and guidance for AAs and PAs described in this consultation will be broadly similar to those which will be introduced for doctors once the new legislation is laid,’ the GMC said. 

While any proposed changes to guidance for doctors will require a separate consultation, the regulator invited views from doctors now on the ‘clarity, fairness, and proportionality’ of its proposals for PAs. 

The consultation has laid out an approach to PA regulation which is broadly similar to the approach for doctors, however there are some key changes where the rules will diverge. 

On fitness-to-practise proceedings, the regulator has proposed a new ‘accepted outcomes’ process whereby a single case examiner can decide whether a PA’s FTP is impaired and decide on any ‘restrictive outcome’ such as suspension or conditions.

This means that where a PA accepts the outcome decided by the case examiner, they can avoid going to a tribunal. 

The consultation document said: ‘The accepted outcome process has the potential to enable us to take quicker action to protect the public and minimise the number of tribunal hearings that we are required to hold. 

‘Given the adversarial nature of hearings, this will reduce potential stress for associates, complainants, and witnesses who would otherwise need to provide evidence at a hearing.’

Other differences to the current approach for doctors

  • Instead of the Medical Licensing Assessment, PAs seeking to register with the GMC will need to pass the PA registration assessment;

  • Unlike the doctors’ register, the PA register will not include information on gender;

  • Currently, the GMC can indefinitely suspend a doctor’s right to apply for re-entry to the register, but the legislation for PAs does not allow this – the GMC will therefore limit the number of applications that a PA can make to three; 

  • PAs will be automatically removed from the register if convicted of certain offences due their ‘seriousness’ – this is not the case for doctors, where the GMC must still demonstrate that FTP is impaired;

  • The legislation for physician associates does not allow the GMC or tribunals to impose ‘immediate orders’ to protect the public during appeal periods, as is the case with doctors.

BMA recently set out its own ‘scope of practice’ guidance regarding PAs, for doctors who act as supervisors or employers.

Meanwhile, earlier this month, the RCGP changed its stance on the regulation of physician associates after a council vote which argued the GMC is the wrong body to take on the job.

The college also announced that it will begin a consultation ‘in the coming weeks’ to develop new guidance on PAs working in GP settings, including their scope of practice and supervision arrangements.

Also, following a controversial debate at the Royal College of Physicians, which is home to the Faculty of Physician Associates, members voted through a motion calling for a scope of practice.

At the start of the year, NHS England launched a survey on a career framework for physician associates, highlighting that the safety of patients ‘must be paramount’ when choosing to employ them.



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

David Church 26 March, 2024 9:53 am

GMC appears to be proposing several areas of preferential treatment for PAs compared to Doctors.
This discrimination against Doctors would appear to be inappropriate, and I do not see how it could be legal.
1) sex/gender on register; 2) indefinite suspensions; 3) immediate orders; 4) severe differential in post-basic qualification training (and thus expense of same) before being allowed independent practice.
Is the implication that the vast majority of specialist VTS GP training is a complete waste of time? That has been imposed on doctors for many years by the GMC and Royal Colleges? If so, this is quite an insult to fully trained GPs – but then, maybe Government does not want them any more? I can’t wait to see what the Public thinks at the next election.

Centreground Centreground 26 March, 2024 10:57 am

The more pressing question in my opinion is who is going to regulate the GMC and decisions to which many qualified doctors object to – it is a matter of whether the GMC is fit to continue to practice and whether it should be struck off as as the regulatory organisation for doctors and replaced.

The Locum 26 March, 2024 4:25 pm

Leaving this daft country to go medicine in pastures new. 6 weeks and counting.

Truth Finder 27 March, 2024 3:28 pm

The BMA should form a new GMC and take us the dentist way. We have lost faith.