Renaming physician associates to ‘assistants’ will require legislation

Exclusive Formal renaming of physician associates (PAs) will require legislation for which work is ‘already underway’, the Leng review team has confirmed.

The review into the safety and effectiveness of the roles – which was published last month and whose recommendations were accepted in full by the Government – 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.  

The review said that the Government should ‘immediately’ implement a name change to assistant from associate, so this ‘becomes custom and practice’ although legislative changes ‘will obviously be subject to Parliamentary time’.

The team leading the review has now confirmed to Pulse that the legislative amendments to formally rename PAs will require public consultation and parliamentary consideration in both houses of the Westminster Parliament and the Scottish Parliament, and that work for this is already underway.

The legislation will be part of a forthcoming GMC order, and stakeholders and the public, including PAs and their representatives and unions, will be invited to provide their view on all changes being made as part of the order.

A spokesperson for the Leng review team told Pulse: ‘Any formal renaming of PAs and PAAs would require legislation, for which work is already underway.

‘This will be undertaken within the forthcoming GMC Order, which is part of a planned programme of reform to modernise the regulation of healthcare professionals across the UK.

‘These legislative amendments will require public consultation and parliamentary consideration in both houses of the Westminster Parliament and the Scottish Parliament.

‘Stakeholders and the public, including PAs, PAAs, and their representatives and unions, will be invited to provide their view on all changes being made as part of the GMC Order. 

‘The Government will conscientiously consider all responses to the consultation on the draft GMC Order and will publish a consultation response once the consultation has finished.’

Pulse has contacted the GMC for comment.

It is unclear whether any other parts of recommendations will require legislative change. So far, using powers under the Health Act 1999, the Government introduced secondary legislation via the Anaesthesia Associates and Physician Associates Order 2024 to provide for the regulation of PAs and AAs by the GMC.

PAs are not legally required to register until December 2026, and this transition period was specified in legislation and designed to allow PAs to complete the ‘necessary steps’ for registration while continuing to work.

GP practices were asked by NHS England to take ‘immediate actions’ implement the changes recommended by the review, but last month an NHS England document appeared to water down these actions, saying that any changes are contingent on ‘local change management policies’, employment law and discussions with trade unions.

Last month, NHS England failed to change PA role descriptions in the new PCN DES specification, and the document continued to refer to ‘physician associates’ and stating PAs employed under additional roles reimbursement scheme (ARRS) could ‘provide first point of contact care for patients presenting with undifferentiated, undiagnosed problems’.

According to the trade union for PAs, UMAPs, the failure to change the specification was a result of a legal case UMAPs has brought against NHS England over implementing the review.

UMAPS had also requested interim injunction to stop NHS England issuing instructions to organisations on implementing the review’s recommendations while a judicial review is ongoing, but this was refused.