PA union’s High Court bid to pause Leng review changes fails

The physician associate (PA) union’s legal bid to stop NHS England from implementing Leng review recommendations was unsuccessful on Friday.

United Medical Associate Professionals (UMAPs) had requested an interim injunction to stop NHS England issuing instructions to organisations on implementing the PA review’s recommendations while a judicial review is ongoing.

But at the hearing, heard at the Royal Courts of Justice on Friday (15 August), Mr Justice Dove refused to grant the injunction.

The Leng review into the safety and effectiveness of the role found 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 Government accepted the recommendations in full and instructed NHS England to implement the changes ‘as quickly as possible’. 

In response, UMAPs submitted its judicial review claim against NHS England and DHSC accusing the Government of ‘unilaterally’ changing the terms and conditions of employment for PAs ‘without any proper consultation with them or their recognised trade union’. 

The judicial review challenged five of the Leng review’s eight recommendations for PAs including the name change, requirement for two years’ experience in secondary care, and recommendation that PAs should not see undifferentiated patients. 

In a statement on Friday’s High Court judgement, UMAPs reaffirmed its plea for organisations to wait for the judicial review’s conclusion before implementing changes. 

Although it was not granted the injunction, the union said it would be adding Professor Leng as a defendant in its judicial review case. 

‘This is a welcome development that will allow us to directly challenge the legality of the Leng Review itself and finally deal with this matter in its entirety’, it said. 

In its judicial review pre-action letters sent to NHS England and DHSC, Professor Leng had been sent a copy as a ‘potential interested party’ rather than a defendant.

Last month, NHS England failed to update PA job descriptions in line with Leng review in the PCN direct enhanced service (DES) specification. 

UMAPs claimed this was the result of the its legal action, although NHS England did not confirm or deny this.  

The BMA GP committee issued advice to GP practices saying that they should review their PA terms of employment to determine whether change needs to be made in light of the review. 

The BMA has also threatened the GMC with new legal action over the regulator’s use of the term ‘medical professionals’ to cover both PAs and doctors, following the review. 

UMAPs was officially recognised as a trade union for physician associates and other medical associate professionals by the Government earlier this year.

A DHSC spokesperson said: ‘The government launched this review to make sure patients get the highest quality care, have clarity about who is treating them, and have confidence in the health system.

‘Gillian Leng is one of the UK’s most experienced healthcare leaders and has delivered a comprehensive report. This included extensive time spent engaging with the professions themselves.

‘The Health Secretary has agreed to implement the recommendations of her report in full, prioritising safety and reassuring patients that, when they seek medical advice they will be seen by the most appropriate healthcare professional.’

Pulse has requested comment from NHS England.