Regulation and the physician associate

The General Medical Council (GMC) (the regulator of doctors in the UK) began its role as regulator of physician associates (PAs) and anaesthetic associates (AAs) in December 2024. A public consultation on the rules, standards and guidance to be put in place to implement the regulation of PAs and AAs was undertaken over March to May 2024. The consultation also allowed the GMC to collect feedback on draft principles that will inform the content of fitness to practise decision-making guidance, which will apply to PAs and AAs. All of this was against a backdrop of much concern regarding roles, responsibilities and patient safety, often played out on social media platforms. The report on the outcome of the public consultation has been published (GMC, 2024).

In recent years, the PA role has become increasingly important in addressing the growing demand for health professionals. The NHS Long Term Workforce Plan in England (NHS England, 2023) intimates that the roles of PA and AA will expand significantly. Despite their significant contribution and their proposed contribution to the NHS and patient care, the role of the PA has come under fire from many quarters, none more so than the British Medical Association (BMA). Its position statement (BMA, 2023) raised concerns that medical ‘associate’ roles unhelpfully blur the distinction between doctors and non-medically qualified professionals, potentially devaluating the doctor-patient relationship along with undermining the trust that patients place in doctors. The BMA argues that there is a high level of public misunderstanding, with patients and their families often unaware that they have not been seen or assessed by a doctor. Confusion is plausible, it says, as on social media there has been a proliferation of PAs who have described themselves as doctors, GPs or medical consultants. Before 2014, PAs were known as ‘physician assistants’. The BMA is of the opinion that the public find the title ‘physician associate’ highly misleading and confusing, adding that patients would be better protected and served by reverting to the original professional title.