10 March 2023

The Department of Health and Social Care (DHSC) published a consultation on the draft legislative provisions giving the General Medical Council (GMC) powers to regulate Anaesthesia Associates (AAs) and Physician Associates (PAs). The deadline for responding to the consultation is 16 May 2023.

This consultation is also relevant for other healthcare professionals, as the aim is that it will pave the way for reform of the regulatory framework of all healthcare professional regulators. With this in mind, the Government has invited professionals, employers, regulatory bodies and training providers to engage with this consultation.

Background

Between 24 March and 16 June 2021, the Government sought views on proposals to reform the regulation of healthcare professionals and to introduce statutory regulation of AAs and PAs. The Government has stated that, “The current UK model of regulation for healthcare professionals is rigid, complex and needs to change to better protect patients, support our health services and to help the workforce meet future challenges…We must ensure that any reforms we introduce deliver a flexible and modern system of regulation for health and care professionals across the UK”.

One of the main driving forces behind the initial consultation was the COVID-19 pandemic. It became clear during this period how inflexible some of the healthcare regulators’ primary and secondary legislation was, for example, there were issues in temporarily registering individuals and holding remote hearings.

Responses to the initial consultation were said to demonstrate clear support for changes to the legislative structure and the Government has since published an executive summary of their position which underpins the draft legislation giving the GMC powers to regulate AAs and PAs and provides a template for subsequent regulatory legislative reforms.

Proposed legislation – AAs and PAs 

The GMC works to protect patient safety and improve medical education and practice across the UK by setting out the professional values, knowledge, skills and behaviours required of all doctors working in the UK. The Government therefore suggests that regulating AAs and PAs will help to increase the contribution they can make to the healthcare system (potentially broadening their scope of practice), whilst at the same time ensuring that patients are kept safe. The aim of the DHSC consultation is to seek views on the proposed legislative provisions from key stakeholders across the health and care, employment, commercial and legal sectors.

The draft legislation will allow the GMC to:

• Register qualified and competent AAs and PAs;
• Set standards of practice, education and training, and continuing professional development and conduct for AAs and PAs;
• Approve AA and PA education and training programmes; and
• Operate fitness to practise procedures to deal with associates where there are concerns about the fitness to practise of an AA or PA.

It will also mean that it is an offence for someone (with intent to deceive) to:

• Use the titles ‘Anaesthesia Associate’ or ‘Physician Associate’ if they are not registered as such with the GMC (although there will be transitional arrangements in place to allow time for individuals to meet the requirements for registration);
• Falsely represent anyone to have an approved qualification (which will cover AA and PA courses) or to be registered;
• Make a false representation as to the content of the register; and
• Procure, or attempt to procure, the inclusion or exclusion of information in the register.  

Whilst the announcement that AAs and PAs will now join their doctor colleagues in being regulated by the GMC appears to have been welcomed by key stakeholders, concerns have been raised around the fact AAs and PAs will be regulated under an alternative regime, in particular under a much more modern regulatory regime.

Future regulation of the health and care professions 

The draft legislation proposed will be a template for the regulation which will later be put in place for existing healthcare professionals regulated under similar regimes. The legislation is intended to  provide the regulators with greater autonomy to set out the details of their regulatory procedures in legislation that they publish (called ‘rules’) and the legislative framework will apply to each of the nine healthcare professional regulators in the UK:

• General Chiropractic Council (GCC)
• General Dental Council (GDC)
• General Medical Council (GMC)
• General Optical Council (GOC)
• General Osteopathic Council (GOsC)
• General Pharmaceutical Council (GPhC)
• Health and Care Professions Council (HCPC)
• Nursing and Midwifery Council (NMC)
• Pharmaceutical Society of Northern Ireland (PSNI)

The Government have admitted that replacing multiple pieces of legislation from different regulators will take some time. Once progress has been made in respect of regulating AAs and PAs, the Government’s priority will be reforming the GMC’s regulatory framework for doctors. Thereafter, they will prioritise the delivery of changes based on criteria such as the size of the regulator’s registrant base, the need for reform and the regulator’s readiness to implement the changes. The Government have suggested that, based on that criteria, they will likely start working with the NMC and HCPC, alongside the GMC, to develop reformed legislation for their professions over the next couple of years.

Final remarks

Given the wide-reaching consequences of the draft legislation for regulating AAs and PAs on the regulation of the health and care professions generally, there are a number of interested parties that may wish to engage in the consultation. If you have any comments or queries in respect of this consultation, our Professional

Sophie Lennox, Solicitor: sle@bto.co.uk / 0131 222 2939