DAUK has given its strong support to a formal complaint made by Anaesthetists United (AU) to the Professional Standards Authority (PSA) over the GMC’s regulation of physician associates (PAs) and anaesthesia associates (AAs).

AU’s lawyers have written to the PSA – the statutory body that oversees the GMC – presenting evidence that the GMC failed to meet at least six of the PSA’s own standards of good regulation when it introduced regulation for PAs and AAs.

The PSA is being asked to carry out an urgent formal review of the GMC’s compliance with its standards.

DAUK has been an early and consistent supporter of Anaesthetists United’s work, including a £30,000 contribution to AU’s crowdfunding campaign.

Regulatory failure

The complaint sets out how the GMC breached multiple PSA standards, including failing to consult stakeholders on scope of practice, failing to ensure patients understand who is treating them, and applying doctor-designed regulation to non-doctors.

It also highlights the GMC’s failure to act on concerns raised by coroners and its failure to implement any of the recommendations made by the Leng Review.

The PSA’s own performance review of the GMC in December concluded that it had met all 18 standards of good regulation. AU describes that review as “astonishingly superficial”.

Dr Matt Kneale, DAUK co-chair, said: “The evidence Anaesthetists United has compiled is significant. The GMC refused to consult on the most important question of all – whether there should be enforceable limits on what PAs and AAs can do.

“It applied frameworks designed for doctors to non-doctors. It ignored warnings from coroners, royal colleges, and frontline clinicians.

“And despite the Leng Review’s clear recommendations, the GMC has not implemented a single one of them.

“The PSA exists for precisely this moment – when a regulator has lost sight of its primary purpose of protecting patients.”

Patient safety

DAUK has long-standing concerns that GMC regulation blurs the lines between doctors and non-doctors, creating a misunderstanding of the role of PAs and presenting a significant risk to patient safety.

The GMC’s own chief executive, Charlie Massey, has apologised to the Health Select Committee for not being clearer about distinguishing between doctors and associates.

Much of the evidence now available only came to light because AU’s judicial review forced the disclosure of documents that the GMC had previously kept from public view.

Dr Kneale added: “We have been consistent in raising these concerns. We called for a pause on recruitment. We opposed GMC regulation. We backed the fatal motion in the House of Lords. We supported the BMA’s legal action.

“At every stage, patient safety has been our paramount concern and at every stage the GMC has failed to act.

“We need the PSA to do its job and hold the GMC to the standards it is supposed to meet.”

Support

DAUK acknowledges the contribution of PAs and AAs to the care of patients. But these roles must be properly bounded, transparently communicated to patients, and subject to enforceable national scopes of practice with proper supervision.

The current regulatory framework fails patients, fails doctors, and fails the associates themselves.

AU relies on donations to fund its legal work. For more information on how to support the challenge, visit the Anaesthetists United donations page.

Physician assistants

It challenges the GMC’s decision not to set out a defined scope of practice for PAs and PAAs. AU is still short of funds and is asking for support to continue its appeal. DAUK has been an early and consistent supporter of this crucial legal action, and contributed £30,000 to AU’s crowdfunding efforts. Our co-chair Dr Matt Kneale said the appeal represented an important step in ensuring patient safety.

Scope of practice

Dr Kneale said: “Questions around their regulation, scope of practice, supervision, and ultimately patient safety need to be answered. “Patients deserve to know exactly who is treating them, what their role is, and what their qualifications are. “Without a nationally defined scope of practice, the lines between doctors and non-doctors are blurred. “There is real danger that PAs and PAAs could be asked to work beyond their training.

Protecting patients

“This appeal is about protecting patients and safeguarding professional standards, and it has our full support.” AU has applied to the judge for permission to appeal the ruling. The appeal is to Mrs Justice Lambert, who heard the original case. If the appeal be rejected, AU can make a submission to the Court of Appeal. Read details of the appeal. For more information on how to support this crucial legal challenge, please visit the Anaesthetists United donations page.