Report evidence summary
Stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised. 32
Faculty of Physician Associates Work with royal colleges and specialist societies to develop physician associate career pathways and guidance for safe deployment within multidisciplinary teams.
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Faculty of Physician Associates Produce and disseminate information explaining the voluntary register, including a patient leaflet and registration advice for student physician associates.
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Faculty of Physician Associates Remind employers to check physician associates’ voluntary register before employment and at regular intervals.
View source
Faculty of Physician Associates Review the procedural skills assessment form to determine whether it should be enhanced to cover consent, risk factors, aftercare and other wider care responsibilities.
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Faculty of Physician Associates Share the physician associate code of conduct and publish the procedure for raising and adjudicating complaints.
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Faculty of Physician Associates Publish guidance for introducing physician associates and explaining their role to patients, supervisors, employers and healthcare organisations.
View source
Faculty of Physician Associates Continue working with stakeholders to improve communication of physician associates’ roles and responsibilities to colleagues, patients and the public.
View source
Faculty of Physician Associates Continue collaborating with regulators, healthcare organisations and professional bodies to promote safe physician associate practice and supervision.
View source
Faculty of Physician Associates Provide qualified physician associates with an e-Portfolio containing workplace-based, supervised learning and procedural skills assessment forms.
View source
Faculty of Physician Associates Maintain a standardised national physician associate curriculum aligned with GMC outcomes for education and qualification.
View source
Royal College of Physicians Work with fellows, members and the Patient Safety Committee to consider further support for evidence and evaluation of physician associate deployment.
View source
Royal College of Physicians Meet regularly with the General Medical Council on physician associate regulation and post-regulation arrangements.
View source
Royal College of Physicians Develop, consult on, revise, approve and publish guidance on safe and effective practice for employing physician associates.
View source
Royal College of Physicians Deliver the working group’s recommendations to the Royal College of Physicians Council.
View source
Royal College of Physicians Host an online roundtable with other professional bodies to discuss developing physician associate clinical scope of practice.
View source
Royal College of Physicians Set up an oversight group for physician associate-related activity.
View source
Royal College of Physicians Respond to the General Medical Council consultation on physician associate regulation, raising patient-safety concerns.
View source
Royal College of Physicians Call on NHS England to review projected growth in the physician associate workforce.
View source
Royal College of Physicians Continue campaigning to limit the pace and scale of physician associate rollout until safe deployment systems are established.
View source
Royal College of Physicians Establish a working group to recommend implementation of motions from the extraordinary general meeting.
View source
Royal College of Physicians Campaign for regulation of physician associates.
View source
Department of Health and Social Care Consider further work to address concerns about physician associate safety, regulation, training, supervision and role clarity.
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General Medical Council Publish guidance supporting physician associate students and course providers pending implementation of statutory regulation.
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General Medical Council Finalise updated guidance for physician associate students on professional standards and the process for approving curricula.
View source
General Medical Council Implement alphabetical prefixes and prominent profession-type labelling on public-facing registers for physician associates and anaesthesia associates.
View source
General Medical Council Approve physician associate courses and curricula once regulation begins, ensuring they meet required clinical knowledge and skills standards.
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General Medical Council Require course providers to update syllabuses and assessments, and check those changes through the education quality assurance process.
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General Medical Council Begin statutory regulation of physician associates and anaesthesia associates from December 2024.
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General Medical Council Support royal colleges’ development of supervision and competency guidance, while encouraging consistent alignment across guidance produced by colleges and NHS employers.
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General Medical Council Strongly encourage physician associates to join the GMC register as soon as possible.
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General Medical Council Publish advice for doctors supervising physician associates and update the clinical governance handbook on their deployment and supervision.
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General Medical Council Consider consultation responses and finalise the rules, professional standards and guidance required to implement associate regulation.
View source Respondent positions A position is what a recipient says about a concern when it does not describe a specific action. 9
Faculty of Physician Associates The DOPS process includes assessment of consent, aftercare and wider procedural care, contrary to the concern that it assesses only technical skill.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it. View source
Faculty of Physician Associates The FPA cannot mandate physician-associate registration because it has no regulatory powers.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action. View source
Royal College of Physicians System leaders, including the GMC, should lead development and oversight of a national physician associate scope of practice.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action. View source
Royal College of Physicians Regulatory oversight of physician associates falls outside the organisation’s role because it is not a regulatory body.
Outside remitThe respondent said that this matter was outside its role or authority. View source
Department of Health and Social Care The Faculty of Physician Associates, which developed the ascitic-drain competency form, is best placed to respond to concerns about it.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action. View source
General Medical Council Responsibility for distinct uniforms to help patients distinguish professionals rests with the NHS and employers.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action. View source
General Medical Council The GMC has no role in determining the investigatory or disciplinary processes of the Faculty of Physician Associates’ voluntary register.
Outside remitThe respondent said that this matter was outside its role or authority. View source
General Medical Council Questions about clinical governance, drain use, ward placement, delegation, supervision and local policy are better explained by the trust.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action. View source
General Medical Council The GMC currently has no power to investigate concerns about physician associates because they are not yet regulated by it.
Outside remitThe respondent said that this matter was outside its role or authority. View source
× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Failure to ensure clear identification and understanding of the Physician Associate role
Wider context from the report “4. There remains limited understanding and awareness of the role of a Physician Associate both amongst medical colleagues, patients and their families. The lack of a distinct uniform and the title “Physician” gives rise to confusion as to whether the practitioner is a doctor.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Lack of a clear mechanism for reporting concerns about individual Physician Associates
Wider context from the report “2. The Physicians Associate Managed Voluntary Register held by the Faculty of Physician Associates (FPA) is voluntary. Whilst employers are encouraged to check the register there is no duty to do so, nor is it clear how the FPA would be made aware of any concerns relating to an individual Physician Associate.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Failure to require employers to verify Physician Associate registration
Wider context from the report “2. The Physicians Associate Managed Voluntary Register held by the Faculty of Physician Associates (FPA) is voluntary. Whilst employers are encouraged to check the register there is no duty to do so , nor is it clear how the FPA would be made aware of any concerns relating to an individual Physician Associate.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Failure of competency assessments to cover the wider aspects of care for ascetic drain insertion
Wider context from the report “5. In June 2022 the Physicians Associate had been signed off as competent for the insertion of ascetic drains. This sign off was completed by a liver nurse specialist using a competency form which was provided by the FPA. Whilst the competency form assessed the technical aspect of placing the drain, it did not include competency around the wider aspects of care such as taking consent, risk factors and after care.
” Is this part of a recurring concern? No recurring-concern membership is currently published.
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Lack of regulatory oversight of Physician Associates
Wider context from the report “1. There is no regulatory body with oversight of Physician Associates. It is understood that this is currently the subject of a consultation by the General Medical Council.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.
PFD Monitor interpretation Lack of a national framework for training, supervision and competence of Physician Associates
Wider context from the report “3. There is no national framework as to how Physician Associates should be trained, supervised and deemed competent. This is placing both patients, Physicians Associates and their employers at risk. The Court heard that since the death of Mrs Pollitt the Northern Care Alliance have put in place a local trust framework. Unlike all other clinical roles there is no national guidance save for very recent guidance issued by the British Medical Association (March 2024).
” Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Work with royal colleges and specialist societies to develop physician associate career pathways and guidance for safe deployment within multidisciplinary teams.
Verbatim wording from the response “The FPA and its members are actively involved in writing PA-related guidance with medical royal colleges, academies and specialist societies and we want to help increase understanding of our role. We recognise that there are concerns about the lack of a post-qualification national career development and competency framework for physician associates. We are working with medical royal colleges and specialist societies as they develop their own pathways, including guidance of how PAs can be safely and effectively deployed within MDTs.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Produce and disseminate information explaining the voluntary register, including a patient leaflet and registration advice for student physician associates.
Verbatim wording from the response “We have also produced a leaflet that explains the PAMVR and can be shared with patients. Student PAs are advised that they should apply to the FPA for registration on the PAMVR post-qualification through university courses, as well as in FPA regular communications to student members.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Remind employers to check physician associates’ voluntary register before employment and at regular intervals.
Verbatim wording from the response “This statement highlights why formal regulation is so important. Neither the RCP nor the FPA has regulatory powers to mandate registration. In the absence of this, the FPA writes to employers on a regular basis reminding them of the existence of the PAMVR and, importantly, of the need to check that a PA is registered on the PAMVR before employment, as well as checking at regular intervals during their employment.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Review the procedural skills assessment form to determine whether it should be enhanced to cover consent, risk factors, aftercare and other wider care responsibilities.
Verbatim wording from the response “Clinicians supervising a DOPS need to be competent in the procedural skill that is being assessed, and the associated management including consent and aftercare. A key component of a DOPS is the wider aspects of the procedure as shown in the attached document. It is important that the assessor is agreed by the clinical supervisor and has the appropriate knowledge and skills, including the wider aspects that you have noted. This should be emphasised to the supervising senior doctor. In addition, continued assurance as part of appraisal is required. We will review the DOPS form to see whether it can be enhanced, and we will take on board what has been raised by your report.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Share the physician associate code of conduct and publish the procedure for raising and adjudicating complaints.
Verbatim wording from the response “The FPA code of conduct is regularly shared with FPA members. Should an employer, patient or others have a complaint about a PA, they can advise the FPA through emailing ████████. The FPA website sets out the complaints procedure here. Attached is the process to adjudicate complaints.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Publish guidance for introducing physician associates and explaining their role to patients, supervisors, employers and healthcare organisations.
Verbatim wording from the response “In October 2023, the FPA published titles and introduction guidance for PAs, supervisors, employers and organisations. The guidance was drawn up with a multi-professional panel of stakeholders, including representation from the RCP PCN, to clarify the role of a PA within a multidisciplinary team. The aim is to ensure appropriate introductions to patients and explanation of the role, particularly highlighting that PAs are not doctors. We recognise that there is a continued need to inform the public, healthcare services and the clinical professions on the role and remit of physician associates.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Continue working with stakeholders to improve communication of physician associates’ roles and responsibilities to colleagues, patients and the public.
Verbatim wording from the response “We agree that there should be a national public and patient information campaign to create better awareness of the PA role. We will continue to work with other stakeholders, including the RCP Patient and Carer Network (PCN), to improve how we communicate the role and responsibilities of PAs. We welcome the opportunity to work collaboratively with others on this.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Continue collaborating with regulators, healthcare organisations and professional bodies to promote safe physician associate practice and supervision.
Verbatim wording from the response “The FPA and any successor professional body for PAs will continue to work with the GMC, the NHS, specialist societies, royal colleges and other stakeholders to ensure that the practice and supervision of physician associates, as part of the multidisciplinary team, are safe.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Provide qualified physician associates with an e-Portfolio containing workplace-based, supervised learning and procedural skills assessment forms.
Verbatim wording from the response “There is currently no national framework for post-qualification competencies (including procedures). PAs increase their clinical skills and competencies post-qualification similarly to other healthcare professionals. The FPA e-Portfolio was launched in October 2023 for qualified PAs and uses workplace-based assessment (WBPA) or supervised learning event (SLE) forms. This also includes Direct Observation of Procedural Skills (DOPS) forms, which were first made available to FPA members in October 2021.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Maintain a standardised national physician associate curriculum aligned with GMC outcomes for education and qualification.
Verbatim wording from the response “The draft PA curriculum sets out guidance on the competencies expected from a newly qualified physician associate. This national higher education institutions (HEIs) across all four UK nations with a standardised framework to ensure high-quality education for PA students. It is owned by the FPA and has been aligned to the GMC’s generic and shared outcomes for PAs and anaesthesia associates.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Work with fellows, members and the Patient Safety Committee to consider further support for evidence and evaluation of physician associate deployment.
Verbatim wording from the response “Working with our fellows and members, the RCP will continue to actively campaign to limit the pace and scale of roll-out of PAs in the NHS until we are reassured that there are safe systems in place for PA deployment. We have repeatedly made clear that PAs are not doctors, and they cannot and must not replace doctors. We have also called on the UK government and the NHS to develop and publish an evidence base and evaluation framework around the introduction of PAs. This should be a priority, and we are working with the RCP Patient Safety Committee to consider what more we can do to support this agenda.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Meet regularly with the General Medical Council on physician associate regulation and post-regulation arrangements.
Verbatim wording from the response “████████ who is acting as RCP president, and ████████ chair of the PAOG, continue to meet regularly with the GMC. We have written to NHS England to ask whether they intend to review the projections for growth in the PA workforce. Both the GMC and NHS England will attend an RCP Council meeting in November 2024 to discuss the post-regulation landscape for PAs.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Develop, consult on, revise, approve and publish guidance on safe and effective practice for employing physician associates.
Verbatim wording from the response “The RCP is developing draft guidance on safe and effective practice for employing PAs. The college recently carried out an external stakeholder consultation on the first draft of this guidance. Work is now taking place to review the consultation feedback, refresh the draft guidance, consider how fellows and members should be consulted, and take the final guidance to RCP Council for sign-off and publication by the end of 2024.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Deliver the working group’s recommendations to the Royal College of Physicians Council.
Verbatim wording from the response “The RCP also established a short life working group (SLWG) to make recommendations to RCP Council for how the EGM motions would be implemented. This group reported in May 2024. All recommendations are on track to be delivered by the end of the year. The RCP has now set up an oversight group for activity related to PAs (PA oversight group, or PAOG).” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Host an online roundtable with other professional bodies to discuss developing physician associate clinical scope of practice.
Verbatim wording from the response “The PAOG is also hosting an online roundtable with other royal colleges, faculties and specialist societies to discuss next steps on developing a clinical scope of practice for PAs. This will have a specific focus on medical teams and the physicianly specialties.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Set up an oversight group for physician associate-related activity.
Verbatim wording from the response “The RCP also established a short life working group (SLWG) to make recommendations to RCP Council for how the EGM motions would be implemented. This group reported in May 2024. All recommendations are on track to be delivered by the end of the year. The RCP has now set up an oversight group for activity related to PAs (PA oversight group, or PAOG).” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Respond to the General Medical Council consultation on physician associate regulation, raising patient-safety concerns.
Verbatim wording from the response “We responded to the GMC consultation on the regulation of PAs earlier this year, raising concerns around the content of the curricula for PA and anaesthesia associate (AA) postgraduate studies, issues around prescribing and medicines safety, the capacity of supervisors, and the impact of the PA role on training opportunities for resident doctors.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Call on NHS England to review projected growth in the physician associate workforce.
Verbatim wording from the response “Following a vote of the RCP fellowship, the RCP is now calling for a limit in the pace and scale of the roll-out of PAs. We have called on NHS England to review its projections for growth for the PA role as set out in the 2023 NHSE Long Term Workforce Plan.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Continue campaigning to limit the pace and scale of physician associate rollout until safe deployment systems are established.
Verbatim wording from the response “Following a vote of the RCP fellowship, the RCP is now calling for a limit in the pace and scale of the roll-out of PAs. We have called on NHS England to review its projections for growth for the PA role as set out in the 2023 NHSE Long Term Workforce Plan.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Establish a working group to recommend implementation of motions from the extraordinary general meeting.
Verbatim wording from the response “Many of our fellows and members have significant concerns about the safe deployment of PAs, especially concerning regulation, scope of practice and supervision. The RCP held an extraordinary general meeting (EGM) to debate issues relating to PAs in March 2024.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Campaign for regulation of physician associates.
Verbatim wording from the response “In the interests of patient safety, the RCP has campaigned for over 5 years for the regulation of PAs. It has been a long and unpredictable journey that will finally see the majority of regulatory provisions come into force in December 2024.” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Consider further work to address concerns about physician associate safety, regulation, training, supervision and role clarity.
Verbatim wording from the response “While the actions I have set out above go some way to respond the significant concerns that you and others have raised, I am considering further work in this area and my officials will write to you in due course.” Source location Response from DHSC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Publish guidance supporting physician associate students and course providers pending implementation of statutory regulation.
Verbatim wording from the response “Regarding PA education and training - once regulation begins in December 2024, we’ll have powers to set the standards for course providers and regularly check that they’re being met. We have already published a range of guidance to support PAs student PAs and course providers pending the implementation of regulation. From December 2024 we will be able to formally approve courses and curricula to ensure that PAs will have the clinical knowledge and skills needed to work safely once they qualify.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Finalise updated guidance for physician associate students on professional standards and the process for approving curricula.
Verbatim wording from the response “In preparation for the start of regulation we have already asked course providers to update their courses, including their syllabus and assessments, using the relevant curriculum as a guide, and we are checking that this has been done through our education quality assurance process. We are also finalising updated guidance for PA students on professional standards and the process for approving PA curricula.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implement alphabetical prefixes and prominent profession-type labelling on public-facing registers for physician associates and anaesthesia associates.
Verbatim wording from the response “In March this year we also announced that we would implement an alphabetical prefix for PA and AA GMC reference numbers and ensure the prominent labelling of profession type on our public-facing registers. This means that in future when patients search our registers it will be very clear whether an individual is a doctor, a PA or an AA not only because of the use of a prefix for PAs and AAs but also because the face of the register will actually spell out in full the professional title of each individual (‘Doctor’, ‘Physician Associate’, ‘Anaesthesia Associate’).” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Approve physician associate courses and curricula once regulation begins, ensuring they meet required clinical knowledge and skills standards.
Verbatim wording from the response “Regarding PA education and training - once regulation begins in December 2024, we’ll have powers to set the standards for course providers and regularly check that they’re being met. We have already published a range of guidance to support PAs student PAs and course providers pending the implementation of regulation. From December 2024 we will be able to formally approve courses and curricula to ensure that PAs will have the clinical knowledge and skills needed to work safely once they qualify.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Require course providers to update syllabuses and assessments, and check those changes through the education quality assurance process.
Verbatim wording from the response “In preparation for the start of regulation we have already asked course providers to update their courses, including their syllabus and assessments, using the relevant curriculum as a guide, and we are checking that this has been done through our education quality assurance process. We are also finalising updated guidance for PA students on professional standards and the process for approving PA curricula.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Begin statutory regulation of physician associates and anaesthesia associates from December 2024.
Verbatim wording from the response “In 2017, the Department of Health and Social Care (DHSC) consulted on which healthcare regulator would be most suitable to regulate one, some, or all the medical associate professions, which include PAs and AAs. Surgical care practitioners are the third profession in this group but are not included in those we will regulate. Following the consultation, the Government determined the GMC was most appropriate and formally asked us to take on the regulation of PAs and AAs which we agreed to do. The UK and Scottish parliaments approved the legislation (Anaesthesia Associates and Physician Associates Order 2024) earlier this year and it has been granted Royal Assent. This means the GMC will become the regulator of PAs and AAs from December 2024 and, from December 2026, they will have protected titles in law (‘Physician Associate’ and ‘Anaesthesia Associate’).” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Support royal colleges’ development of supervision and competency guidance, while encouraging consistent alignment across guidance produced by colleges and NHS employers.
Verbatim wording from the response “Finally, we have been supporting the work that individual royal colleges, and the Academy of Medical Royal Colleges, are currently leading on developing a range of guidance on supervision and how PAs can safely develop their skills and competencies over time once they have qualified and registered with us. The Royal College of Physicians is also concentrating on their guidance and the Royal College of General Practitioners plans to do so shortly. We are also encouraging colleges, NHS employers and others to ensure that all guidance being produced is aligned and consistent so as not to cause confusion for employers, supervisors or PAs themselves.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Strongly encourage physician associates to join the GMC register as soon as possible.
Verbatim wording from the response “We anticipate that employers will make GMC registration a condition for their PAs in the same way as they have done up to now in relation to voluntary registration. Although GMC registration doesn’t become a legal requirement for practice until December 2026, we will strongly encourage all PAs to join our register as soon as possible.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Publish advice for doctors supervising physician associates and update the clinical governance handbook on their deployment and supervision.
Verbatim wording from the response “We have also published our own advice for doctors who supervise PAs, and earlier this year we updated our clinical governance handbook to set out our expectation that organisations who employ PAs should make appropriate arrangements for their deployment and supervision.” Source location Response from GMC
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Consider consultation responses and finalise the rules, professional standards and guidance required to implement associate regulation.
Verbatim wording from the response “We recently consulted on the rules, standards and guidance needed to implement the legislation that gives us the power to regulate PAs and we’re now considering the responses so that we can finalise our approach. Once regulation begins, we will have powers to:” Source location Response from GMC
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The DOPS process includes assessment of consent, aftercare and wider procedural care, contrary to the concern that it assesses only technical skill.
Verbatim wording from the response “Clinicians supervising a DOPS need to be competent in the procedural skill that is being assessed, and the associated management including consent and aftercare. A key component of a DOPS is the wider aspects of the procedure as shown in the attached document. It is important that the assessor is agreed by the clinical supervisor and has the appropriate knowledge and skills, including the wider aspects that you have noted. This should be emphasised to the supervising senior doctor. In addition, continued assurance as part of appraisal is required. We will review the DOPS form to see whether it can be enhanced, and we will take on board what has been raised by your report.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The FPA cannot mandate physician-associate registration because it has no regulatory powers.
Verbatim wording from the response “This statement highlights why formal regulation is so important. Neither the RCP nor the FPA has regulatory powers to mandate registration. In the absence of this, the FPA writes to employers on a regular basis reminding them of the existence of the PAMVR and, importantly, of the need to check that a PA is registered on the PAMVR before employment, as well as checking at regular intervals during their employment.” Source location Response from Faculty of Physician Associates
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation System leaders, including the GMC, should lead development and oversight of a national physician associate scope of practice.
Verbatim wording from the response “A comprehensive, national, safe and clear scope of clinical practice for PAs is essential. However, we note the following:” Source location Response from Royal College of Physicians
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Regulatory oversight of physician associates falls outside the organisation’s role because it is not a regulatory body.
Verbatim wording from the response “The RCP has confirmed that the FPA will close in December, along with the PAMVR. The initial transfer of PAMVR data from the RCP to the GMC will begin on 31 October 2024. The GMC register will open on 13 December 2024, when regulation begins, but will continue to be voluntary for the first two years. The PAMVR will remain static, but searchable, until 31 March 2025 when it will be closed.” Source location Response from Royal College of Physicians
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PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The Faculty of Physician Associates, which developed the ascitic-drain competency form, is best placed to respond to concerns about it.
Verbatim wording from the response “In relation to the specific competency form you mention relating to the insertion of ascetic drains, we note that you have also written to the Faculty of Physician Associates. As the form has been developed by them, they will be best placed to respond on this point. However, it is worth reiterating that, as set out in NHS England’s guidance on the deployment of PAs in the NHS: “PAs must always work within their competencies; and must be supervised appropriately. Employers must ensure that the overall responsibility for supervision of PAs is by a named senior doctor.”” Source location Response from DHSC
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Responsibility for distinct uniforms to help patients distinguish professionals rests with the NHS and employers.
Verbatim wording from the response “The issue you raise about the need for distinct uniforms to help patients distinguish between professionals is for the NHS and employers to address.” Source location Response from GMC
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The GMC has no role in determining the investigatory or disciplinary processes of the Faculty of Physician Associates’ voluntary register.
Verbatim wording from the response “I will leave it to the FPA to explain how they currently deal with concerns raised about a member of their voluntary register. The GMC currently has no power to investigate concerns raised about PAs as they are not yet regulated by us, and we have no role in determining the investigatory and disciplinary processes of the FPA. However, we can and will look at any outstanding concerns about an individual PA’s fitness to practise when considering their application for registration with us from December this year.” Source location Response from GMC
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Questions about clinical governance, drain use, ward placement, delegation, supervision and local policy are better explained by the trust.
Verbatim wording from the response “Regulation is an important part of patient safety, but it alone cannot prevent future deaths. Good clinical governance by healthcare providers remains the most important factor. Your report raises significant questions that cannot be answered by those to whom the report is currently addressed, and are better explained by the trust:” Source location Response from GMC
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The GMC currently has no power to investigate concerns about physician associates because they are not yet regulated by it.
Verbatim wording from the response “I will leave it to the FPA to explain how they currently deal with concerns raised about a member of their voluntary register. The GMC currently has no power to investigate concerns raised about PAs as they are not yet regulated by us, and we have no role in determining the investigatory and disciplinary processes of the FPA. However, we can and will look at any outstanding concerns about an individual PA’s fitness to practise when considering their application for registration with us from December this year.” Source location Response from GMC
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