Report Jan. 24 2024
Committee: Health, Social Care and Sport CommitteeFound: The Anaesthesia Associates and Physician Associates Order 2024 [draft] This report sets out the Health
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent discussions she has had with the General Medical Council on (a) regulating (i) physician and (ii) anaesthesia associates and (b) ensuring that increased use of these roles in hospitals does not impact (A) the professional competence of other healthcare professionals and (B) patient safety.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has been working closely with the General Medical Council (GMC) since 2019, on the regulation of Anaesthesia Associates (AAs) and Physician Associates (PAs). Regulation with the GMC will provide set standards of practice, education, and training for AAs and PAs, as well as requirements around continual professional development (CPD) and conduct. Regulation with the GMC will mean that individual AAs and PAs can be held to account if serious concerns are raised.
The NHS Long Term Workforce Plan commits to growing these roles alongside recruiting and training more doctors, nurses, and allied health and other professionals. NHS England is working with partners, including the GMC, royal colleges, trade unions, doctors, and medical associate professional groups to develop comprehensive curricula, core capability frameworks, standards for CPD, assessment and appraisal, and supervision guidance for AAs and PAs, ensuring the roles are expanded safely and effectively.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many physician associates are employed in the NHS; and what assessment he has made of the adequacy of the regulation of physician associates.
Answered by Will Quince
Latest data published by NHS England shows that, as of March 2023, there are 1,490 full time equivalent (FTE) physician associates (PAs) working across National Health Service trusts and integrated care boards. In addition, in June 2023 there were a total of 1,805 FTE physician associates working in primary care settings.
The Faculty of Physician Associates at the Royal College of Physicians currently provides professional support to PAs across the United Kingdom. This includes setting standards for education and training. The Faculty also oversees a voluntary register of qualified PAs who have been declared fit to practise in the UK.
Work is ongoing to bring PAs into statutory regulation under the General Medical Council (GMC). We plan to lay legislation before Parliament at the end of 2023, which will allow the GMC to commence regulation by the end of 2024. Regulation by the GMC will provide a standardised framework of governance and assurance for the clinical practice and professional conduct of PAs.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they will publish their Social Care regulatory reform programme and what new protected professional medical titles they are considering introducing.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no plans to publish a social care regulatory reform programme. However, the Government has consulted on its proposed approach to modernising the legislation of the professional health and care regulators. As part of this work, we will consider whether to make any changes to the medical titles protected in law. Any proposals will be subject to statutory consultation, and the affirmative parliamentary process.
The Anaesthesia Associates and Physician Associates Order 2024 was made on 13 March 2024, and will bring Aanaesthesia Associates and Physician Associates into regulation by the General Medical Council (GMC), under a reformed regulatory framework. We are currently working on the next phase of reform, which includes introducing a new regulatory framework for medical practitioners. The future GMC order relating to the medical profession will be drafted and published for consultation in due course.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the status of the guidance issued by the British Medical Association in its report Safe Scope of Practice for Medical Associate Professionals (MAPs) in relation to Physician and Anaesthesia Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the adoption of the British Medical Association’s report Safe Scope of Practice for Medical Associate Professionals (MAPs) would restrict the role of Physician Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will issue guidance to the NHS on whether the Government endorses the British Medical Association’s report Safe Scope of Practice for Medical Associate Professionals (MAPs) in relation to Physician and Anaesthesia Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will discuss the implications for Physician and Anaesthesia Associates of the British Medical Association report Safe Scope of Practice for Medical Associate Professionals (MAPs) with the United Medical Associate Professionals.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Catherine West (Labour - Hornsey and Wood Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to bring forward legislation to regulate physician associates.
Answered by Will Quince
Both in training, and subsequently qualified practice, physician associates (PAs) must work with a dedicated medical supervisor which will be a consultant, general practitioner, or other senior medical personnel.
PAs undertake two years of postgraduate training which involves supervised practice with real patients in clinical attachments. The dedicated medical supervisor is responsible for the supervision and management of a student’s educational progress throughout the clinical placements of the course. However, any professional in a placement location who is competent to do so may train, supervise, and assess a PA student in a particular skill, procedure, or competence. This includes practising PAs, nurses, and other healthcare professionals.
The Government is progressing the required legislation which will the enable the General Medical Council (GMC) to regulate the PA role. We plan to lay legislation before the House at the end of 2023, which will allow the GMC to commence regulation by the end of 2024. Regulation by the GMC will provide a standardised framework of governance and assurance for the clinical practice and professional conduct of PAs.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of the potential merits of having a single regulator with different registers.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In 2021, the Government commissioned a review of the number of healthcare regulators, considering whether opportunities exist for simplifying the regulatory landscape. There are no current plans to reduce the number of healthcare professional regulators, but the government is committed to reforming the system of regulation for healthcare professionals in the United Kingdom, making it faster, more flexible and less adversarial for registrants.
A modernised regulatory framework is being introduced firstly for anaesthesia associates and physician associates. The Anaesthesia Associates and Physician Associates Order 2024, laid on 13 December 2023, allows for the statutory regulation of anaesthesia associates and physician associates by the General Medical Council under the new framework. The reformed regulatory framework will be rolled out to doctors, and to the professions regulated by the Nursing and Midwifery Council and the Health and Care Professions Council over the next couple of years.