The General Medical Council (GMC) were appointed to be the PA regulator by the UK government, with the support of the devolved governments in 2019, following a public consultation on the regulation of medical associate professionals held in 2017. Regulation will help assure patients, colleagues and employers that PAs and AAs have the knowledge and skills to work safely and that they can be held to account if serious concerns are raised.
Now, the Professional Standards Authority for Health and Social Care (the PSA) has reviewed the GMC’s plans for regulating physician associates. The PSA promotes the health, safety and wellbeing of patients, service users and the public by improving the regulation of people who work in health and social care. The PSA is an independent body, accountable to the UK Parliament. The PSA oversee the work of 10 statutory bodies that regulate health professionals in the UK, such as the GMC, the HCPC or NMC amongst others. The PSA review the regulators’ performance and audit and scrutinise their decisions about whether people on their registers are fit to practise.
The PSA have four main concerns about the GMC’s proposed plans for regulation of physician associates.
The PSA highlight that there is no information about the early stages of the fitness to practise process in the draft rules published by the GMC.
When the GMC investigates a complaint against a doctor, there are various stages involved. This is the initial step of the fitness to practise investigation, in which regulators will use the “real prospect” test to evaluate whether a complaint or allegations should be submitted to a full fitness to practise hearing or closed. Before choosing whether to launch an investigation, regulators typically request supporting information or proof from third parties, such as your employer or the police.
In other words, the Case Examiners will consider whether the evidence is sufficient to establish that the doctor’s fitness to practise is impaired to a degree justifying action.
According to the PSA, the draft regulations for medical associates do not allow for any decision to be made prior to referring a case to a case examiner. This means that there is no equivalent to the ‘real prospect test’ recommended for assessing a PA’s fitness to practise.
The GMC also proposes in the proposed guidelines that decisions be made solely by single case examiners. The PSA is worried that this may pose a public safety issue. The PSA further claims that the procedure for contesting these judgements is ineffective for public safety.
According to the PSA, the GMC’s draft regulations do not give a clear framework for case examiners to refer a case to a Tribunal if they are unsure about their capacity to make a good conclusion. The interpretation of the case examiner’s authority to recommend a matter to a Tribunal contradicts what is stated in the AAPAO Order and the PSA. This discretion is especially crucial given the GMC’s choice to solely deploy single-case examiners.
The PSA further states that there is an imbalance between the rights of the registrant to appeal and public protection procedures. This means that registrants will have ‘two bites of the cherry’ when it comes to disputing an accepted conclusion – on the basis of factual or legal error, as well as on the basis of injustice. In contrast, any public protection appeal will be limited to errors of fact or law, with no broader standard similar to ‘injustice’. The PSA claims to have raised this gap with the Department of Health and Social Care.
The GMC conducted an 8-week public consultation on its draft regulations for regulating physician associates, which ended on May 20th. The GMC is anticipated to publish its answer to the consultation in due course.
United Medical Associate Professionals – UMAPS – told us at The PA+PER that they first became aware of the Professional Standards Authority’s (PSA) statement through social media. UMAPs notices that the PSA report was being misrepresented online by a campaign being ran by the vocal anti-MAP community.
UMAPS said: “After reading their statement it was apparent there had been a wilful misinterpretation designed to further denigrate hardworking MAPs. We reached out to the PSA to seek clarification and to alert them of this disinformation circulating on social media. We were reassured by their response which confirmed the PSA was commenting only on the fairness of the draft rules by which the GMC would regulate AAs and PAs, not on the GMCs suitability to regulate or against the roles themselves. We thank the PSA for taking the welfare of MAPs seriously and for their work reviewing GMCs draft rules, ensuring high standard are held. Once again, we are saddened, but not surprised, by the malicious acts of individuals within the anti-MAP movement.”
In December 2024, the General Medical Council will take on the legislative role of regulating doctors, physician associates (PAs), and anesthesia associates (AAs).