The General Medical Council (GMC) has officially confirmed that regulation for physician associates (PAs) will commence on 13 December 2024, with the full legal requirement for registration expected to take effect in two years.
In a communication sent to royal colleges and NHS organizations, GMC’s Chief Executive Charlie Massey outlined the significant upcoming milestones. He confirmed that responses to the consultation on PA regulation, which concluded in May, will be published ahead of the regulatory start in December.
Voluntary Registration and Transition Period
Starting 16 December, both PAs and anaesthesia associates (AAs) will be able to voluntarily register with the GMC. A select number of PAs will be invited to register by the end of 2024, with the remaining PAs on the voluntary register being invited by January 2025.
The regulation legislation introduces a two-year transition period during which registration is optional, allowing PAs and AAs to complete the necessary steps while continuing to work. Registration will become mandatory in December 2026.
Charlie Massey encouraged early registration, stating, “While PAs and AAs aren’t legally required to register until December 2026, we’ll encourage everyone currently practising in the UK to apply as soon as possible and work directly with employers to promote early registration.”
GMC’s Role and Limitations During the Transition
Since mandatory registration will not be enforced until late 2026, the GMC will not be able to investigate concerns about PAs who have yet to register. Massey acknowledged this challenge: “During the initial phase of regulation, we may receive concerns about PAs and AAs who are not yet registered. While we can’t take action in those cases, we’ll log the information for future reference and, where appropriate, refer concerns to employers or relevant bodies.”
Education Standards and Course Approval
From December 2023, the GMC will be responsible for setting the standards for PA education and training. This includes the approval of courses and curricula to ensure that PAs are trained to operate safely. The regulator will also conduct quality assurance checks of PA courses in collaboration with the Royal College of Physicians and the Faculty of Physician Associates.
PAs who register with the GMC will need to adhere to Good Medical Practice, the same standards expected of doctors. The GMC is also developing a model for revalidation, with further consultations on the rules to be carried out before dates are established.
Public Consultation and Next Steps
Earlier in 2023, the GMC conducted a public consultation on the proposed rules and standards for PA regulation. Massey confirmed that the regulator is still analyzing the responses and will release a detailed report in December. The report will provide quantitative data and explain how feedback from the public and research has shaped the final rules and standards.
Importantly, the GMC stressed that it will not define a scope of practice for PAs beyond initial qualification competencies. The final guidance and rules will be published after approval from the GMC’s governing Council in December.
Legal Challenges and Professional Concerns
The GMC is currently facing potential legal challenges from various doctors’ groups regarding PA regulation. Anaesthetists United has been fundraising for a case to demand clear and enforceable guidance on what PAs can and cannot do. This week, the BMA confirmed its financial support for Anaesthetists United’s case.
Additionally, the Royal College of General Practitioners (RCGP) recently issued guidance limiting the practice of PAs. They recommended that PAs should not see un-triaged patients and are best suited for handling a set of minor illnesses typically managed by Pharmacy First. Although the RCGP’s guidance is not enforceable, it advised that it could influence legal cases involving alleged negligence.
This regulatory development represents a significant shift in how PAs and AAs will be integrated into the UK healthcare system, with the GMC assuming a critical role in their professional oversight.