Legislation proposed by the UK Government for the regulation of physician and anaesthesia associates by the General Medical Council (GMC) has been welcomed by the regulator, although it fears some aspects will have unintended consequences.
The proposed reforms will allow the GMC greater flexibility to adapt policies and procedures to meet the needs of healthcare systems, registrants and patients. However, it says some areas, such as the grounds for fitness to practise action, need a rethink before they become law.
The GMC has published its response to the DHSC’s consultation Regulating anaesthesia associates (AAs) and physician associates (PAs). AAs and PAs will in future be regulated by the GMC, and the reforms will, eventually, serve as a template for the regulation of other healthcare professionals, including doctors. The GMC says the proposed legislation is a crucial step in enabling it to take a compassionate approach to regulation, with tangible benefits including:
- A simpler and streamlined regulatory framework – allowing fitness to practise cases to be resolved more quickly, for example new powers to administratively remove people convicted of serious criminal offences from register.
- Faster and less adversarial processes – where concerns are raised about an AA or PA that meet the threshold for investigation it will be possible, where appropriate, for them to be addressed through a process of ‘accepted outcomes’.
- An end to the ‘five year rule’ – the GMC is currently unable to consider complaints relating to matters more than five years old, unless certain criteria are met. The rule will not apply to AAs and PAs, and it is expected that, in future, it will not apply to doctors either.
- Greater autonomy – allowing the regulator to make and amend legally-binding rules that govern how it operates, balanced by a requirement to consult stakeholders.
Reform will also allow the GMC to support the UK’s health workforce by streamlining registration and making more accessible for those who want to work in the UK.
However, the GMC has raised some issues that it wants to be addressed before the proposals become law, including a plan to reduce the grounds on which fitness to practise action can be taken. There are currently six grounds, but the legislation would reduce that to just two; inability to provide care to a sufficient standard and misconduct.
The regulator argues that such a change, in particular dropping ‘adverse health’ as one of the grounds, risks unintended consequences, as the GMC would be required look at a person’s current ability to provide care rather than focus on risk.
It argues that such a move would undermine a compassionate approach to managing registrants’ health concerns, and the practical effect could mean the GMC having to wait for harm to have occurred before it was able to intervene.
Charlie Massey, the GMC’s Chief Executive, said: "There are issues to address and it is important the Government gets this right, but overall we welcome the proposals. We are pleased to be another step closer to having a framework for regulating AAs and PAs, which will enhance their professional standing and the contribution they make to health services and patient care.
"Our work is currently governed by legislation that is 40 years old and wildly misaligned to the needs of today’s patients and practitioners. We have been calling for change for some time, and so this is an important milestone. It is also a prelude to wider reforms that will affect all regulated healthcare professionals.
"The Government must continue to deliver on its commitment to prioritise this work. A more flexible and modern approach to regulation, so we can work ‘upstream’ to prevent harm from occurring, will allow us to devote our energies to the work of highest priority – supporting clinicians to deliver first-class care for patients."
Following the outcome of the DHSC’s consultation the new legislation, the Anaesthesia Associates and Physician Associates Order, will be laid before UK legislatures before coming into effect.
The GMC’s response to the Regulating anaesthesia associates and physician associates consultation is available online.