Statement about MWF support for Anaesthetists United in their legal case
At the March 2025 council meeting, the Medical Women’s Federation agreed to support Anaesthetists United (AU) in their legal case against the GMC over its failure to institute performance standards for Physician Associates and Anaesthesia Associates. MWF supports this because of the impact on our own members and on patient safety.
MWF viewpoint:
- Medical Women’s Federation (MWF), the largest membership organisation of women doctors and medical students in the UK. MWF is strongly supportive of a clear scope of practice for Physician Associates and Anaesthesia Associates.
- Women doctors now number over 50% of licensed doctors on the medical register. Women doctors are frequently mistaken for other staff and 91% experience sexism regularly(1). Having Physician Associates without a clear scope of practice is confusing for patients and for other staff. It also risks worse care, in that patients do not know who is the doctor, with whom they should discuss the complexities of their medical condition. It is a risk to patient safety if patients confuse the staff groups, which frequently occurs.
- Women doctors are over 50% of doctors in General Practice. Our MWF GP members report that they spend time managing test results that have been requested by other staff (such as Physician Associates) who do not have the competencies to interpret them. Some of these tests were unwarranted, or identify issues that are not clinically significant.
- Women doctors are 57% of those in postgraduate training (as resident doctors). They report that training opportunities are being lost to Physician Associates.
- Because the years of postgraduate training coincide with when many doctors are starting a family, every moment of potential training that is lost has far more impact on many women doctors during pregnancy, maternity leave, returning from parental leave and being a parent. This contributes to a failure of retention of women doctors and a worsening of wellbeing.
- Our members are also being required to supervise Physician Associates without the role being clearly defined.
- What doctors need, at all stages, is more assistance with administrative and basic clinical skills. The MWF President, Scarlett McNally, in her own Trust led a very successful pilot of a role at Band 3 of “Doctors’ Assistant”, doing the work of a clinical scribe with basic clinical and administrative skills, as delegated by the doctor. This improved doctors’ efficiency and staff satisfaction (2). It won prizes for staff development. The NHS needs more staff in this support level role rather than increasing numbers of other autonomous practitioners (such as a Physician Associate, who typically works at a higher Band 6 or 7). The Level 3 apprenticeship for Doctors Assistants (as support workers) should be implemented.
- Doctors can uniquely handle the complexity of patients with multiple co-morbidities (24% of the UK adult population), reducing unwarranted investigations and interventions. Failure to have a clear scope of practice for Physician Associates and Anaesthesia Associates means organisations are attempting to employ them as if they are interchangeable with doctors.
- MWF is offering moral support, but not financial support.
Information provided from Anaesthetists United about their legal case.
The case against the GMC is simple - why are they failing to set performance standards for Physician Associates and Anaesthesia Associates? Why is there nothing defining what Associates can and cannot do? And what levels of supervision are required?
Physician Associates (PAs) and Anaesthesia Associates (AAs) are not doctors. They are taking over roles and responsibilities that have traditionally been undertaken by doctors, even though they have had less training.
The government has presented them as delivering “vital specific aspects of patient care” but nobody knows what those aspects are. In fact, many PAs are working by themselves, with little or no oversight, without patients even realising that they aren’t seeing a doctor. “Supervision” often amounts to nothing more than a doctor being reachable by phone, if the PA chooses to contact them.
The General Medical Council (GMC), who is now the regulator, has refused to establish national standards for supervision of PAs, their scope of practice, or processes for gaining patient consent. This has created a ticking time bomb in patient safety; and as the number of PAs grows then so too does the size of the problem.
Doctors Association UK (DAUK) is supporting this action, including with financial support.
The Anaesthetists United legal case rests on three grounds:
Abdication of responsibilities: The GMC’s refusal to implement safe and lawful practice measures is irrational and flies in the face of the regulatory framework outlined in the 2024 Anaesthesia Associates and Physician Associates Order. Their inaction is indefensible and endangers patients.
Failure to Investigate: The GMC has made no effort to examine the real-world risks posed by current practices in NHS Trusts. Our Freedom of Information requests have uncovered chilling policies, where Associates are given dangerously inappropriate responsibilities. This is happening already and is likely to get worse if it remains unchecked.
Encouraging Unlawful Practices: The GMC’s vague and misleading policies on supervision, delegation, and informed consent put clinicians and associates at risk of breaking the law. Patients have a legal right to know who is treating them, yet the GMC’s failures are paving the way for gross violations of consent.
The GMC have claimed that they themselves don’t have the expertise to say what Associates can and cannot do. So how can they, and their patients, be certain? There are many accounts of PAs providing excellent service to patients. But invariably this is when they are in a clearly-defined role. On the other hand, PAs working without supervision in primary care or A&E and seeing undifferentiated patients is a great cause for concern.
This judicial review aims to compel the GMC to define rules for Scope. This is needed in addition to the Leng review which might eventually result in defining scope - however AU argue that the law as it currently stands requires the GMC to take action immediately. And the longer the status quo is maintained the harder it will be to rein back Associates who are acting beyond their capabilities.
The Anaesthetists United case is based on: https://anaesthetistsunited.com/our-legal-case/
Emily Chesterton’s parents, grieving the loss of their daughter after a PA’s misdiagnosis, have joined AU in this fight. Their involvement is a stark reminder of how high the stakes are: https://anaesthetistsunited.com/bereaved-families-to-join-our-legal-case-over-physician-associate-supervision/
What are AU fighting for?
AU are calling for “safe and lawful practice” measures that will:
Set specific and safe limits on the tasks that PAs and AAs may undertake after qualification
Ensure proper levels of supervision
Ensure that informed patient consent is obtained.
How far has the legal case progressed?
Mr Justice Chamberlain, the Lead High Court Judge dealing with judicial review cases, has passed judgement. He has bypassed the first (permission) stage for AU and has expedited the hearing. In doing so, he has commented that the grounds of the case are reasonably arguable and added that the claim raises serious issues of importance to the relevant professions and to patients. The case is due to be heard in Court before the end of the Easter term. https://anaesthetistsunited.com/court-gives-us-the-go-ahead/
There is more information at: https://anaesthetistsunited.com/
