The Government, NHS England and Professor Gillian Leng must now defend the renaming of Associates as ‘Assistants’, and the lack of consultation with UMAPs, at a substantive judicial review hearing, on the evidence.
United Medical Associate Professionals (UMAPs) welcomes the decision by the High Court to grant permission to bring its judicial review of the decisions of 16 July 2025 to make, accept and implement the recommendations of the Leng Review. Mr Justice Sheldon granted permission on three of UMAPs’ grounds against NHS England and the Secretary of State, and two against Professor Leng, in a judgment handed down on 1 October 2026, following an oral hearing at the Royal Courts of Justice on 8 September 2026, having reconsidered the application following its refusal on paper on 16 July 2026.
The claim, brought against NHS England, the Secretary of State for Health and Social Care and Professor Leng, with the British Medical Association (BMA) as an interested party, will now proceed to a substantive hearing on those grounds at which the evidence of all parties will be examined in open court.
On the grounds that will now be tested at a substantive hearing, UMAPs argues that:
- The decision to rename Physician Associates and Anaesthesia Associates as ‘Assistants’ subverted or contradicted the statutory scheme under which Associates are regulated, and was irrational.
- NHS England and the Secretary of State were under a duty to consult UMAPs before making the title change, and Professor Leng failed to consult fairly on her recommendations, treating UMAPs unequally with other stakeholders.
- By not giving UMAPs the opportunity to advance its members’ interests before the decisions were made, NHS England and the Secretary of State breached Article 11 of the European Convention on Human Rights.
UMAPs is looking forward to a thorough analysis of the evidence in open court during the judicial review. In over a year of litigation the Government has disclosed only one substantive document: the Ministerial Submission on which the then Secretary of State, Wes Streeting, was advised to accept all 18 recommendations of the Leng Review on the day it was published. Neither the Secretary of State nor NHS England did, at the time of taking the impugned decision(s), identify the statutory power under which such decisions were taken.
The Ministerial Submission explicitly makes the link between the Leng Review and the Government’s dispute with resident doctors, referring to the Secretary of State’s “wider agenda with industrial relations, the 10 Year Plan and resident doctors”. Its very first page recommends that all 18 recommendations be accepted immediately. The Review was published on 16 July 2025: the Secretary of State accepted every recommendation that day while resident doctors were due to strike days later. Safety – the question Professor Leng was commissioned to answer – is mentioned only once in the body of the submission.
With permission granted, UMAPs will now press all three Defendants to comply in full with their duty of candour and disclose the key documentation that shows exactly how these decisions were made.
Stephen Nash, General Secretary of UMAPs, said:
“We wholeheartedly welcome Mr Justice Sheldon’s decision that key parts of our case are arguable and deserve to be heard.
The decision to rename our members as ‘Assistants’ was taken without consulting the union that represents them. The Court has now decided that the Government, NHS England and Professor Leng must answer to that, and for whether our right as a trade union to speak up for our members before decisions are made about them was respected.
We look forward to arguing this further during the judicial review with a full examination of the evidence. Our members are entitled to know why the decisions affecting them were taken and who they were really taken for, and patients deserve to know why their access to care has been restricted during these past 14 months.
UMAPs will continue to fight to hold to account those who have leveraged a dominant position within the NHS to shut out a group of workers who were trained to help patients. Our members have lost their jobs, have been pushed out of roles they trained and qualified for, and have been subjected to a hostile campaign against them by their colleagues, both online and in the workplace. This has had a profoundly damaging impact on the Associate workforce, which is around 80% female and over a third from Black, Asian and minority ethnic backgrounds.
Our message to NHS employers remains unchanged. The Leng Review and NHSE/DHSC’s advice to adopt the Review’s recommendations carries no legal authority and is not a mandatory instruction. Its lawfulness is now to be decided by the High Court, and any Associate dismissed or restricted on the basis of it will be supported by UMAPs in any potential claim(s) they wish to pursue before the employment tribunals.”
UMAPs is represented by Patrick Green KC, Jack Castle, Thomas Mallon and Kate Gardiner, instructed by Sneha Nainwal and Katherine Burnett of Shakespeare Martineau.
