Help us defend your friend, family member or colleague
Someone you know has shared this page because they need your help. Physician Associates and Anaesthesia Associates have spent more than 20 years working alongside doctors in the NHS, helping patients access care and supporting overstretched clinical teams. Today, this small profession of around 3,500 people is fighting some of the most powerful organisations in UK healthcare for the right to continue doing the work it was trained to do.
Since 2023, organisations that helped create and develop these professions have instead supported increasingly severe restrictions on them. UMAPs holds correspondence and other evidence which, in our view, demonstrates a deliberate strategy to restrict and ultimately remove Associate roles, alongside wider objectives concerning doctors’ labour market position and pay. The consequences are now devastating careers.
Experienced clinicians have had established duties removed, employment opportunities have disappeared and members are facing redundancy from a profession in which there may be nowhere else to go. Around 80% of this workforce is female and approximately half is from minority ethnic backgrounds. We are seeing the impact on people who are already vulnerable to inequality within established professional hierarchies, including women returning from maternity leave.
This matters to patients too. Removing trained clinicians does not create more doctors, appointments or NHS capacity. UMAPs is an interested party in coronial proceedings concerning a patient who died after waiting for assessment in an Emergency Department where restrictions had been placed on what Physician Associates were permitted to do. Meanwhile, UMAPs’ analysis of NHS England workforce figures shows an alarming continuing loss of clinicians from the profession since these measures were deployed, with recent figures indicating falls of around 10% month on month. NHS England has been able to see the consequences developing. At any stage it could have paused its approach while the legal position was resolved. It did not.
On 8 September 2026, UMAPs will ask the High Court for permission to continue our judicial review. The respondents have repeatedly been asked to identify the statutory power relied upon to impose these restrictions and, to date, no such power has been identified to us. At the injunction hearing they maintained that their actions were intended to support the professions, and subsequently clarified that their measures were advice rather than mandatory requirements. That history is particularly concerning to us because the NHS has been here before. In BAPIO v Secretary of State [2008] UKHL 27, the House of Lords held Department of Health guidance to NHS employers unlawful where guidance was used in a way that interfered with an existing statutory scheme. UMAPs believes there are serious questions for the Court about whether national bodies have again attempted to achieve through employer guidance what they do not have lawful authority to impose directly.
UMAPs represents around 1,700 members. We are taking on national institutions and professional organisations with vastly greater resources, influence and access to power. But this fight is bigger than our profession. It is about whether the NHS is governed by evidence, patient need and fairness, or whether dominant professional hierarchies can determine who else is allowed to provide care. It is about protecting a predominantly female and ethnically diverse workforce from having careers dismantled without proper authority or accountability. And it is about preserving the NHS’s ability to use trained clinicians to help patients who desperately need care.
Please stand with the friend, family member or colleague who sent you this page and help us raise £320,000 to take this fight forward.
