UMAPs has become aware of recent articles in medical publications reporting that there are employers still allowing Physician Associates to treat undifferentiated patients over a year after the Leng Review, and that this “deeply concerned” some doctor representatives.
Our response to this is clear; If the doctor representatives’ main concern was genuinely patient safety, they would focus on the ~13,500 fitness to practice concerns referred to the GMC against doctors last year, or the 1300 plus deaths per month caused by lack of access to clinicians in A&E. Instead, they have been driving largely unsubstantiated complaints against Associates – a workforce which has never been found unsafe, including by the Leng Review team itself.
It is absolutely crucial to note that the Leng Review and the NHSE/DHSC advice, to adopt the Review’s recommendations, carries no legal authority and is not a mandatory instruction. Following UMAPs’ challenge in August last year, both NHSE and DHSC retrospectively confirmed that their guidance is advisory only – although they offered the clarification only after they had prematurely instructed employers that PAs “must not” see undifferentiated patients. That instruction did not come about in a vacuum, but instead was the result of a lobby campaign, waged since 2023, of a protectionist group of doctors with the aim of preventing any professional who is not a doctor from seeing patients regardless of patient need. Their campaign has harassed the Associate workforce out of their roles, and they now seek to do the same to advanced practice clinician workforces – as evidenced currently on social media.
Employers who continue to deploy physician associates, who are themselves GMC-regulated, clinically trained professionals, are not defying anything other than protectionist opinion, and are instead exercising their own judgement about how to deliver safe care.
Judicial review update
UMAPs has been granted an oral renewal hearing in its judicial review challenging the making and adoption of the Leng Review recommendations. The hearing will take place on 8 September 2026, when UMAPs’ application for permission to proceed will be considered in open court. UMAPs filed its renewal notice on 23 July 2026 and rejects all 19 conclusions reached in the paper refusal.
UMAPs General Secretary Stephen Nash says:
“We are thrilled that our members will receive the hearing they deserve. We will have the opportunity to present the full picture of our case in open court, where employers, Associates and patients can see the arguments for themselves and draw their own informed conclusions about the motive for, handling of, and consequences of the Leng Review – instead of relying on the characterisations put forward by other parties to these proceedings, including the BMA.
The Leng Review and its recommendations have caused untold harm to employers, Associates, and patients. This oral hearing is the next step in delivering a just outcome for them.”
The judicial review remains our most significant tool for achieving accountability and lasting change for our members. Every contribution goes directly towards our legal fight. If you have not yet donated to the legal fund, or would like to increase your contribution, please visit this link: Donate here
