The DHSC has launched a three-month consultation on legislation that will overhaul the General Medical Council’s (GMC) regulation of doctors, physician associates and anaesthesia associates. Just days ago it was announced that this consultation now also includes the implementation of Leng Review recommendations relating to renaming the professional titles of Medical Associate Professionals. UMAPs supports genuine, good-faith consultation. What we do not support is the appearance of consultation as a procedural formality for a decision that has already been made. Based on the Leng Review process – in which our 66 submissions were ignored, our representatives were excluded from pre-publication engagement, and all 18 recommendations were accepted by the Secretary of State on the day of publication – we have no confidence that this consultation will be any different.
Our position is as follows: the proposed rename (which is part of the consultation) from “Physician Associate” to “Physician Assistant” is regressive, professionally damaging, and serves no patient safety purpose. It is a concession to a lobby group rather than a response to clinical evidence. We call on DHSC to reject it.
1. UMAPs Has No Confidence in This Consultation Process
The Leng Review was presented as an independent, open-minded inquiry. Published Royal College of Anaesthetists (RCoA) Council minutes from 14 May 2025 record that the Review team invited the RCoA and the Association of Anaesthetists to review draft recommendations before publication. UMAPs, representing over half of all practising physician associates, was excluded from reviewing these draft recommendations. Following the publication of the Leng Review findings, the British Medical Association’s GP Committee England (BMA GPCE) was consulted on proposed changes to the ARRS Physician Assistant and Apprentice Physician Assistant role descriptions directly affecting PAs. Once again, UMAPS was excluded.
The BMA has publicly stated it has “long called for the return of the name ‘assistant’”. Professor Leng then recommended this change after receiving a “dossier” of material from the BMA. The Secretary of State then accepted that recommendation on the day of publication. The question this consultation is asking has, in effect, already been answered by those conducting it.
2. This Change Reverses a Decision the DHSC Itself Made on Exactly These Grounds
The name “physician associate” is a statutory title. The Royal College of Physicians (RCP) records that the profession was originally introduced into the NHS as “physician assistants”, and that the title was formally changed to “physician associates” in 2013. It was then put on a statutory basis by The Anaesthesia Associates and Physician Associates Order 2024. That change was made, in the RCP’s own words, because it was “strongly suggested from within the DHSC that the term ‘assistant’ would hold the profession back from becoming regulated, as it was perceived at that time that ‘assistants’ did not need to be regulated.” Why, if the concern is patient safety, would DHSC want to row back the regulation of MAPs? It simply makes no sense, unless the Secretary of State’s true motive is to appease lobby groups like the BMA.
3. “Assistant” Is Reductive and Professionally Inaccurate
Physician associates are qualified clinicians, trained to master’s level, regulated by the GMC, who assess, diagnose, and manage patients under named consultant supervision. The proposal to rename them “assistants” is an unjustified diminishment of a profession that has spent over twenty years building clinical credibility within the NHS.
The international direction of travel is clear: countries with decades of experience in this profession are moving away from “assistant” because it does not reflect the reality of the role. The United States, Ireland and India are all moving towards “associate” terminology that better captures clinical responsibility and expertise.
The UK is now being asked to go backwards. This is despite having shown early leadership in 2013, when it deliberately moved from “assistant” to “associate” as part of a path towards professional recognition and regulation, before establishing legal protection for the titles “Physician Associate” and “Anaesthesia Associate” under the Anaesthesia Associates and Physician Associates Order 2024 (“AAPA”). Why is the UK regressing while others are progressing?
There is no clinical case for this reversal. The Leng Review found no evidence that the term “associate” causes patient confusion or compromises safety. The BMA, which has “long called for” this change in title, confirmed in its BMA’s own submission to the Leng Review that “physician’s assistant” is preferable because it makes clear “where in the healthcare team” the role sits.
This is about status and hierarchy rather than patient safety, and does not reflect modern collaborative healthcare. UMAPs rejects this framing entirely. Professional titles should describe what clinicians do, not diminish it.
The proposed renaming also makes a mockery of its own stated purpose: to enhance clarity. Under the draft order, anaesthesia associates would be renamed “Physician Assistant in Anaesthesia”. But a physician associate currently working in an anaesthesia team would become a “Physician Assistant”, working alongside a “Physician Assistant in Anaesthesia”. Two different professionals, in the same clinical environment, with near-identical titles. The clarity argument collapses.
4. The Timing and Context of This Proposal Cannot Be Ignored
This consultation follows the Leng Review that found no evidence that PAs are unsafe, but nevertheless recommended sweeping restrictions on the scope of practice for MAPs. The recommendations were adopted by the Secretary of State on the day of publication. UMAPs is currently in challenging a number of those recommendations in judicial review proceedings.
The name change was recommended by the same review, and was immediately adopted by royal colleges, including the RCP, before any consultation had taken place. Recommendation, adoption, then consultation – this is not a consultation process. It is a ratification exercise.
5. Conclusion and Call to Action
UMAPs calls on DHSC to:
- Reject the proposed rename on the grounds that it is regressive, professionally inaccurate, and unsupported by any evidence of patient safety benefit.
- Publish the full consultation findings transparently, with a clear account of how responses were weighted and which evidence informed decisions.
- Cease the pre-emptive adoption of the “physician assistant” title by royal colleges and NHS bodies until the consultation is complete, otherwise the consultation is rendered meaningless.
We urge every physician associate, colleague, patient, and supporter to respond directly to this consultation. Responses must be submitted by 24 June 2026. You can respond online via the official consultation page at: https://www.gov.uk/government/consultations/reforming-the-general-medical-council-legislative-framework
Your response matters. Answer the survey questions clearly and in your own words. Volume of response, and quality of argument, are both counted.
UMAPs reserves its position in relation to ongoing judicial review proceedings, which encompass questions about the propriety of the process by which the Leng Review’s recommendations, including this one, were reached and adopted.
Quote from UMAPs’ General Secretary Stephen Nash:
“The DHSC changed this title to ‘associate’ in 2013 because their own department recognised that the term ‘assistant’ would hold the profession back. They are now looking to reverse that decision without any evidence or credible explanation. More than just a title, this is about professional recognition – and the rationale for legislative change cannot be simply because another organisation, such as the BMA, asked for it. We have 95% of our members reporting significant strain to their mental health, which highlights the real human impact of this proposal. Legislating a title that implies subordination and undermines professional recognition is deeply concerning.”
