United Medical Associate Professionals (UMAPs) has sent pre-action letters to Health Secretary Wes Streeting and NHS England notifying them of an intended judicial review claim. The union is urging the Government to reconsider its decision to implement the recommendations of the Leng Review, which severely limit the roles of Physician Associates (PAs) and Anaesthesia Associates (AAs) in the health service.
Professor Gillian Leng CBE, who authored the Leng Review, has also received copies of the letters as a potential interested party.
UMAPs is represented by leading law firm Shakespeare Martineau and Patrick Green KC of Henderson Chambers, best known for representing sub-postmasters in the Horizon IT Scandal.
Among the claims made in the letter, UMAPs is alleging that the Government and health service failed to properly consult Medical Associate Professionals (MAPs) before implementing recommendations which massively impact their scope of work and pre-existing contracts. The union also accuses the Government of failing to carry out a proper cost/benefit analysis of how reducing the scope of MAPs’ work would affect NHS delivery targets.
Furthermore, UMAPs charges the government and health service with ignoring the potential bias of information included in the Leng Review and making recommendations which apparently seek to address grievances of Resident Doctors, rather than the safety of MAPs.
Commenting on the proposed legal action, Stephen Nash, General Secretary of UMAPs said:
“Despite admitting that there is a toxic debate around MAPs and a risk of bias in the existing research, the Leng Review found no hard evidence that physician associates are unsafe or ineffective. Nevertheless, Wes Streeting has accepted the Review’s recommendations to completely overhaul our job roles, without so much as consulting UMAPs as the recognised trade union for PAs and AAs. That is both unfair and completely irrational.”
“We are incredibly concerned about how these changes will impact patients’ access to care, particularly during the ongoing BMA strikes. Prior to these changes, PAs undertook approximately 20 million appointments a year in primary care alone. Now, every day we hear from employers who are struggling to manage patient loads because PAs and AAs are no longer allowed to carry out the jobs we are trained to do. Yet the Health Secretary has seemingly not carried out any assessment of how the Leng recommendations will affect NHS backlogs.”
“It is hard to see Mr Streeting’s decision as anything other than an attempt to mollify the increasingly radical BMA, which has spent the last few years waging a vindictive and highly coordinated campaign against Medical Associates. Now he has played right into the BMA’s hand, preventing qualified medical professionals from treating patients properly so that their strikes bite even harder.”
Sneha Naiwal, a partner at Shakespeare Martineau who is leading the case for UMAPs said:
“This case is not about resisting change, but about ensuring that change is lawful, evidence-based, and respectful of the professionals who have long served on the front lines of patient care. Physician Associates deserve a meaningful voice in shaping their future – not to be sidelined by decisions taken without full and open engagement. The claimants are concerned that the current approach could undermine a vital part of the clinical workforce and increase pressure on NHS services, to the detriment of patients and staff alike.”
UMAPs is asking both the Secretary of State and NHS England to reconsider the decision to implement the recommendations of the Leng Review. If they refuse to do so, UMAPs has requested that they provide reasons for having originally accepted the Leng Review recommendations on the day of publication and reasons for refusing to reconsider by Friday 1 August.
The union is also asking Mr Streeting and NHS England to explain any contact they had with Professor Leng prior to the publication of her review, as well as any prior notice of the review’s contents. Additionally, they are requesting that both parties disclose any and all correspondence relating to the Review from the date of commission.
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About UMAPs
United Medical Associate Professionals Trade Union (UMAPs TU) was founded in December 2024 to represent medical associate professionals and students, providing advocacy, legal support, and professional development advice to MAPs at every stage in their careers.
