An independent review led by Professor Gillian Leng has proposed major changes to the role of Physician Associates (PAs) within the UK healthcare system. These proposals are likely to have important implications for employment law and employee relations, particularly for medical employers.
Key changes proposed
One of the most notable recommendations is to rename PAs to “Physician Assistants” . The aim is to better reflect their role and reduce confusion for patients about their level of training and responsibilities.
While this may seem like a simple rebrand, it could trigger a range of practical and legal changes and employers will likely need to update:
- employment contracts
- job descriptions
- organisational charts.
To ensure clarity and compliance with employment law, securing agreement from affected employees will, as always, be the cleanest way to get a contractual change confirmed.
Clearer boundaries around PA responsibilities
In a letter to NHS England members, it has been clarified that PAs should not assess undifferentiated patients outside clearly defined clinical protocols. They should also not be used for patient triage.
This means that employers must establish and document specific clinical protocols within which PAs can operate.
Emphasis on supervision and training
The review underlines the importance of effective supervision. Doctors supervising PAs should receive formal management training to ensure safe and effective clinical practice. As such, employers should ensure that these supervisory duties are clearly defined in employment contracts and provide appropriate training and support for supervising doctors.
This approaches not only ensures legal compliance but also support patient safety and workforce development.
Upcoming regulation and union involvement
We understand the General Medical Council (GMC) will be bringing forward separate regulations to formally codify the recommendations of the Leng report.
In parallel, the United Medial Associate Professionals (UMAP) – the union representing PAs – is reportedly seeking legal advice on the NHS England guidance and its implications for members.
Employers must stay informed about these regulatory changes and ensure that their employment practices comply with the new regulations.
What should medical employers do now?
The proposed changes to the role of PAs have significant implications for employment law and employee relations. To remain compliant and avoid legal risk, medical employers should:
- Review and update employment contracts (ideally with employee agreement)
- Refresh job descriptions and organisational policies
- Monitor developments from the GMC and UMAP
- Ensure supervisory roles and responsibilities are properly supported.
By acting early, employers can improve clarity across teams, support patient safety and professional growth of their employees, and help embed the PA role more effectively within their organisations.
