GMC welcomes judgment following judicial review by British Medical Association
The GMC welcomes the decision of the High Court, in a judgment handed down today, to dismiss on all three grounds a judicial review claim brought by the British Medical Association (BMA). In the claim they had challenged our decision to apply our core professional standards – Good medical practice – to doctors, physician associates (PAs) and anaesthesia associates (AAs) and our use of the term "medical professionals" within this guidance.
Charlie Massey, Chief Executive and Registrar of the GMC, said:
‘We welcome Mrs Justice Lambert’s judgment, which dismisses in its entirety the BMA’s claim for judicial review of our decision to apply our core professional standards – Good medical practice – to all three professions we regulate (doctors, PAs and AAs), and our use of the term "medical professionals" within this guidance.
‘We are pleased the court has recognised that our decision to produce our guidance in the form of a single set of core standards for all three professions we regulate was a logical and lawful decision to reach, and one which followed an exhaustive and detailed process of consultation, research and inquiry which engaged all major stakeholders, including the BMA.
‘Our approach, in publishing a single set of core standards, is consistent with what we heard during the consultation period, as well as with that of other multi-profession healthcare regulators. The judge concluded that PAs and AAs following the same professional standards as doctors was logical, and that in doing so the GMC had acted at all stages to further patient safety.
‘This comprehensive judgment also finds that there is nothing irrational or inherently confusing about the use of the term “medical professionals” as a collective term in this context.
‘We have made it very clear that we recognise and regulate doctors, PAs and AAs as three distinct professions. We have also been consistent in saying that, as their regulator, we expect PAs and AAs to always work under supervision and to practise within their competence. They have a responsibility to clearly communicate who they are, and their role in the team.
‘To register with us, PAs and AAs also need to show that they have the knowledge, skills, and experience to treat patients safely, and that there are no outstanding concerns about their fitness to practise. Bringing PAs and AAs into regulation provides assurance to patients, colleagues and employers that they are safe to practise and can be held to account if serious concerns are raised.’
- Ends
Key extracts of Mrs Justice Lambert’s judgment
“All of the evidence indicates to me that, in producing shared standards, the GMC acted to further patient safety. It undertook a lengthy process of consultation and pre-consultation before the final decision to issue merged guidance was made by the General Council in April 2023. … All these steps were designed to inform the GMC as to the form of regulation which would best protect the public.
“The outcome of the process pointed, in the GMC’s view, in one direction: that associates should be held to the same high professional standards as doctors and that a single set of guidance for use by doctors and associates was (as Mr Massey, the GMC Chief Executive explained in his letter of 4 April 2024 to Anaesthetists United (see paras. 54 – 56 above)) in the interests of both patients and professionals; it would instil confidence in colleagues and patients that all registrants are working to the same expectations and that when concerns are raised about the conduct of doctors, PAs and AAs those concerns would be considered against the same set of expectations.
“The history of the development of the policy clearly demonstrates in my judgement that the GMC acted at all stages with the aim of promoting the statutory purpose.”
She continues:
“The defendant is an experienced regulator and its decision to produce single guidance followed an exhaustive and detailed process of consultation, research and inquiry which engaged all major stakeholders, including the claimant. The process pointed towards the application of the same high standards of practice for associates as for doctors.
“The guidance was developed in the knowledge of various concerns having been raised about the role of associates which the defendant considered may be addressed by the holding of associates to the same high standards as doctors. … It is true that the guidance does invite the reader to establish for themselves which standards were relevant to their specific circumstances; but this has always been the case with previous iterations of GMP which applied to doctors only. No one set of standards guidance will apply to all registrants irrespective of their clinical circumstances, whether doctor or associate.”
“Nor was the outcome of the reasoning process, in my judgement, outside the range of reasonable responses open to the defendant. On the contrary, I conclude that it was open to the GMC to consider that the protection of the public would be best served by applying the same high professional standards to associates, who are trained to the medical model and who undertake medical duties in order to free up qualified doctors for more complex work.
“The use of shared standards was logical given the overlap in work undertaken by doctors and associates and the need for regulatory concerns affecting all three professions to be considered against the same standards. There is nothing irrational or inherently confusing about the application of the same standards to doctors and associates.
“Nor is there anything irrational or inherently confusing about the use of the term “medical professionals.” Associates are members of a profession, trained to the medical model, undertaking work which might otherwise be performed by doctors and working as members of a multi-disciplinary team in a healthcare context. Viewed in this way, the defendant was entitled to conclude that the term “medical professional” was apt.”
Additional information
Our consultations with the BMA on Good medical practice 2024 included:
- A pre-consultation survey in 2021 which included a specific question on applying the core professional standards to doctors, PAs and AAs. No concerns were raised by the BMA in relation to this question.
- Our formal public consultation on Good medical practice in 2022 stated clearly that we intended to have one set of core professional guidance for all medical professionals registered with us. It also stated that we had adopted the term ‘medical professionals’ to describe all the professional groups we regulate. The BMA did not address either of these matters in its response to the consultation.
- In 2023 the GMC emailed an embargoed copy of Good medical practice 2024 to the BMA, in which it was confirmed the guidance would also apply to PAs and AAs when we became their regulator.
- We also presented at several BMA committee meetings and held informal meetings with BMA staff throughout the review at which the development of Good medical practice 2024, and the standards to be applied to doctors, PAs and AAs, were discussed.
- BMA members were part of an External Advisory Forum which was set up to act as a ‘critical friend and sounding board’ for key decisions and developments throughout the development of Good medical practice 2024.
