Implementing PA and AA regulation - progress so far

Dear colleagues,

I hope you’re keeping well.

Following my January email, I wanted to share an update on the progress we’re making to implement regulation for physician associates (PAs) and anaesthesia associates (AAs).

I’d be grateful if you could share this update within your networks.

Welcoming new PA and AA registrants

Since regulation came into effect in December 2024, we’ve focused on providing support and information to new and future registrants, employers, and other key stakeholders.

To date, we’ve granted registration to 2358 PAs and 104 AAs, and a further 680 PAs and AAs have submitted their application. 897 are in progress but not yet submitted.

We continue to encourage all eligible PAs and AAs, including those who were not previously on voluntary registers, to apply as soon as they’re able to. Your support in reinforcing this message across UK health services is greatly appreciated.

Beyond registration, we’re maintaining regular contact with new registrants to reinforce what it means to be a regulated professional. Throughout 2025 and beyond, we’ll offer guidance and resources to help them understand the standards expected of them and the support available.

Ensuring high standards of PA and AA education

A key benefit of statutory regulation is ensuring high and consistent standards in PA and AA education. By setting clear requirements for course content and delivery, we help to make sure that newly qualified PAs and AAs have the knowledge and skills needed to provide good, safe patient care.

Over the past few years, we’ve been working with course providers to assess whether their programmes meet our standards. Our governing Council has now formally approved 33 PA courses and three AA courses:

• 29 PA courses received full approval
• four courses were approved with conditions, meaning that while they have met our standards and students will be eligible to apply for registration, certain areas require improvement through targeted action plans. For example, ensuring that all aspects of the national curriculum for PAs are fully incorporated into teaching and assessment, where further alignment is needed.
• one PA course at the University of East London has not yet met the required standards. To address this, we’re implementing enhanced quality assurance measures, including regular engagement with course leaders, educators, and students to monitor progress and ensure the necessary improvements are made. The course will defer awarding qualifications to current students and pause further recruitment until we’re assured that our standards have been met, students have been supported to meet the required outcomes, and the course can be approved. We’ll continue working closely with both the provider and students to ensure clear communication and guidance throughout this process.
• all three AA courses in the UK have received full approval.

We’re writing to course providers to explain what this means for them and will ask them to communicate directly with students on our behalf.

Looking ahead

We recognise that discussions around the deployment, supervision and future development of PA and AA roles are ongoing. Last month, we submitted our response to Professor Gillian Leng’s review of these professions in England. Our submission highlights the benefits of statutory regulation, the progress made so far in implementing it for PAs and AAs, and the need for a coordinated, system-wide approach to their deployment, development, and oversight. We look forward to the review’s findings and hope they will bring clarity and assurance for patients, PAs and AAs, and doctors alike.

We’ve also developed a new resource on our ethical hub to support doctors supervising PAs and AAs. It consolidates relevant sections of the professional standards, provides practical advice on supervision, and signposts to useful resources from other organisations. We’ll be sharing it with registrants through our channels.

Alongside we continue to work with employers to make sure they understand their role in managing and supporting PAs and AAs. This includes implementing effective clinical governance arrangements, ensuring access to annual appraisals, and enabling PAs and AAs to collect the information that will be needed for future revalidation. We’re currently developing a revalidation process that will help PAs and AAs remain up to date and continue to meet our standards once they’ve registered with us. We plan to consult on the rules for how revalidation will be delivered later this year, and we’ll share more details in the coming months.

I hope this update has been helpful. If you have any questions or need further information, please don’t hesitate to get in touch.

Best wishes,

Charlie Massey

Chief Executive and Registrar
General Medical Council

Shared with key stakeholders across the four UK health systems, including system leaders, employer organisations, and education bodies.