Preparing for the regulation of PAs and AAs: working together to strengthen patient safety

Published 21 November 2024

Dear colleagues,I hope you're finding these updates helpful as we approach the start of the regulation of physician associates (PAs) and anaesthesia associates (AAs). While this remains a challenging period, we’re focused on completing the final steps for regulation to begin and the positive impact it’ll have on strengthening both patient safety and public trust in these professions.

Your continued support is vital as we work together to ensure we, the system, and individual PAs and AAs are ready for this important milestone.

Yesterday the Secretary of State for Health and Social Care announced a review of the roles and deployment of PAs and AAs. We welcome this review and are pleased that he confirmed regulation will come into effect in December as planned. We expect the review will provide clarity for patients, doctors, PAs, and AAs alike.

Below, I’ve provided a recap of our final preparations and key dates over the coming weeks.

21 November: update on registration fees for PAs and AAs

Today, Thursday 21 November, we’ll share information about the fee that PAs and AAs will pay to register with us. We’re sharing this now so that PAs and AAs understand and can plan for the cost.

We expect the fee to be £320, subject to approval by our Council on 13 December. It reflects the expected costs of regulating PAs and AAs and our statutory responsibilities to:

  • set the standards of patient care and professional behaviours PAs and AAs need to meet
  • set the outcomes and standards that students qualifying from PA and AA courses must meet to join our register, and approve the curricula that courses must deliver
  • check who is eligible to work as a PA or AA in the UK and check they continue to meet the professional standards we set throughout their careers
  • investigate where there are concerns that patient safety, or the public’s confidence in PAs and AAs, may be at risk, and take action if needed.

Find out more about PA and AA fees.

Early December: reporting on our consultation

We’ll soon publish a detailed report on the outcome of our consultation on the proposed rules, standards and guidance for regulating PAs and AAs.

The report will include quantitative data for each question we asked, a summary of responses to our proposals and an explanation of how they, along with insights from research carried out with members of the public, have shaped our final approach. We’ll also share information about other issues raised with us that were outside the scope of this consultation. And, where relevant, we’ll explain how we, or other bodies, are addressing these.

13 December: regulation comes into effect

The powers for regulation to begin will come into effect on 13 December 2024. Our governing Council will also approve the final rules, standards, and guidance that will implement the legislation introducing regulation of PAs and AAs.

16 December: Registration opens

Registration will officially open on 16 December 2024. We’ll invite a small number of PAs and AAs to apply before the end of the year, followed by others on the voluntary registers by the end of January.

When PAs and AAs gain registration with us, we’ll give them a reference number that is prefixed with the letter ‘A’. We’ve added this letter to distinguish it from the reference number that we give doctors, which is purely numerical. We’ll also prominently label each profession type on our public-facing registers, and in search functions. This means that when patients search our registers it will be very clear whether an individual is a doctor, a PA or an AA.

Supporting PAs and AAs to join a regulated profession

We’ve been engaging directly with PAs and AAs to help them understand the standards they’ll need to meet when they gain registration with us, including always introducing themselves and explaining their role; as well as working within their competence to ensure safe patient care.

We’re also providing practical details on the registration process and how PAs and AAs can apply. You can find more details of what this entails in our recent update for employers. We’d also appreciate your help in encouraging PAs and AAs to register as soon as possible in the new year.

Thank you for ongoing support.

Best wishes,

Charlie Massey

Chief Executive and Registrar
General Medical Council

Sent to:

  • Academy of Medical Royal Colleges
  • Chief Medical Officers in England, Northern Ireland, Scotland, Wales
  • Department of Health and Social Care England
  • Government officials in Northern Ireland, Scotland and Wales
  • Health Education and Improvement Wales
  • NHS Confederation
  • NHS Education for Scotland
  • NHS Employers
  • NHS England
  • NHS Providers
  • Northern Ireland Medical & Dental Training Agency