Revalidation for physician associates and anaesthesia associates

Revalidation is the process we’ll use to make sure PAs and AAs on our register remain fit to practise. We already do this for licensed doctors.

As we prepare for regulation, we’re developing a revalidation model that will support PAs and AAs to reflect on and develop their practice, give colleagues and patients confidence that they’re keeping up to date, and help drive improvements in clinical governance.

When will PAs and AAs have to revalidate?

Revalidation for PAs and AAs will be implemented after the regulation transition period. At that point it will be a legal requirement for all PAs and AAs in the UK to be on our register. This means that revalidation will start no sooner than two years after regulation. 

How will revalidation work for PAs and AAs?

Revalidation will be based on the collection of six pieces of supporting information. The information will be discussed and reflected upon at annual appraisals. Then, usually once every five years, we’ll ask employers to make a recommendation to confirm that a PA or AA remains up to date and fit to practise.

Before regulation starts, we’ll issue further guidance on the information to be collected. This will mirror the six categories of supporting information that we currently require for doctors: 

• continuing professional development, 
• complaints and compliments, 
• feedback from colleagues, 
• feedback from patients,
• quality improvement activity, and; 
• significant events. 

Just as for doctors, our revalidation model will not routinely require PAs or AAs to sit an exam.

PAs and AAs who are working in educational, rather than clinical roles, will still be able to meet our revalidation requirements. Our model will be flexible enough to ensure those who take a temporary break from work are not disadvantaged and are still able to revalidate. For instance, revalidation might be deferred for a sabbatical, sickness absence or parental leave.

Those who are not working as an AA or PA at all will need to give up their registration and re-apply when they’re ready to return to practice. The process of restoring registration will normally be quick and straightforward. 

How will PA/AA revalidation work for employers?

Once every five years we’ll ask employers for a recommendation about each PA and AA to confirm they are:

• collecting the required supporting information and discussing this during annual appraisal
• fit to practise, complying with any conditions on their registration and working within the bounds of their competence
• keeping their knowledge and skills up to date by participating in CPD/lifelong learning, training and other activity
• working within a locally agreed framework of clinical governance that includes a requirement for supervision appropriate to their role and experience.

During 2023, we’ll update our existing guidance for employers, Effective clinical governance for the medical profession, so that it will be ready to apply to PAs and AAs in future. This guidance supports organisations to evaluate the effectiveness of their local arrangements, including clinical governance, appraisal, managing concerns and pre-employment checks. Extending it to cover PAs and AAs once they’re regulated means we expect these professionals to be subject to the same high standards as doctors.

Who will be able to make revalidation recommendations about PAs and AAs?

The new legislation (AAPAO) will allow us to set out in rules who can make a revalidation recommendation. We expect it will be possible for current Responsible Officers – who make such recommendations for doctors – to take on this role if they wish but it won’t be limited to them. 

How we decided on our approach

We carried out extensive engagement to make sure our approach to revalidation was informed by the views of PAs, AAs and those who employ and supervise them. This included discussions with bodies representing PAs, AAs and doctors, and government health departments. We ran a workshop session attended by more than 40 employer representatives and we reviewed how revalidation operates for other UK healthcare professionals.

In summer 2022 we set out our proposed revalidation approach in a survey to our Community of Interest. Almost 600 people responded (including 403 PAs and 34 AAs) of which 132 people have a role in the governance and management of PAs and AAs. There was strong support for our proposals. Read the full analysis of the survey in our Summary of engagement activity – proposed revalidation approach for PAs and AAs.

What’s happening to the Faculty of Physician Associates’ PA recertification exam?

The Faculty of Physician Associates (FPA) have recently updated their recertification requirements for the voluntary register and these will no longer include an exam. For information on how PAs on the voluntary register will continue to demonstrate that they are keeping their knowledge and skills up to date until the start of regulation see the FPA website.