Achievement of 'parity of esteem for PAs and AAs with doctors'
Dear Department of Health and Social Care,
I refer to the Memorandum of Understanding between your Department and the General Medical Council on implementing the regulation of physician associates and anaesthesia
associates, kindly provided by your Department.
The aims for the GMC include, at points 17.4: 'To develop and implement a regulatory framework that provides parity of esteem for PAs and AAs with doctors'
and for the DHSC, at point 17.7: 'To ensure that the implemented regulatory framework provides parity of esteem for PAs and AAs with doctors'
Please provide information on the activities that are intended to lead to this stated aim of 'parity of esteem with doctors'.
Please provide information on the monitoring of progress by DHSC towards this outcome.
Please advise what key indicators will allow either body to claim that this aim has been achieved.
Please advise the consequences if either party fails in its aims and objectives.
Yours faithfully,
Susan Sollazzi
This is an acknowledgement - please do not reply to this email.
Thank you for contacting the Department of Health and Social Care (DHSC).
Your correspondence is being handled by the appropriate team.
If you have made an FOI request, DHSC is required under section 10(1) of
the FOIA to provide you with a response within 20 working days. If DHSC is
unable to do this, we will contact you nearer the time.
This e-mail and any attachments is intended only for the attention of the
addressee(s). Its unauthorised use, disclosure, storage or copying is not
permitted. If you are not the intended recipient, please destroy all
copies and inform the sender by return e-mail. Any views expressed in this
message are not necessarily those of the Department of Health and Social
Care. Please note: Incoming and outgoing email messages are routinely
monitored for compliance with our policy on the use of electronic
communications.
Dear Ms Sollazzi,
Please find attached the Department of Health and Social Care's response
to your recent FOI requests (our refs: FOI-1544934 and FOI-1544935).
Yours sincerely,
Freedom of Information Team
Department of Health and Social Care
Dear Department of Health and Social Care,
Thank you again for your response to my queries about the agreement between the DHSC and the GMC in relation to the registration of PAs and AAs. Freedom of Information Request References FOI-1544934 and FOI-1544935
The phrase 'parity of esteem for PAs and AAs with doctors', which is one of the aims set out in the MoU, has attracted attention and controversy. You have kindly sought to clarify the meaning of this phrase as follows: 'The principle of parity of esteem simply means that the GMC will apply the same robust regulatory processes fairly and equally to all its registrants.'
This explanation raises two points:
1. Applying the same robust regulatory processes fairly and equally to all registrants would be parity of process, nothing at all to do with esteem
2. The GMC cannot apply the same robust regulatory processes to PAs as to doctors, given that PAs:
- have no scope of practice against which to judge their actions, nor has the GMC any intention of introducing/accepting one
- have no specialist training or exams to demonstrate their safety in specialist areas where they may work, leaving their competence to be judged locally
- work in supervised positions, meaning they are not ultimately responsible for their patients, entirely unlike doctors.
Therefore your definition of 'parity of esteem' appears meaningless. Given that the phrase appears twice in the MoU, as a responsibility both for the Department and for the GMC, and that you have described it as 'an underpinning principle of regulation', I feel it is not satisfactory to leave the matter there and must ask two further questions.
1. Noting the dictionary definition of esteem as 'respect and admiration', what is the real meaning of 'parity of esteem for PAs and AAs with doctors'?
2. Even accepting your explanation, how would parity of esteem be possible for a workforce that will remain unregulated even after the GMC's registration comes fully into force in 2026, unlike doctors who are highly regulated?
Thank you for considering these important issues.
Yours faithfully,
Susan Sollazzi
┌───────────────────────────────────────────┬───────────────────────────────────────────┐
│ │ From the Ministerial Correspondence │
│ │ │
│ │ and Public Enquiries Unit │
│A black background with white │ │
│text<br><br>Description automatically │ 39 Victoria Street │
│generated │ London │
│ │ SW1H 0EU │
│ │ │
│ │ │
├───────────────────────────────────────────┼───────────────────────────────────────────┤
│ │ │
├───────────────────────────────────────────┼───────────────────────────────────────────┤
│Our ref: DE-1550187 │ │
├───────────────────────────────────────────┼───────────────────────────────────────────┤
│ │ │
├───────────────────────────────────────────┼───────────────────────────────────────────┤
│ │ 11 February 2025 │
├───────────────────────────────────────────┴───────────────────────────────────────────┤
│Dear Ms Sollazzi, │
│ │
│Thank you for your correspondence of 28 November about regulation of physician │
│associates (PAs) and anaesthesia associates (AAs). I have been asked to reply, and I │
│apologise for the delay in doing so. │
│ │
│ │
│ │
│Further to your previous Freedom of Information responses, the meaning of 'parity of │
│esteem for PAs and AAs with doctors' is the underpinning principle that all General │
│Medical Council (GMC) registrants will be subject to their regulatory processes, │
│without any one professional group receiving preferential treatment. For example, the │
│GMC holds all the education provision it regulates to high standards, whilst also │
│recognising doctors, PAs and AAs as three distinct professions. │
│ │
│ │
│ │
│The GMC’s approach to quality assurance of PA and AA courses is very similar to that │
│for undergraduate medical courses, as explained on its website, which can be found at │
│[1]www.gmc-uk.org/education/how-we-quality-assure-medical-education-and-training. In │
│addition, published standards for medical courses and those for PA/AA courses can be │
│found at │
│[2]www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes. │
│ │
│ │
│ │
│GMC regulation has now begun. As the regulatory body for PAs and AAs, the GMC will: │
│ │
│ │
│ │
│ • set the standards of patient care and professional behaviours PAs and AAs must │
│ meet; │
│ │
│ • set the outcomes and standards that students qualifying from PA and AA courses must│
│ meet to achieve registration, and approve the curricula that courses must deliver; │
│ │
│ • check who is eligible to work in the UK and that they continue to meet professional│
│ standards throughout their careers; │
│ │
│ • provide guidance and advice to help PAs and AAs understand what is expected of │
│ them; and │
│ │
│ • investigate if there are concerns that a PA or an AA may have acted in a way that │
│ risks patient safety or public confidence and take action if needed. │
│ │
│ │
│ │
│With regard to the reference that GMC regulation will only come into force in 2026 │
│given the two-year transition period set out in the Anaesthesia Associates and │
│Physician Associates Order, it is worth noting that the GMC anticipate that the │
│majority of practising PAs and AAs will register within the first three to six months │
│of regulation beginning. │
│ │
│ │
│ │
│I hope this reply is helpful. │
│ │
│ │
│ │
│Yours sincerely, │
│ │
│ │
│ │
│Correspondence Officer │
│ │
│Ministerial Correspondence and Public Enquiries │
│ │
│Department of Health and Social Care │
│ │
│ │
│ │
│Please do not reply to this email. To contact the Department of Health and Social Care,│
│please visit the [3]Contact DHSC section on GOV.UK │
└───────────────────────────────────────────────────────────────────────────────────────┘
This e-mail and any attachments is intended only for the attention of the
addressee(s). Its unauthorised use, disclosure, storage or copying is not
permitted. If you are not the intended recipient, please destroy all
copies and inform the sender by return e-mail. Any views expressed in this
message are not necessarily those of the Department of Health and Social
Care. Please note: Incoming and outgoing email messages are routinely
monitored for compliance with our policy on the use of electronic
communications.
References
Visible links
1. https://www.gmc-uk.org/education/how-we-...
2. https://www.gmc-uk.org/education/standar...
3. https://www.gov.uk/government/organisati...
We work to defend the right to FOI for everyone
Help us protect your right to hold public authorities to account. Donate and support our work.
Donate Now