Freedom of Information Team
Department of Health and Social Care
39 Victoria Street
London SW1H 0EU
www.gov.uk/dhsc
Ms Susan Sollazzi
By email to:
xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
25 November 2024
Dear Ms Sollazzi,
Freedom of Information Request References FOI-1544934 and FOI-1544935
Thank you for your requests dated 5 November to the Department of Health and Social
Care (DHSC), copies of which can be found in the accompanying annex.
Your requests have been handled under the Freedom of Information Act 2000 (FOIA).
Where more than one request is received for the same or similar information, section 5(2)
of the Freedom of Information and Data Protection (Appropriate Limit and Fees)
Regulations 2004 allows public authorities to aggregate requests and respond to them
together.
FOI-1544934
DHSC does not hold the information you have requested.
We have additional information which we are providing to you on a discretionary basis.
This is outside the scope of the FOIA and not subject to internal review.
Section 6.4.1 of the Memorandum of Understanding (MoU), which we provided to you in
our previous response (FOI-1536643), sets out the governance arrangements for the
project. These include a quarterly governance group and a financial accountability group.
The papers from these meetings are not published.
More specifically, in relation to expenditure, the General Medical Council (GMC) invoices
DHSC for work relating to the regulation of Physician Associates (PAs) and Anaesthesia
Associates (AAs) on a quarterly basis. Upon receipt, DHSC considers the invoice against
Annex C of the MoU,
and only approves once satisfied that the spend is in keeping with
the principles set out in the MoU and ensures value for money.
DHSC publishes details online of all departmental spending over £25,000 on a monthly
basis and can be found a
t DHSC spending over £25,000 - GOV.UK (www.gov.uk). This
dataset includes all payments made to the GMC relating to this project from 2022 until the
present date. Spend is published one month in arrears and invoices relating to this project
are paid in January, May, July and October of each year.
FOI-1544935
DHSC does not hold specific documents relating to parity of esteem between doctors, PAs
and AAs.
We have additional information which we are providing to you on a discretionary basis.
This is outside the scope of the FOIA and not subject to internal review.
In addressing this question, it is important to highlight the meaning of the phrase ‘parity of
esteem’ as referenced in the MoU. 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. Parity of esteem does not mean that PAs and AAs are the same as doctors or
that they have equivalent knowledge and skills. The GMC has been clear that it will
recognise and regulate doctors, PAs and AAs as three distinct professions.
As set out above in response to FOI-1544934, and in the MoU, DHSC holds regular
governance and finance meetings with the GMC where progress is discussed. There is no
specific progress indicator relating to parity of esteem, as this is an underpinning principle
of regulation rather than a standalone metric.
It must also be noted that the Professional Standards Authority for Health and Social Care
(PSA) has oversight of the healthcare regulators, including the GMC, and carries out a
performance review of each regulator in a three-year cycle. This represents a more
targeted approach whereby the PSA reviews a regulator in detail once every three years (a
‘periodic review’). In the other two years of the cycle, the PSA continues to monitor the
work of the regulator, along with any concerns it has and risks that emerge.
As part of the review, the PSA checks how well the regulators have been protecting the
public and promoting confidence in health and care professionals and themselves against
the PSA’s
Standards of Good Regulation. These reports are published and, once
regulated, the PSA’s assessment of the GMC will include its activities in relation to PAs
and AAs.
Finally, we understand that the GMC has recently published an update on its consultation
report:
Preparing for the regulation of PAs and AAs update - GMC. If you are not satisfied with the handling of your requests, you have the right to appeal by
asking for an internal review. This should be sent to
xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx or
to the address at the top of this letter and be submitted within two months of the date of
this letter.
Please remember to quote the reference number above in any future communication.
If you are not content with the outcome of your internal review, you may complain directly
to the Information Commissioner’s Office (ICO). Generally, the ICO cannot make a
decision unless you have already appealed our original response and received our internal
review decision. You should raise your concerns with the ICO within three months of your
last meaningful contact with us.
Guidance on contacting the ICO can be found at
https://ico.org.uk/global/contact-us and
information about making a complaint can be found a
t https://ico.org.uk/make-a-complaint. Yours sincerely,
Freedom of Information Team
xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx
Annex
FOI-1544934 From: Susan Sollazzi <xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx>
Sent: Tuesday, November 5, 2024 11:48 AM
To: FreedomofInformation <xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx>
Subject: Freedom of Information request - Monitoring of the GMC re registration of PAs
and AAs
Dear Department of Health and Social Care,
Thank you for sending the Memorandum of Understanding between your Department and
the General Medical Council (GMC) relating to implementing the regulation of physician
associates and anaesthesia associates.
Q1. What monitoring does the DHSC undertake to ensure that the GMC is meeting its
objectives in a timely and efficient manner? Where can results be viewed?
Q2. What supervision is there of expenditure/claims by the GMC to ensure financial probity
and value for money? Where can results be viewed?
Q3. What oversight is there of the overall probity of the GMC, given its failure to provide
transparency on its activities to registrants or to the public? (I refer, as examples, to the
GMC's refusal to make public the outcomes of the consultation on PAs and AAs concluded
in May and the recent claim that the consultation was actually research; and to the GMC's
refusal to divulge the agreement between the DHSC and the GMC, i.e. the MoU so kindly
provided by your Department.) Where can results be viewed?
Yours faithfully,
Susan Sollazzi
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Please use this email address for all replies to this request:
xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
FOI-1544935 From: Susan Sollazzi <xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx>
Sent: Tuesday, November 5, 2024 12:07 PM
To: FreedomofInformation <xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx>
Subject: Freedom of Information request - 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
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Please use this email address for all replies to this request:
xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
