Reforming healthcare professional regulation 

Reforms to healthcare professional regulator powers

From 13 December 2024, the General Medical Council (GMC) began to regulate Anaesthesia Associates (AAs) and Physician Associates (PAs). This change has been introduced through legislation called the Anaesthesia Associates and Physician Associates Order (AA and PA Order). The decision to regulate AAs and PAs was made by the Government.

The  AA and PA Order is the first step in a programme of reform to the other healthcare regulators and will act as the blueprint for these reforms. The current Government has announced a renewed commitment to proceed with reform for the rest of the GMC, the NMC and the HCPC.  We know that, from our work overseeing the regulators, there is an urgent need for reform and we welcomed this commitment.

The regulatory model set out in the AA and PA Order presents distinct advantages. It grants regulators more flexibility to determine how they use their powers, and provides for a new fitness to practise model that allows more cases to be decided consensually with the registrant, outside a formal hearing.

However, we want to make sure that the right balance is struck between autonomy and accountability for the regulators. We would also like to see greater engagement with a wider range of stakeholders in the next rounds of reform, including patient representatives, to ensure that public protection is at the heart of regulatory reform.

What the PSA is doing to support reform

To support the regulators make best use of the new powers they will gain when their legislation is reformed the PSA has published guidance to encourage good practice. 

The regulators will have new powers to use a less adversarial and quicker ‘accepted outcomes’ process for dealing with complaints about healthcare professionals. Our accepted outcomes guidance:

• provides pointers to help regulators decide when a case can be resolved without a public hearing
• advises on when a hearing might be needed to maintain public confidence and ensure a robust review of the evidence
• helps regulators decide who should make the final decision on a case when not referring it to a hearing
• helps regulators decide what information to include when publishing decisions.    

The regulators will also have new powers to make and amend the rules governing the way they regulate. Our rulemaking guidance:

• lays out principles to guide regulators to use their powers transparently, with appropriate consultation and in a way which prioritises public protection
• encourages regulators to consider how their use of these powers aligns with the practice of other professional regulators, as appropriate.

This guidance currently applies to the processes set out in the Anaesthesia Associates and Physician Associates Order (AAPA Order). 

This guidance is intended for healthcare professional regulators to use when developing their own guidance and processes. For most regulators, this will only be applicable once their legislation has been updated in line with the government’s programme of regulatory reform.  

This guidance is not mandatory, and regulators can take a different approach to drafting their guidance. However, we will have regard to our guidance when we assess how regulators are using their new powers under our review of their performance. There is further information in the guidance about how we will use this guidance in relation to our performance review.  

We consulted on this guidance and have now published the consultation outcome report summarising how we took feedback into account.

Other reforms relevant to our role

The Health and Care Act

The Health and Care Act was passed by Parliament in 2022. It is a large and wide-ranging piece of legislation, however the key elements of interest for professional regulation include new powers for the Secretary of State to: merge or abolish any of the healthcare professional regulators or to deregulate professional groups.

We published our view of the Government’s proposals for reform of professional regulation in the Health and Care Bill in October 2021.

Legislation was also amended outlining a commitment to introduce a licensing scheme for non-surgical cosmetics, see further details below.

Non-surgical cosmetic procedures

We responded to the Government’s consultation on licensing of non-surgical cosmetics and also published a briefing outlining the key points we raised in our response. We also responded to the Scottish Government consultation on introduction of a licensing scheme.  

The Scottish Government have now committed to take forward implementation of such a scheme and the UK Government also announced the intention to move forward with a licensing scheme for England as well as additional safeguards for higher risk procedures including new age restrictions.

The PSA will be working with both Governments to support the development and implementation of the new regulations and to encourage a consistent UK-wide approach where possible.   

Regulation of NHS managers 

Following a public consultation the UK Government has announced that it will bring forward legislation to introduce a barring scheme for senior NHS Managers in England. The scheme will be operated by the Health and Care Professions Council (HCPC) and will sit within a package of measures to strengthen leadership within the NHS, alongside the leadership and management framework currently under development by NHS England.

The PSA welcomed the announcement as a step towards strengthening accountability for senior managers within the NHS and will be monitoring proposals closely as they are developed and considering further any implications for our oversight of the HCPC, in partnership with the DHSC and NHS England.