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Reforms to healthcare professional regulator powers

Recent reforms

In December 2024, the General Medical Council (GMC) became the regulator for Anaesthesia Associates (AAs) and Physician Associates (PAs) under the Anaesthesia Associates and Physician Associates Order 2024. This was the first step in a wider programme of healthcare professional regulation reform. 

In 2026, the Government consulted on a new legislative framework for the GMC. The proposed GMC Order would modernise how the GMC regulates doctors, AAs and PAs and is intended to provide a blueprint for wider reform across the regulatory sector. The Government has also committed to bringing forward reforms for other regulators, including the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC) within this Parliament. 

Why reform is needed

We know from our oversight work that reform is needed. The proposed model would give regulators greater flexibility to use their powers effectively and introduce a more proportionate fitness to practise process, allowing more cases to be resolved without a full hearing where appropriate. 

The PSA supports the overall direction of reform. However, it is important that greater flexibility for regulators is balanced by appropriate safeguards, transparency and accountability. It is important there is strong engagement with patients, the public and professionals in all further phases of reforms is developed.

What the PSA is doing to support legislative 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). However it will be updated once the GMC order passes into law and in line with subsequent legislation passed.

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.

The PSA is also reviewing its operational readiness for reform to ensure that we are able to adapt our processes to provide robust oversight for reformed and unreformed regulators.