It has been reported that GP Practices could be facing approximately 200 union-backed Employment Tribunal claims from individual Physician Associates (PAs). 

Background 

The PA role, its deployment, regulation and the plans to increase the use of PAs in the NHS and general practice have proved to be a controversial issue that remains unresolved. A central issue is the ‘scope of practice’ for PAs which remains uncertain as there is currently no statutory, regulatory or centrally-backed guidance on what they can and cannot safely do in clinical practice or how they should be supervised.   

In an attempt to remedy this, the British Medical Association (BMA) and the Royal College of General Practice (RCGP) issued guidance ( Physician associates in general practice: making it safe for patients and GPs and Physician Associates in general practice: Scope of practice) in October 2024 that aimed “to standardise practice and avoid variation in what PAs working in general practice are expected to undertake”.  

This guidance is only advisory, with GP practices not under any obligation to adopt it. However, amongst those that have, the interpretation of it has varied, with some practices stating that they will no longer employ PAs.  

In the meantime, the Leng review - an independent review of the PA and anaesthesia associate professions – is ongoing. It will consider the safety of the roles and their contribution to multidisciplinary teams in order to inform the workforce to deliver the 10-Year Health Plan. (Leng review: independent review of physician associate and anaesthesia associate professions terms of reference - GOV.UK and Leng review: further detail on the areas to be covered by the review of physician associate and anaesthesia associate professions - GOV.UK) It is anticipated that the findings and recommendations in the review (expected in Spring 2025) will provide a much needed direction for GP practices on the scope and supervision of PAs. 

The union’s position 

United Medical Associate Professionals (UMAPs), a newly recognised trade union, recently conducted a survey of its PA members to understand the impact of the guidance. UMAP has reported that, of the 387 members that responded, approximately 200 had been made redundant, dismissed or had their role materially altered by their employer since the guidance was issued in October 2024. In addition, UMAP reports that such action has disproportionately affected women and ethnic minorities.  

UMAP has now offered support to their affected PA members to bring employment tribunal claims against their employers. Given the employers’ reliance on the guidance, there are indications that the BMA and RCGP could also be named as respondents in the claims.   

Key takeaways for GP practices 

Reliance solely on the guidance produced by the BMA or RCGP to vary or terminate a PA’s role unfairly or unjustifiably may leave GP practices at risk of claims for breaches of contract, unfair dismissal and unlawful discrimination. Where practices are considering terminating the employment of any of their PAs or changing the scope of their roles, we recommend that a broad range of evidence is considered carefully, with a full evaluation of risk being carried out and documented.  

Legal advice should be sought before any decisions are made, to ensure that the legal risks are fully understood and minimised.  

How Capsticks can help 

Capsticks has significant experience in supporting GP employers to navigate changes in employment law and policy, from reviewing current policies, contracts, practice and implementing change, to delivering training to employees at all levels. We regularly support employers in handling complaints from staff and issues that arise in individual cases, by conducting investigations, supporting decision makers and HR and drafting and advising on key documents in management processes. As one of the leading healthcare employment litigation specialists in the country, we are also well placed to support GP practices in defending any employment tribunal claims they might face. 

For further information on how we might assist your organisation with any employment law issues, in particular with any concerns relating to the use of PAs, please contact Marsha Thompson or Maddie Lawrence.