The College of Medical Associate Professionals (CMAPs) has considered the DHSC’s consultation on the draft General Medical Council Order 2026 and submits this response in relation to Recommendations 1 and 9 of the Leng Review: the proposed renaming of physician associates as “physician assistants” and anaesthesia associates as “physician assistants in anaesthesia”. 

We take seriously our responsibility to represent the profession’s interests within the 3-month consultation process. We do so, however, with significant reservations about the evidential basis for the proposed title changes and about aspects of the process by which they have reached this stage. 

1. The title change does not address the root problem 

The Leng Review’s stated rationale for recommending “assistant” over “associate” is that it better positions the role as supportive rather than independent. CMAPs does not accept that this change achieves that aim, or that “associate” is the source of the confusion the Review identifies. 

Physician associates are GMC-regulated clinicians, trained to master’s level, practising within defined scope under named consultant supervision. The term “assistant” does not reflect that clinical reality. It conflates a regulated, postgraduate-qualified profession with a broad category of support roles across the NHS, roles that carry no equivalent training requirements, regulatory obligations, or clinical accountability. 

The international evidence does not support the proposed direction. In the United States, the jurisdiction with the longest experience of the role, there has been a deliberate move toward “Physician Associate” as the more accurate modern title. This movement is not limited to the US – Ireland and India are also moving towards “associate” terminology that better captures clinical responsibility and expertise. The UK is being asked to reverse course, re-adopting a term that comparable health systems are moving away from, without a clinical evidence base for doing so. This would create direct divergence from international trends and increase confusion for internationally trained professionals and their employers. 

2. The proposed renaming will create confusion among healthcare teams 

The consultation document states that the aim of the title changes is to enhance clarity. CMAPs submits that the opposite is likely to result. 

Under the draft order, physician associates would become “Physician Assistants” and anaesthesia associates would become “Physician Assistants in Anaesthesia”. A physician associate currently working within an anaesthesia team would carry the title “Physician Assistant”, while the anaesthesia associate working immediately alongside them would become a “Physician Assistant in Anaesthesia”. Two separate regulated professions, with different training pathways and scopes of practice, in the same clinical environment, distinguished in title only by the addition of two words. The risk of misidentification by patients, colleagues, and employers, including potential misallocation of staff, is a patient safety concern.  

The new titles would also overlap with existing roles across the NHS that informally use the title “Physician Assistant,” as well as risking conflation with “Healthcare Assistant,” “Practitioner Assistant,” and other support roles carrying no equivalent regulatory or training requirements. This dilutes rather than strengthens professional identity. 

3. The timing compounds the risk of confusion for the public 

Due to the significant media attention the profession has received in recent years, public awareness of the physician associate role has grown considerably. “Physician Associate” is more widely recognised now than at any previous point. A title change at this moment would disrupt that emerging public understanding, require active re-education of patients and the public, and risks being perceived, rightly or wrongly, as rebranding in response to controversy.  

4. A reversion would be inconsistent with previous policy 

The title “physician associate” was adopted in 2013, changed from the original “physician assistant”, because the DHSC considered that the term “assistant” would impede the profession’s path to statutory regulation. That judgment is now being reversed without a substantive evidential case that circumstances have changed in a way that justifies it. 

Reverting to a title that was deliberately discarded sends a signal of policy inconsistency to employers, educators, and the profession itself. It risks undermining the confidence of the very stakeholders whose sustained commitment is required to integrate the role effectively within NHS systems. 

CMAPs asks that any final decision be accompanied by a published account of how the 2013 rationale has been weighed and on what grounds it has been found no longer to apply. 

5. There is no clear evidence of benefit 

CMAPs has identified no published evidence that changing “associate” to “assistant” improves patient understanding, reduces complaints, or materially addresses the confusion the Review describes. A title change of this consequence, with these implications for a regulated profession, should be underpinned by evidence that it will achieve its stated purpose. That evidence has not been presented. 

CMAPs also notes and commends the detailed work undertaken by the United Medical Associate Professionals  (UMAPs) in analysing and publicly setting out the evidential and procedural deficiencies of the proposed rename. Their thorough documentation of the absence of a clinical or patient safety case for this change reflects the breadth of concern across the profession, and we encourage members to read their initial statement.   

6. Process concerns 

CMAPs notes that the draft order already uses the proposed new titles throughout, and that several royal colleges adopted the “physician assistant” terminology prior to the close of this consultation. We raise this to observe that pre-emptive institutional adoption of a title that remains under active consultation undermines the weight that responses from the profession and the public can reasonably be expected to carry. 

We also note that CMAPs, as the professional college for physician associates and anaesthesia associates, was not included in pre-publication engagement on the Leng Review’s draft recommendations. We consider this a significant gap in the Review’s stakeholder process, and we record it here for the purposes of transparency. 

7. CMAPs’ position and recommendations 

CMAPs calls on DHSC to: 

• Reject the proposed title changes on the grounds that they lack an adequate evidential basis, do not address the root cause of patient confusion, and risk creating new confusion in clinical settings. 

• Publish a reasoned account of how the 2013 rationale for adopting “physician associate” has been weighed, if the title change proceeds. 

• Consider whether any future review of professional titles should be conducted as a standalone, evidence-led exercise rather than as a subsidiary recommendation of a broader review. 

• Ensure that the findings of this consultation are published with a transparent account of how responses were analysed and weighted, and how the profession’s views were considered. 

CMAPs remains committed to constructive engagement with DHSC and GMC on the regulatory framework for physician associates and anaesthesia associates and is willing to meet with officials to discuss these concerns further. 

How to respond: The consultation closes on 24 June 2026. Responses can be submitted at https://www.gov.uk/government/consultations/reforming-the-general-medical-council-legislative-framework. Questions 1 and 2 relate directly to professional titles. CMAPs encourages all members to submit individual responses in addition to this institutional submission.