The College of Medical Associate Professionals (CMAPs) welcomes the General Medical Council’s (GMC) newly published supervision guidance for doctors working with Physician Associates (PAs) and Anaesthesia Associates (AAs). This is a significant and timely step forward in reinforcing safe, transparent, and collaborative multidisciplinary practice across the NHS. The guidance rightly reflects the realities of modern healthcare, where effective patient care depends on an integrated team, supported by proportionate and context-specific supervision.
We support the GMC’s evidence-based, patient-centred approach, which prioritises safety without compromising the ability of healthcare teams to respond flexibly to patient needs.
We remain committed to working with the GMC, employers and medical royal colleges to ensure supervision arrangements are workable, realistic and transparent, and that they are grounded in robust governance. Ongoing, collaborative dialogue is essential to supporting safe practice, professional development, and mutual trust between team members.
However, we are concerned by recent public commentary issued by organisations that neither represent nor meaningfully engage with the PA and AA professions. Whilst we welcome open discussion, we encourage all contributors to ensure that such dialogue is grounded in evidence, shaped by consultation, and cognisant of existing legal and regulatory frameworks.
In this context, we note with concern the suggestion by the Royal College of Physicians’ PA Oversight Group that PAs should not be requesting ionising radiation. PAs are no longer overseen by the RCP. It is important to clarify that, as registered medical professionals, PAs who have completed appropriate training under IR(ME)R and are authorised by their employer’s governance processes are legally permitted to request imaging involving ionising radiation. This position is consistent with current regulatory and legal frameworks and reflects standard practice across many clinical settings.
We fully support the principle that all members of the clinical team, including PAs and AAs, must work within appropriate frameworks of supervision and accountability to ensure patient safety and quality of care. Robust local governance, tailored and sensible supervision arrangements, with a clear focus on competence, are essential to achieving this aim. However, proposals to arbitrarily exclude PAs and AAs from working alongside doctors in training, or to impose scope restrictions without reference to individual competence and local governance, lacks a clinical basis and appears driven more by protectionism than by patient safety. Employers are encouraged to be mindful of employee contracts when implementing college positions.
Patients and staff alike deserve leadership that is constructive, evidence-informed, and committed to the integrity of multi-disciplinary care. CMAPs will continue to engage with all stakeholders who share this vision and who are genuinely invested in advancing high standards, equitable practice, and, above all, patient safety and wellbeing.
