Thank you for taking the time to read this update, and thank you for standing with us through what has been an unsettling and uncertain period. We know the weeks following the publication of the Leng Review have felt far too quiet and stagnant, and I want to acknowledge openly that this silence has been difficult. 

This pause was not due to inaction, but because we needed time; time to examine the Leng Report and its recommendations in full, to understand the implications of the ongoing UMAPs judicial review, and importantly, time for each of us as individuals and as a leadership team to process the very real grief, distress, and confusion that many of us felt in response to the Leng Review outcome. 

We can now share a detailed update as to what has been happening nationally regarding the Leng Review and the future professional landscape for CMAPs. 

CMAPs Today: A Strong and Determined Professional Body 

First and foremost, CMAPs remains a passionate, committed, and forward-looking organisation representing PAs, students, new graduates, and educators. The team continues to work to strengthen and safeguard the professional home that PAs deserve. 

As many of you will know, nominations for CMAPs’ Office of Physician Associates elected positions have recently closed. We will now move into the next phase with formal, independently run elections through Civica (a system we are familiar with from historical FPA elections). This ensures that your leadership is chosen by you, transparently and democratically. Please do take the time to engage in this process and cast your vote when elections are opened. 

National Landscape: Movement After a Long Pause 

Many of you understandably have questions about what is happening nationally. The prolonged period of inertia following the Leng Review has been unacceptable, with several organisations placing blame for their inaction upon the Judicial Review . This has caused immense frustration for PAs, and for those who support us across all four nations. 

However, things are now beginning to progress. 

The DHSC and NHSE Leng Implementation meetings have commenced, bringing together stakeholders to begin examining how recommendations will be put into practice. CMAPs has been invited to attend both the DHSC Oversight Group and the NHSE Implementation Group. These are soon to become a single body, with responsibilities divided into four workstreams – two led by DHSC and two by NHSE. 

Whilst I cannot share slides at this stage, I can confirm that: 

• The meetings take a four-nations approach. 
• CMAPs and the Physician Associate Schools Council (PASC) are represented, alongside the Academy of Medical Royal Colleges, other medical royal colleges, and relevant national bodies. 
• Areas under consideration include: 
• professional standards 
• credentialing 
• prescribing 
• clinical protocols and line management 
• updates to safety reporting (which NHSE assure us are system-wide, not PA-focused, reflecting that the Leng Review found no significant safety concerns) 

It is disappointing, though important to note, that for our AA colleagues the current workstreams remain predominantly PA-focused, which has understandably added to their concerns. 

These meetings often raise more questions than answers, but I want to reassure you that CMAPs – and equally, the PASC Chair and their Deputy – are advocating forcefully and unapologetically on behalf of the profession at every single opportunity. We are not alone at the table; several other stakeholders make a point of offering their support for PAs, and we do believe these voices are being heard. 

In the coming weeks, I will speak at the Westminster Health Forum alongside Stephen Nash, UMAPs General Secretary, an event bringing together policymakers, stakeholders and healthcare leaders, on the regulatory journey for Associates. Sophie Newbold (Student and Graduate Liaison Officer) and I have also been invited to present at the British Associate of Physicians of Indian Origin (BAPIO) Conference at the end of November. We will follow talks from Sir Chris Witty and Sir Jim Mackie, which is an exciting opportunity for CMAPs to share a platform with such influential speakers. This is an encouraging sign that CMAPs is now recognised amongst stakeholders as the professional body for PAs, and we intend to maintain this position.  

A Message of Solidarity and Support 

One particularly positive development has been Professor Leng’s welcome of our suggestions for clinicians experienced in working with PAs who may join Clinical Advisory Panels (CAPs) to help shape the implementation of her recommendations. We firmly believe that all members of CAPs should have extensive experience of working with PAs and have raised this formally with the Leng Review team. 

The response from our members was overwhelming. Thanks to you, my inbox was filled with messages from colleagues across primary and secondary care, from clinicians working across an array of specialities throughout the UK. Reading message after message from clinicians who value, trust, and champion PAs and AAs was deeply moving. It served as a powerful reminder that we are not isolated, and that we are respected clinicians who deserve support, recognition, and a safe professional future.  

We are still collating names, especially from colleagues in Mental Health – so please do continue to submit suggestions to info@cmaps.org.uk  

In January 2026, I plan to meet with colleagues from SPAN, PA Cymru, and our colleagues in Northern Ireland to strengthen our collaboration and ensure our nations move forward together.  

Standing Together: Supporting the Judicial Review 

Finally, I want to address the judicial review launched by UMAPs. This challenge is crucial for the profession, and they need our solidarity. If every PA contributed even a modest amount the required funds would be met quickly. Please consider supporting this effort so we can stand strong together. 

Judicial Review Fundraiser | UMAPs.org.uk 

 Thank you once again for your resilience, your professionalism, your commitment to our patients – and to one another. We are navigating a challenging moment in our history, but we are doing so as a united profession, and I am proud to represent you. 

With all best wishes, 
Alice Fitzpatrick