Regulation for anaesthesia associates and physician associates

4th January 2024

The reform of the regulation of healthcare professionals continues with the introduction of new legislation for anaesthesia associates and physician associates.

On 13 December 2023, the long-awaited Anaesthesia Associate and Physician Associate Order (AAPAO) was laid before Parliament. On completion of the draft affirmative procedure for statutory instruments, the Order will pass into law and anaesthesia associates (AAs) and physician associates (PAs) will be subject to statutory regulation by the General Medical Council (GMC) for the first time from December 2024. There will be a two-year transition period during which those already working as AAs and PAs can register with the GMC.

Recent data suggests that there are fewer than 5000 AAs and PAs working in the UK, so why is the AAPAO such an important development?

As our previous article explained, the AAPAO is the template for future reform to the statutory regulation of all healthcare professionals in the UK. It’s the culmination of six years of consultations on reform, and the start of a series of legislative changes that will have significant consequences for all registered healthcare professionals and their regulators.

Aim of the reform

The aim of the reform programme is to introduce a modern, fit-for-purpose regulatory system that better protects patients, supports the UK’s health services, and helps the workforce to meet future challenges. It seeks to provide greater consistency between the regulators’ fitness to practise functions – something that its increasingly important for fairness in a healthcare system that uses multi-disciplinary teams. The intention is to deliver a fitness to practise system that is swifter, fairer and less adversarial.

Our previous article set out the key changes proposed, and these are broadly reflected in the AAPAO. For details about changes made to the draft AAPAO following the detailed consultation on its provisions, see here: Regulating anaesthesia associates and physician associates – GOV.UK (

Now that the AAPAO has been laid, the Department of Health and Social Care (DHSC) will be working with the GMC, Nursing and Midwifery Council (NMC) and Health and Care Professions Council (HCPC) to develop reformed legislation for them. They have been selected to go next because between them, they regulate over 1 million professionals across over 15 professions, and the HCPC has particularly rigid fitness to practise legislation at present.

What next?

The timescales for the next steps are not entirely clear. The DHSC says it will be working with the GMC, NMC and HCPC “over the next couple of years”, and that although it intends to move “at pace”, there will be a three-month consultation period for every regulator. It’s not clear what impact, if any, the 2024 election will have on this timescale. Nor is there any indication about when the other healthcare regulators, including the General Dental Council, General Optical Council, and General Pharmaceutical Council, will be receiving their reformed legislation.

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