The independent review of physician associate and anaesthesia associate roles (since renamed as physician assistant and physician assistant (anaesthesia) roles) published its findings on 16 July 2025.

New proposals allowing physician assistants to see undifferentiated patients

A stakeholder consultation on proposals to allow PAs to see undifferentiated patients (as recommended by Professor Leng) has been published.

You can also read our press release reacting to the release of the consultation and our letter to Professor Leng outlining our concerns. 

The BMA’s red lines

• No loopholes for undifferentiated patients. Triage must not become a substitute for assessment by a doctor. The BMA opposes PAs assessing, diagnosing, or managing undifferentiated patients in any setting, including general practice.


• Only a clear national scope of practice can set safe limits on PA work. Any protocol must not permit local variation which would undermine patient safety.

• Do not shift responsibility onto resident doctors. The BMA is categorical that resident doctors at any level must not supervise PAs, and prescribing requests must not become supervision by the back door.

• Proposed GP supervision is unsafe and unworkable. Both the BMA and the Royal College of General Practitioners agree that there is no role for physician assistants in general practice.

• Learn from patient deaths, rather than repeat the risks. Incidents of patient harm and death demonstrate the need for clear role boundaries and medical oversight.

We have written to Professor Leng objecting to both the proposals and the process used to develop them. The BMA raised concerns earlier this year that the medical profession’s elected representatives were excluded from the drafting Clinical Advisory Panel, whose members remain anonymous. 

Have your say

The BMA will be responding in full to this consultation, and we are interested in hearing your views. Any general or specific comments you would like to share with the BMA can be directed to [email protected]. Please share you feedback with the BMA by 09.00 Monday 16 November, as we intend to publish our response ahead of the final deadline for submission on 14 December. 

If you have seen or experienced unsafe practice where a PA has been required to assess an undifferentiated patient, please report it through the BMA’s reporting portal.

Contact your medical royal college

Despite the BMA's representations to the Department of Health and Social Care’s Leng Review asking that this should be a public consultation, a decision was taken to limit this to stakeholder organisations only. Doctors should therefore share their views on the draft clinical protocols with their relevant medical royal college or faculty via the links in the dropdown below.