Draft Associates Order – does your MP understand it?

On the 17th January MPs are to look at the draft Anaesthesia Associates and Physician Associates Order 2024. But they won’t give it a proper look. It will be glossed over. Because they are using a parliamentary technique – secondary legislation  that evades proper scrutiny.

Many MPs will have been sold the line that Associates are merely “assistants” working under the direction of doctors and carrying out menial and simple tasks. Manifestly that is not the case. A quick search on NHSJobs, for example, will show that PAs in General Practice are required to see unsupervised new-patients and are expected to work largely autonomously.

MPs have also been sold the line that by bringing Associates into regulation then their working patterns and scope of practice will be defined and controlled. But nothing could be further from the truth. Regulation will not bring clarity to the role of Associates, it merely provides a list of approved names.

Supervision and the definition of Associates role/scope of practice, which are interlinked,  are enormous unresolved issues and are not addressed by either the GMC nor by the Draft Order. The GMC washes their hands of defining scope of practice by claiming they do not have the expertise to take this on. The Royal Colleges do have the expertise but neither the power or authority, and the CQC (which does have the authority) does not have the information or expertise. It is a mess in which no one body wants to take on responsibility; and meanwhile Trusts are pressuring Associates into taking on more and more tasks.

The Association of Anaesthetists has put out a strong statement  calling for stricter regulation and controls on scope of practice. But we have a government that doesn’t listen to experts.

The Associate programme is being lubricated by subsidies, so as to be of minimal cost to the Trusts. Proper analysis shows that Associates are not cost-effective. It feels that the motivation for this is political and ideological rather than being in the interests of patient care.

You can read the draft order here.

There is still time to write to your MP with the details of the debate and ask them to ensure the draft order gets proper scrutiny. You can look up your MP here.