Everyone was surprised at a Council meeting of the Royal College of Physicians Council meeting on 19th November, when Mr Massey of the GMC gave the impression that the GMC would accept College guidance on Physician Associate scope. Until then there had been some equivocation to say the least, about what use, if any, the GMC would make of such documents. 

But the exact words that were used are very important. 

In a recording of that meeting circulating on social media, in response to a question by Professor Kar, Mr Massey replies “Will we accept scope from Royal Colleges? I hope so…”. (the clip with a 1’19” duration).

But the published minutes of the meeting report that Massey was asked whether NHSE and the GMC would adopt the scope of practice for PAs produced by the Royal Medical Colleges; and that Mr Massey “noted GMC’s intention to utilise such documents once finalised”, subject to resolving any conflicts between Colleges.

Accept College scope? Adopt College scope? Utilise College scope? Utilise as long as there are not conflicting scopes? Is there truly a difference between these words?

Why do the words matter?

In the new regulatory world in which the GMC is responsible for associates, everyone – doctors, associates themselves, their employers and most importantly, the public – needs to know where they stand and what associates can and can’t be expected to do. We already know what the tragic consequences can be of associates being expected to, and acting, as if they were doctors. 

Our position is straightforward. Either the GMC needs to adopt and enforce scopes of practice produced by others, or it must come up with its own, following appropriate consultation. There can be no more equivocation over what standards the GMC is enforcing. After all, the main reason why it was given the responsibility to regulate associates was that the Royal College of Anaesthetists’ scope of practice was being noted then routinely deviated from by AAs under pressure from their employing Trusts and there was no settled scope for PAs. 

So if the GMC finally committed to adopt scopes of practice, as we asked it to in our letter before claim sent before our judicial review began, that would be an important step in the right direction. 

But a commitment to “utilise” rather than “adopt” would mean GMC having regard to, but not consider itself bound to or committed to enforce, such guidance – a hopelessly ambiguous state of affairs for everyone. 

So why would the minutes use the word ‘utilise’ if that was not the exact word that was said? We know that the recorded transcript and the minutes have been carefully reviewed and at least one amendment has been made already.

We would not want to think the College had had the wool pulled over its head by nuances of wording, so we would welcome clarification from the RCP as to the exact terminology that was used in the answer given to Professor Kar’s question.

Legal case update

It is only 16 days now until we go to the High Court. Our lawyers are working flat-out through this weekend dealing with thousands of pages of evidence and legal arguments from the GMC and honing our own.

We have asked the court whether it will be possible to live-stream the hearing and are awaiting their reply. We will keep you posted.

In the meantime, we remain short of funds. We are hoping that the statement by the World Medical Association will help. The WMA are calling for

• The terminology to be changed to “assistants” rather than “associates”
• Associates not to be described as being “trained in the medical model”
• Associates to work within clearly defined scope of practice.

Please help us reach our financial target – the GMC has been able to spend unlimited funds on its own lawyers thanks to the metaphorical blank cheque handed to it by the Department of Health and Social to cover all costs associated with regulation. 

We don’t have that luxury and it’s important we are able to pay our lawyers for their hard work in taking this vital public interest case forward.