High Court allows judicial review challenge to Leng Review decisions

The High Court has granted permission for the United Medical Associate Professionals (UMAPs) union to proceed with a judicial review challenging key decisions arising from the Leng Review, including the renaming of Physician Associates and Anaesthesia Associates as “Assistants”.

In a judgment handed down on 1 October 2026, Mr Justice Sheldon granted permission for several of UMAPs’ grounds of challenge against NHS England, the Secretary of State for Health and Social Care, and Professor Gillian Leng to proceed to a full hearing. The case follows an oral hearing at the Royal Courts of Justice in September and comes after the claim was initially refused on paper earlier in 2026.

The legal challenge centres on decisions made following publication of the Leng Review on 16 July 2025. UMAPs argues that the decision to rebrand Physician Associates and Anaesthesia Associates as “Assistants” was unlawful, irrational and inconsistent with the statutory framework governing the professions. The union also contends that it should have been consulted before the changes were implemented and alleges that its members’ rights were not adequately considered during the decision-making process.

According to UMAPs, the judicial review will also examine whether the consultation process surrounding the Leng Review treated the organisation fairly in comparison with other stakeholders, and whether the failure to engage with the union breached protections under Article 11 of the European Convention on Human Rights.

The case, which names NHS England, the Secretary of State and Professor Leng as defendants, with the British Medical Association (BMA) listed as an interested party, will now proceed to a substantive hearing where evidence from all parties will be scrutinised in open court.

UMAPs said it welcomed the decision and argued that the hearing would provide an opportunity to examine the evidence behind the Government’s acceptance of all 18 recommendations contained within the Leng Review. The organisation is also seeking disclosure of further documents relating to the policy decisions and their implementation.

Commenting on the ruling, Stephen Nash, General Secretary of UMAPs, said the court had determined that key elements of the union’s case were arguable and deserved a full hearing. He said the organisation would continue to challenge decisions affecting Associate professionals and seek greater transparency over how the recommendations were adopted.

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