High Court dismiss BMA physician associates and anaesthesia associates Judicial Review claims

The British Medical Association (BMA) brought the judicial review proceedings against the General Medical Council (GMC) in the case of British Medical Association, R (on the application of) v General Medical Council [2025] EWHC 960 (Admin), challenging “significant regulatory decisions” made by the GMC in its newly extended role as regulator of both doctors and the associate professions—namely, Physician Associates (PAs) and Anaesthesia Associates (AAs).

This challenge arose after the GMC’s regulatory ambit was broadened by the Anaesthesia Associates and Physician Associates Order 2024, which, effective from 13 December 2024, required the GMC to include these non-medically qualified professionals within its oversight. At the core of the dispute were two interrelated decisions: first, the GMC’s adoption of the umbrella term “medical professionals” to collectively describe doctors alongside PAs and AAs, and second, its choice to produce a single set of professional standards—embodied in the guidance document known as Good Medical Practice (GMP)—that would apply uniformly to all these groups.

In summary, the BMA argued that the use of the term “medical professionals” was inappropriate because it conflated clearly distinct statutory categories. Under the existing regulatory framework established by the Medical Act 1983, only medically qualified individuals are recognized as “medical practitioners,” while PAs and AAs, whose training pathways and scopes of practice differ significantly from doctors, have historically been seen as supportive and subordinate roles within the healthcare team.

The BMA contended that by using an umbrella term and unifying the guidance, the GMC had blurred these statutory distinctions, potentially creating confusion among patients regarding who was truly qualified to independently manage their care. This conflation, the BMA argued, risked undermining public safety by failing to signal the appropriate differences in clinical responsibility and oversight between doctors and the newly regulated associates. Additionally, the BMA maintained that the decision to impose a single set of standards on both groups was legally and administratively flawed, as it did not adequately reflect the differing levels of training, supervision, and scope of practice inherent to each group.

In its judgment, Mrs Justice Lambert DBE undertook a comprehensive review of the GMC’s decision-making process, including the extensive consultation with stakeholders, public surveys, focus groups, and research into the practices of other multi-professional regulators.

The Court recognized that while there were inherent differences between doctors and associates, the GMC’s integrated approach in developing a unified set of core standards was both methodologically sound and consistent with its overarching statutory duty to protect the public.

The judge held that the use of the term “medical professionals” was appropriate within the context of the broader statutory objectives and did not erode the necessary distinctions in practice or compromise patient safety. Furthermore, the decision to apply a single guidance framework, underpinning shared values and high-level professional conduct, was deemed rational and proportionate to the dual functions of maintaining public confidence and ensuring high standards of care.

Charlie Massey, Chief Executive and Registrar of the GMC, said:

‘We welcome Mrs Justice Lambert’s judgment, which dismisses in its entirety the BMA’s claim for judicial review of our decision to apply our core professional standards – Good medical practice – to all three professions we regulate (doctors, PAs and AAs), and our use of the term “medical professionals” within this guidance.

‘We are pleased the court has recognised that our decision to produce our guidance in the form of a single set of core standards for all three professions we regulate was a logical and lawful decision to reach, and one which followed an exhaustive and detailed process of consultation, research and inquiry which engaged all major stakeholders, including the BMA.

‘Our approach, in publishing a single set of core standards, is consistent with what we heard during the consultation period, as well as with that of other multi-profession healthcare regulators. The judge concluded that PAs and AAs following the same professional standards as doctors was logical, and that in doing so the GMC had acted at all stages to further patient safety.

‘This comprehensive judgment also finds that there is nothing irrational or inherently confusing about the use of the term “medical professionals” as a collective term in this context.

‘We have made it very clear that we recognise and regulate doctors, PAs and AAs as three distinct professions. We have also been consistent in saying that, as their regulator, we expect PAs and AAs to always work under supervision and to practise within their competence. They have a responsibility to clearly communicate who they are, and their role in the team.

‘To register with us, PAs and AAs also need to show that they have the knowledge, skills, and experience to treat patients safely, and that there are no outstanding concerns about their fitness to practise. Bringing PAs and AAs into regulation provides assurance to patients, colleagues and employers that they are safe to practise and can be held to account if serious concerns are raised.’

Professor Phil Banfield, chair of BMA council, said: 

“This is a disappointing ruling from the High Court. Physician associates do not study medicine and are trained to a very different standard to doctors. By labelling both doctors and PAs as ‘medical professionals’ the public are being misled to think they are similarly or equally qualified. They are not. Having ruled on the legal technicalities the Court has ignored common sense, and the effect will be to perpetuate the patient safety issues caused by this confusion.

“The potential for patient harm in equating the two roles has been shown in the testimony of doctors recently published by the BMA, which includes hundreds of examples of patients put at risk or harmed. This has been recognised by an increasing number of coroners urging the GMC to clearly differentiate between doctors and physician associates following avoidable patient deaths. The danger is even acknowledged by the Health Secretary who agrees that the concerns of patients and doctors have been ignored for too long, concerns which must be properly addressed by the Leng Review due to report later this Spring.            

“During the hearing the GMC was at pains to stress that it had no enforceable statutory duty to protect patient safety: a terrible statement from the medical regulator, though in keeping with its determination to ignore the blaring alarm bells sounded by doctors, coroners and patients. 

“As doctors, however, we do have a duty to uphold patient safety and to speak out when it is compromised. The BMA is considering its next steps in relation to this regrettable ruling.” 

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