UMAP loses High Court Leng Review legal challenge

United Medical Associate Professionals (UMAP) has failed in its attempt to challenge the Government’s adoption of the Leng Review, after the High Court refused permission for judicial review on the papers and without a hearing. The organisation had sought to overturn decisions arising from the review, arguing that thousands of physician associates (PAs) and anaesthesia associates (AAs) have been harmed by its recommendations and subsequent implementation.

The Leng Review, commissioned by the Government and led by Professor Gillian Leng, examined the PA and AA roles following sustained concerns about patient confusion and safety. It recommended significant changes, including renaming physician associates to reduce the risk of patients mistaking them for doctors. As reported by Fitness to Practise News, the review concluded that the PA title “causes widespread confusion and poses risks to patient safety”, prompting ministers to signal support for a formal name change.

UMAP said it was “extremely frustrated” by the Court’s refusal of permission, noting that its case was dismissed without an oral hearing. General Secretary Stephen Nash criticised the decision, arguing that members “never had their case put in open court” and that those responsible for adopting the review should be required to account for its impact on a workforce that is predominantly female and significantly represented by Black, Asian and minority ethnic clinicians. UMAP is now considering applying for an oral reconsideration.

The British Medical Association (BMA) welcomed the dismissal, stating that every argument advanced by UMAP was “unarguable”. Dr Emma Runswick, BMA deputy chair of council, rejected claims that the review was designed to appease the BMA, describing the allegation as “baseless”. She emphasised that the review’s recommendations—though limited—were intended to strengthen patient safety and reduce the risk of patients being assessed by PAs without clear boundaries or oversight.

The BMA also criticised the pace of Government action, noting that a year after publication, key safety measures remain outstanding. It urged ministers to “go further and faster”, including prohibiting PAs from seeing undifferentiated patients and ensuring clearer role demarcation across the NHS.

The High Court’s refusal of UMAP’s challenge clears the way for full implementation of the Leng Review. With UMAP considering its next legal steps and the BMA pressing for accelerated reforms, the future of PA and AA practice now hinges on how quickly the Government moves to deliver the review’s patient‑safety recommendations.

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