Just before Christmas, the Department of Health's consultation on the regulation of medical associate professions in the UK closed. In its response, the General Medical Council argued strongly that it is best placed to regulate these new professional roles. But what are these new roles, and is the GMC right?
What are medical associate professions?
These professionals are all trained to provide patient care under the supervision of a doctor. Duties vary, but principally MAPs take medical histories, examine patients, analyse test results, and generally manage and diagnose illnesses under supervision. They may also be involved in pre and post op care, performing surgical intervention or general anaesthesia.
The intention is that this gives doctors extra time to consider more complex patient needs. There are currently four types of MAP:
- Physician associates;
- Advanced critical care practitioners (ACCPs);
- Surgical care practitioners (SCPs);
- Physicians' assistants (anaesthesia).
Each role requires completion of an applicable training programme or a post-graduate diploma.
Why and how should they be regulated?
As MAPs are taking on tasks previously reserved for doctors, there is no doubt they need to be regulated – both to maintain patient safety and to ensure public confidence. The consultation asked responders about the level of professional assurance they felt appropriate, and it is hard to argue with the GMC's view that statutory regulation is the only real option.
When you consider the numerous other health and care professions which are regulated – nurses, physiotherapists, occupational therapists and radiographers, to name but a few – it would be anomalous for MAPs to be unregulated.
The GMC argues that, in addition to the benefit to the public, regulation may help to expand the number of MAPs. Employers will be more inclined to make use of them if they have defined standards and accountability. It will also help ensure an appropriate balance of responsibilities and meet concerns among medical staff that MAPs are being given tasks which should be undertaken by doctors.
The GMC set out a plan for the Government to implement regulation with them as a statutory regulator. They say MAPs should be treated as a single profession with different areas of practice. This will allow for a cohesive approach to regulation and will make it easier for the public to understand how these roles interact with doctors. Further, the legal framework must be flexible in order to allow for the development of MAP roles in other practice areas in the future.
The Health & Care Professions Council also responded to the consultation, noting its support for regulation and willingness to be the regulator. However, they did not consider there was a need for statutory regulation of SCPs and ACCPs: there is no direct entry into these roles, which means they are already accountable to another regulator. However this does not account for development and expansion of the MAP roles, nor would it prevent practitioners allowing their original professional registration to lapse once they had transitioned into their MAP role.
When might this happen?
A report on the outcome of the consultation is expected in early 2018. While nothing is confirmed, the GMC has support from both the Academy of Medical Royal Colleges and the Faculty of Physician Associates.
There is little doubt we will see some form of regulation of MAPs. What remains to be seen is whether insurers or MDOs will step forward to offer indemnity at an affordable level for MAPs and support them through regulatory complaints.