In short: On 13 December 2024 the GMC began regulating physician associates and anaesthesia associates, becoming a multiprofessional regulator of three distinct professions. Registered PAs and AAs must now meet the standards in Good Medical Practice and are subject to the same fitness to practise process as doctors. From December 2026 registration becomes mandatory. For doctors, the change also brings supervision responsibilities into sharper focus.
The regulation of physician associates and anaesthesia associates is one of the most significant changes to UK medical regulation in years, and it affects far more people than the associates themselves. Doctors who work alongside them, supervise them, or lead teams that include them all have a stake in understanding what has changed.
This guide explains what the change means in practice, the standards that now apply, when registration becomes compulsory, and where doctors' own responsibilities sit. If a concern has already been raised about you or a colleague, our guide on what to do when you receive a letter from your regulator covers the immediate steps.
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What changed in December 2024?
On 13 December 2024, under the Anaesthesia Associates and Physician Associates Order, the GMC formally began regulating physician associates and anaesthesia associates. The rules, standards and guidance covering education, registration, standards and fitness to practise were approved by the GMC's Council on the same date. This was a government decision, implemented through legislation, and it turned the GMC from a regulator of doctors into a multiprofessional regulator. The timeline below sets out the key milestones.
Key milestones
The main dates in the move to statutory regulation.
Who are PAs and AAs, and how does the GMC see them?
The GMC now recognises and regulates doctors, physician associates and anaesthesia associates as three distinct professions, not as a single group. That distinction is central to how the regulator approaches each role, and to how patients and colleagues should understand them.
Doctors
Regulated by the GMC for many years, and the reference point for the standards now applied across the professions.
Physician associates
Work with doctors and teams to support diagnosis and management, within their competence and under appropriate supervision.
Anaesthesia associates
Work within anaesthetic teams, again within their competence and with appropriate supervision.
What standards do PAs and AAs now have to meet?
Once registered, physician associates and anaesthesia associates must follow the professional standards and behaviours set out in Good Medical Practice, the same core framework that applies to doctors. Two expectations are worth highlighting because they come up often in concerns. The first is working within their competence, which means not taking on tasks beyond their training and role. The second is clearly introducing themselves and their role to patients, so that patients understand who is providing their care. The GMC is also developing a revalidation model so that associates, like doctors, demonstrate they remain up to date.
What does regulation mean for the fitness to practise process?
It means PAs and AAs are now subject to a fitness to practise process aligned with the one that applies to doctors. Concerns are assessed against the same core principles, and the GMC has deliberately brought its decision-making for doctors into line with how associate cases are considered. As explained in our guide to what triggers a GMC referral, the same three questions about seriousness, context and response apply. Serious cases can be referred to a tribunal, and our guide to the MPTS hearing process applies to associates as well as doctors, because the MPTS now hears cases for all three professions.
When does registration become mandatory?
The GMC has said that from December 2026 it will be an offence to practise as a physician associate or anaesthesia associate without being registered. Until that point, a transitional period applies, during which those on the earlier voluntary registers move across to statutory registration. For associates, the practical message is to ensure registration is in place well ahead of the deadline. For doctors leading teams, it is worth knowing the status of the associates you work with.
Standards that now apply across the team
Good Medical Practice underpins concerns about doctors and associates alike. Structured CPD aligned with CPD UK guidelines helps evidence insight and remediation against those standards.
What does this mean for doctors who work with or supervise PAs and AAs?
This is the part most relevant to doctors, and it deserves care. Supervising or working alongside associates carries responsibilities, and a concern about how a doctor delegated a task or oversaw an associate can engage that doctor's own fitness to practise. The safest position is one of clarity: being clear about what falls within an associate's competence, ensuring appropriate oversight, and documenting decisions where responsibility could later be questioned. None of this is about mistrust. It is about the ordinary discipline of safe delegation, which protects patients, associates and the supervising doctor alike.
Why has this been the subject of debate?
Because a significant regulatory change of this kind naturally raises questions, and it is fair to acknowledge them without taking sides. There has been public discussion about role boundaries, supervision and how associates should be distinguished from doctors. An independent review led by Professor Gillian Leng recommended new titles to make the distinction clearer, though at the time of writing the names set out in the Order were unchanged, with some organisations beginning to adjust job titles locally. The GMC's fitness to practise framework for associates has also been tested in the courts and was upheld. For the individual professional, the practical takeaway is simply to be clear about role, scope and supervision in day-to-day practice.
How do insight and remediation apply across all three professions?
In exactly the same way. Because concerns about doctors and associates are judged against the same standards, the value of demonstrating insight and evidenced remediation is identical across the professions. Whether you are a doctor, a physician associate or an anaesthesia associate, showing that you have understood a concern and taken genuine steps to address it is the strongest response available to you. It does not guarantee any outcome, but it consistently strengthens your position at every stage of a case.
Related courses
The structured CPD most relevant to standards, supervision and teamwork across the professions, each aligned with CPD UK guidelines and mapped to GMC standards:
