NHS long term workforce plan and ambitions around medical associate roles


Charlie Massey
Chief Executive and Registrar
General Medical Council
Regent’s Place
350 Euston Road

Dear Charlie, 

NHS Long Term Workforce Plan and ambitions around Medical Associate roles

Thank you for your letter of 20 October regarding our ambitions for Medical Associate roles in the NHS Long Term Workforce Plan (LTWP).

As you reiterate there is considerable discussion about these roles which we sought to address in our letter to you and Royal Colleges on 17 October. This public debate is concerning thousands of colleagues already in these roles across the NHS. We share your desire to support those colleagues so they can continue to care for patients as part of multi-disciplinary teams under appropriate supervision and will continue to work with local leaders and educators on this.

As you know, we continue to work with partners, including Medical Associates and Doctors, to agree how we deliver the NHS LTWP and address the concerns raised around how Medical Associates can play their role safely and effectively.

Thank you for the offer to continue to speak publicly about the benefits of regulation, we will also. We are particularly pleased you outline next steps as we believe both the regulations and your public consultation are vital to public and professional confidence.

We have valued the strong collaboration between the GMC and Health Education England in getting to this stage and look forward to continuing that collaboration in the new NHS England. We stand ready to support you as you put regulation in place for these roles.

In response to the public debate, we have made clear there is absolutely no plan or desire to replace doctors. The NHS LTWP doubles medical degree school places to 15,000 compared to 1,500 physician associate places.

This will mean a major expansion of specialty training which we are working with the Royal Colleges on. The commitment to further expanding high-quality postgraduate medical training, building on the additional 1,500 places we established at HEE, is core to the NHS LTWP and NHS England’s vision for the future workforce.

We have already said that we will set our recruitment trajectory based on how confident we are that the local education capacity and faculty is in place to train all professionals to the highest standards.

We also outlined in our letter dated 17 October that we would:

  • Work with partners to develop appropriate curricula, core capability and career frameworks, standards for CPD, assessment and appraisal and supervision guidance for PAs and AAs.
  • Continue to ensure the required expertise, infrastructure and leadership so associate roles can be effectively trained and integrated into teams, through developing national standards, defined scope of practice, and assessment of educational capacity.
  • Remind local employers about their responsibility for ensuring effective and appropriate supervision of all associate colleagues, that they are shaping associate roles within an acceptable scope of practice, and making sure associates are working within established guidelines.
  • Continue work with the Academy of Medical Royal Colleges and individual professional bodies to respond to further concerns or issues as a result of our continuing engagement.

We look forward to working with you and other partners over the coming weeks and months to deliver the NHS LTWP we worked so hard to create together.

Kind regards

Professor Sir Steve Powis, National Medical Director, NHS England.
Dr Navina Evans CBE, Chief Workforce, Training and Education Officer, NHS England.