GMC chief executive Charlie Massey has said he wishes his organisation had done more to clearly distinguish between the roles of doctors and assistants.

Mr Massey offered apologies and accepted his organisation could have ensured greater clarity in the way it sought to regulate doctors and PAs and AAs (physician and anaesthetist assistants).

His admission came during an oral evidence session of the Parliamentary health committee 21 January, which sought to examine the GMC’s role in respect of vetting and regulating PAs and AAs.

The use of PAs and AAs in the NHS has generated significant criticism and opposition from organisations such as the BMA, particularly regarding the roles and responsibilities of these staff and the potential for confusion among patients.

Following the GMC becoming the PA and AA regulator after implementation  of the Anaesthesia Associates and Physician Associates Order in December 2024, the BMA was part of an unsuccessful joint legal challenge arguing that the regulator’s approach had been irrational and unlawful.

Health committee chair Layla Moran MP and committee member Andrew George MP questioned elements of the GMC’s approach to its regulation of PAs/AAs, particularly the regulators use of the term ‘associate’ rather than ‘assistant’, and the lack of clarity on how many PAs/AAs were unregistered with the GMC.

Mr George asked Mr Massey whether he wished to apologise to doctors and assistant professionals for the GMC’s approach to regulation, which they labelled as having generated considerable ‘controversy and anxiety’.

He said: ‘Don’t you think you owe it to the to the industry, to those who are regulated by you, to both acknowledge the fact that perhaps you could have done more, and to apologise to them and to say that you have a role in repairing those relationships going forward?’

In response, Mr Massey said that, while he remained proud of his organisation’s efforts in taking on the role of PA/AA regulator, he accepted things could have been done differently.

He said: ‘I’m sorry, with the benefit of hindsight, that we [the GMC] weren’t clearer about distinguishing between those [roles]. We did make a decision to have different reference numbers for PAs and doctors but we could, and with the benefit of hindsight, should have gone further in terms of that differentiation than we did.’

He added: ‘I need to put on record that I do believe my team did a really excellent job, and continue to do an excellent job in that, in that task that we've been asked by Parliament to take on.’

Last year saw the BMA and campaign group Anaesthetists United jointly pursue a judicial review of the GMC’s approach to PA/AA regulation, arguing the medical regulator had damaged patient trust by failing to introduce a scope of practice or adequate guidance around supervision.

Following this legal challenge, an independent review into the safe and effective use of PAs/AAs by Professor Gillian Leng vindicated many of the concerns that had previously been expressed by the BMA.

These included insufficient evidence to support the expansion of PA/AA roles and calls for these staff to be restricted treatment of undifferentiated patients and to be renamed as ‘assistant rather than ‘associate’.

To this end, health committee chair Layla Moran quizzed Mr Massey over practical aspects of the GMC’s regulatory approach – particularly the issue of supervision and whether the regulator envisaged introducing best practice guidelines for these staff.

Mr Massey responded by stating that medical royal colleges were the bodies best placed to determine scope of practices, adding that the GMC lacked the ‘clinical expertise’ to produce such guidelines across all medical specialties.

On the issue of doctor supervision of PAs/AAs, he stressed that responsibility for the deployment of assistant staff fell to employers adding that supervising doctors would not be held accountable.

He said: ‘We’re very clear that PAs and AAs work under the supervision of doctors [but] employers are responsible for deploying PAs and AAs appropriately and they’re also responsible for ensuring that they have proper and effective supervision.

‘Doctors are not accountable for the actions and decisions of PAs and AAs provided that they’ve delegated responsibility to them in line with our guidance.’