Physician associates in the UK have now threatened legal action against GPs that implement recommendations from the Leng Review.
Tension is rising between physician associates (PAs) and GPs across the pond, with the PA union now attempting legal action.
The United Medical Associate Professionals (UMAP) has been stumped in securing a High Court injunction that would prevent the UK government from introducing restrictions on scope of practice.
This has prompted the UMAP to begin its own rollout of legal action threats to individual GP practices that are set to adopt the restrictions.
A report led by the Royal Society of Medicine president Professor Gillian Leng made the recommendation to ban PAs who had only attained a two year post graduate degree from seeing undifferentiated patients.
"Clarity about the roles, how to work in multidisciplinary teams, and how to ensure the roles are distinct is needed. The review recommendations aim to provide that clarity." Gillian Leng on the outcomes of her review on physician and anaesthesia associate roles www.bmj.com/content/390/…
— The BMJ (@bmj.com) 17 July 2025 at 01:57
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This recommendation came after the UK government ordered an independent review amidst concerns of inadequate care from PAs.
Many cases were brought to attention as part of the review including the death of a woman via an embolism after a PA had misdiagnosed her with an ankle sprain.
Within 24 hours of the review’s release back in July, the NHS made the call for general practices to stop recruiting PAs who did not have minimum two years of hospital experience.
Concerns surrounding misdiagnosis and initial treatment in both general practice and emergency care were the main gripes with PAs in the Leng Review.
“It is here that the risk of missing an unusual disease or condition is highest and where the more extensive training of doctors across a breadth of specialties is important,” the review said.
“Making the wrong initial diagnosis and putting patients on an inappropriate pathway can be catastrophic.”
Upon NHS approval, the government agreed to rename physician associates to physician assistants to reduce patient confusion over title association.
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The UMAP then launched judicial review proceedings in an attempt to reverse the government decision, along with applying for an injunction to block immediate changes until the judicial review was completed.
The UK High court has since rejected the injunction bid prompting UMAP to add Professor Leng as a defendant to the judicial claiming that it would showcase how the review was illegal.
“We are now adding Professor Gillian Leng as a third defendant to our judicial review case, which is being expedited,” the UMAP said in a statement.
“We strongly urge all NHS trusts and primary care networks to await the outcome of our upcoming judicial review before making any changes to medical associates’ job roles, as we know many are doing already.
“Any employer that hastily presses ahead with implementing the recommendations while the judicial review is pending will face legal action from UMAPs.
“UMAPs continues to stand up for PAs and anaesthesia associates across the country who are being dismissed or unfairly treated because of the Leng Review, including assistance at employment tribunals where necessary.”
Just in case you haven’t seen anything funny this weekend:
— NHS Swipe Card (@nhsswipecard) August 16, 2025
UMAPs 🤡: “Any employer that hastily presses ahead with implementing the recommendations (from Leng’s review) while the judicial review is pending will face legal action from UMAPs.” pic.twitter.com/0mVuN38asx
