The High Court has dismissed in full a judicial review brought by the British Medical Association (BMA) against the General Medical Council (GMC). In a ruling that clarifies the regulator’s authority to apply its Good Medical Practice guidance across the 3 professions it oversees: doctors, physician associates (PAs), and anaesthesia associates (AAs).
Mrs Justice Lambert found the GMC’s approach which is using a unified set of professional standards and the collective term “medical professionals”, to be lawful, rational and grounded in patient safety. The BMA had challenged the inclusion of PAs and AAs under these standards. They argued that such decisions blur the lines between doctors and non-doctor roles, mislead the public and potentially endanger patients. All three grounds for the BMA’s claim were rejected.
GMC Welcomes a “Comprehensive” Endorsement
Charlie Massey, Chief Executive and Registrar of the GMC, welcomed the ruling as a “comprehensive judgment”, praising the Court’s recognition of the Council’s methodical consultation and policy development process.
“We are pleased the court has recognised that our decision…was a logical and lawful decision to reach,” Massey said, emphasising that extensive engagement with stakeholders, including the BMA, shaped the guidance. “The judge concluded that PAs and AAs following the same professional standards as doctors was logical, and that in doing so the GMC had acted at all stages to further patient safety.”
The GMC has consistently maintained that while it regulates doctors, PAs, and AAs under one framework, it recognises them as distinct professions, with differing scopes of practice, and a clear expectation that PAs and AAs operate only under appropriate supervision. The judgment supports this tiered view of regulation.
Shared Standards, Not Equal Professions
In her written judgment, Mrs Justice Lambert stressed that the GMC’s objective in publishing shared guidance was rooted in public protection. Not in equating PAs or AAs with doctors.
“All of the evidence indicates to me that, in producing shared standards, the GMC acted to further patient safety”.
She further dismissed the argument that using the term “medical professionals” was misleading or confusing:
“Associates are members of a profession, trained to the medical model, undertaking work which might otherwise be performed by doctors… The defendant was entitled to conclude that the term ‘medical professional’ was apt.”
The judgment underscores that while the same guidance document is applied, it is still up to each practitioner,whether a doctor, PA or AA, to interpret its relevance in light of their own clinical competence and supervisory obligations. And that is the point that could be setting a dangerous precedent according to the BMA.
BMA Finds it a “Disappointing” Outcome
The BMA, which represents doctors across the UK, responded sharply, calling the ruling “disappointing” and warning that the decision may fuel ongoing confusion in clinical settings.
Professor Phil Banfield, chair of BMA Council, reiterated concerns that the public is being misled about the qualifications of PAs:
“Physician associates do not study medicine and are trained to a very different standard to doctors. By labelling both doctors and PAs as ‘medical professionals’, the public are being misled to think they are similarly or equally qualified. They are not.”
Banfield criticised what he described as a failure to heed repeated warnings from coroners and frontline clinicians about patient harm arising from confusion between the roles. He added that the GMC’s argument in court, that it has no statutory duty to protect patient safety, was “terrible” and inconsistent with the responsibilities of a medical regulator.
The BMA also pointed to the forthcoming Leng Review, commissioned by the Department of Health and expected to report in spring 2025, as a critical opportunity to revisit the structure and clarity of associate roles in the NHS.
| British Medical Association (BMA) | General Medical Council (GMC) | |
| Type of Organisation | Professional association and registered trade union | Independent statutory body |
| Membership | Open to doctors and medical students in the UK | Mandatory for all doctors registered to practice in the UK |
| Primary Role | Represents, supports, and negotiates on behalf of its members. Promotes the medical profession & public health. | Regulates doctors, ensuring they meet standards of patient care and professional conduct; maintains the medical register. |
| Key Activities | Lobbying government and policymakers | Setting standards for medical education, training, and practice |
| Negotiating terms and conditions of employment for doctors | Maintaining the register of medical practitioners | |
| Providing legal and professional support to members | Investigating concerns about doctors’ fitness to practise | |
| Publishing journals and guidance | Setting ethical guidance for doctors | |
| Promoting research and education | Quality assuring medical education and training | |
| Focus | Doctors’ professional interests, well-being, and the advancement of medicine. | Regulation and public confidence in the medical profession. |
| Funding | Membership subscriptions | Registration fees paid by doctors |
| Relationship with GMC | Can have differing views and has recently taken legal action against the GMC regarding the regulation of Physician Associates. | Independent body that the BMA may engage with and sometimes challenge on policy and regulatory matters. |
An Ongoing Dispute Over Role Clarity
This legal battle is about a broader and increasingly contentious debate within UK healthcare over the expansion of associate roles. And the associated dangers. Physician associates, originally intended to support doctors by taking on less complex tasks, have become more prominent in clinical settings. This has raised questions about scope, transparency and accountability.
While the GMC argues that regulation ensures a consistent standard of professionalism and improves patient safety, critics, including not only the BMA but also patient groups and several coroners, suggest that title inflation and blurred role boundaries risk eroding trust and safety.
The BMA has said it is “considering its next steps” following the court’s ruling. Whether through further legal avenues, political lobbying, or professional guidance, the battle over how medical and non-medical roles are defined and communicated to the public is far from over. But likely to be lost.
The GMC is moving forward with its unified guidance, reiterating that shared standards do not mean equal qualifications, but rather a shared responsibility to uphold safety, professionalism, and accountability in patient care.