MAPs PMB minutes 21/03/2023

Minutes from GMC MAPs Programme Board, 21 March 2023

This is a transcript of the minutes provided by the GMC provided via FOI

Minutes and actions from the last meeting

Programme update

  • HA presented a set of slides to the Board covering current areas of work.

  • In relation to PAs and AAs who currently prescribe using another registration, we have delayed publishing our position because DHSC/NHSE wish to seek legal advice on whether this practice will be acceptable once PAs/AAs are separately regulated.

  • The Board were asked for a specific steer on whether we should charge PAs and AAs for registration appeals/revisions once we have the power under the AA and PA Order, or whether we should defer doing so until we are able to introduce charges for doctors:

    • NR and UL advised that we should be ready to charge from Day 1 of regulation. PA/AA regulatory costs will not initially be fully covered by registration fees so, if we don’t charge for appeals, then we are effectively asking DHSC to subsidise the cost of us choosing not to use a power they’ve given us.

    • LW noted that appeal numbers will be low, since we only receive about 100 each year from doctors (which includes specialist applications and licence removal).

    • JA noted the value of doing the necessary policy and process worknow,in anticipation of future powers for doctors.

    DECISION: We should carry out the work necessary to be able to charge a fee for registration appeals by PAs and AAs from the start of regulation

Draft presentation for April Council seminar on the revised draft AA and PA Order

  • HA shared the draft presentation that is going to the Council Seminar in April. The Board members agreed the presentation content is appropriate and would be a valuable introduction to some of the challenges arising from multi-professional regulation.

Education QA – findings so far and issues arising

  • ES presented an overview of the QA work that has been undertaken so far with PA/AA course providers and highlighted some of the issues and risks identified.

    • SC noted the need to assure ourselves sufficiently of the prescribing content of courses as one element of arrangements for future extension of prescribing responsibilities to these professions. She also suggested we look at how other apprenticeship/vocational healthcare courses are quality-assured.

    • HA commented on emerging risk in relation to AA courses, where students train in the workplace with comparatively little oversight from the course provider. Additional funding from HEE means the number of employers is expanding rapidly and, once we introduce the AA registration assessment in 2025, it will be very apparent if students aren’t able to meet the outcomes.

    • NR asked that we keep in mind the affordability of different models of QA. GW confirmed that we have budgeted for the existing MAPs QA team (3 FTE) to continue into BAU, but nothing more than that.

  • Board members agreed that our approach to QA of PA/AA courses should be proportionate, based on risk and available resources, without cross-subsidisation from doctors. They also agreed it’s worth looking at QA models from other professions.

ACTION: ES to continue work to establish options for the model of QA once regulation commences and seek input from GW on costs as needed.

Post-qualification landscape for PAs/AAs

  • HA and NF presented on the current position for post-qualification progression of PAs and AAs, plus challenges arising for our future regulatory development.

  • NR asked if we have the power under the AAPA Order to regulate post-qualification education for PAs/AAs and whether other bodies could equally well develop education and training for them. CB and SC confirmed that as a regulator we’ll have a power to oversee post-qualification training and we wouldn’t be seeking to devise training but rather to regulate governance and systems

  • SC noted the fundamental question is whether we see PAs and AAs progressing through structured training like doctors, or not (like other healthcare professions).

  • LW said that it’s important for us to engage with other organisations, like HEE for example, to develop a strategy about how we support people in their progression, because we’ll almost certainly be dragged into these debates in future.

  • TA noted this is huge and fascinating debate. Is it for us to lead, to convene, or to follow? One option would be for us to set out what we think it should look like, and that’s unlikely to be identical to PG medical education and training (because we wouldn’t choose to invent what’s there now).

  • PC confirmed that we’ll have the power to approve qualifications, set standards and QA them. We have the power to supervise post-qualification education and we could choose to standardise the post-graduation qualification structure.


  • There was no other business raised. The next full MAPs Programme Board meeting is scheduled for 16 May 2023.