This is in follow-up to the HSCS committee hearing, 16/01/24.
Original request, 16 January 2024:
I refer to your appearance before the HSCS Committee today, 16th January 2024, regarding the regulation and expansion of Medical Associate Professional roles within NHS Scotland.
I request the following information from you, under FOI if necessary:
You stated “This order [the Anesthesia Associates and Physician Associates Order 2024] is the culmination of years of collaborative working between the four governments of the UK and multiple public consultations.” Aside from the 2017 consultation conducted by the DHSC, published 2019, please supply a list of all the other consultations (plural) you refer to.
You referred to a “MAPs Implementation Programme, overseen by a Programme Board made up of a range of key partners”. Please supply:
a. A list of all the key partners / stakeholders
b. A copy of the latest minutes of the latest MAPs Implementation Programme committee meeting (or if no such committee exists, the latest minutes for the committee immediately responsible for the Programme aforementioned)
You referred to “a consultation exercise on which regulatory body would be most appropriate for the regulation of [PAs] … a very significant majority of those that responded to the consultation said it was the GMC would be the most appropriate body to carry out that regulatory function … the feedback rate … under 60% if I recall correctly.” Please provide me with the source for this number.
With reference to Government funding, you referred to this being “part of the initial process to support the GMC in taking on this regulatory role”. Please confirm whether the Scottish Government gave funding to the GMC to undertake this role (separate from the funds given to the GMC by DHSC for the same). If so, how much, and over what period of time.
You made at least two references to undertaking a “much more evidence-based [approach]” vs NHSE re the introduction of MAPs across NHS Scotland. Please provide copies of, or references to, two or three key pieces of evidence (articles, studies or similar) that have been used to guide the Scottish Government’s approach to the expansion of MAP roles within NHS Scotland.
You referred to meeting with the GMC to discuss their undertaking the regulatory function of MAPs in Scotland. Please provide minutes of the latest meeting you held with the GMC.
Response, 08 February 2024:
- In relation to your request for a list of all other consultations that the Cabinet Secretary for NHS Recovery, Health and Social Care referred to during his committee appearance in relation to the Anaesthesia Associates and Physician Associates Order 2023, please find a list of relevant resources below:
The regulatory landscape has evolved in a gradual and piecemeal manner following the publication of a joint report between the Scottish Law Commission, the Law Commission for England and Wales and the Northern Ireland Law Commission, in 2014, recommending, among other things, a single legal framework for the regulatory bodies: https://lawcom.gov.uk/project/regulation-of-health-and-social-care-professionals/
Building on this report, in 2017 the Department of Health (now DHSC) published a consultation on options for reforming the regulation on healthcare professionals in the UK: https://assets.publishing.service.gov.uk/media/5a81d78ce5274a2e8ab561e7/Regulatory_Reform_Consultation_Document.pdf
In 2019, the UK Government published its consultation response and committed to working with the Devolved Governments and the regulators to develop draft secondary legislation. The response can be found at: https://assets.publishing.service.gov.uk/media/5d386abfed915d0d0446885f/Promoting_professionalism_reforming_regulation_consultation_reponse.pdf
In 2017, Department of Health also published a consultation seeking views on the regulation of Medical Associate Professions (MAPs) in the UK (MAPs is the umbrella term for AAs, PAs and Surgical Care Practitioners; although at the time of consultation it also encompassed Advanced Critical Care Practitioners): https://assets.publishing.service.gov.uk/media/5a81d87440f0b62305b911d5/The_regulation_of_MAPs_in_the_UK.pdf
Detailed proposals for the reform of the legislation underpinning healthcare regulation were then set out in a consultation published by DHSC in 2021: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/978833/Regulating_healthcare_professionals__protecting_the_public.pdf
The response, published on 17 February 2023, can be found at: https://www.gov.uk/government/consultations/regulating-healthcare-professionals-protecting-the-public/outcome/regulating-healthcare-professionals-protecting-the-public-consultation-response-executive-summary#closing-summary
The consultation for this instrument was published by DHSC on 17 February 2023 until 16 May 2023. It can be found at: https://www.gov.uk/government/consultations/regulating-anaesthesia-associates-and-physician-associates
The report on the Consultation, published on 11 December 2023 by the Scottish Ministers and the Secretary of State, reflects the final positions that have been used as the basis for drafting this instrument that will give the GMC the power to effectively regulate AAs and PAs under the new regulatory framework. It can be found at: https://www.gov.uk/government/consultations/regulating-anaesthesia-associates-and-physician-associates
- In relation to your query regarding the newly constituted MAPs Programme Board, please see copied below the proposed membership. Please note that we are currently still in the process of finalising arrangements and therefore this list is subject to change:
- Scottish Government Health Workforce Directorate (Co-Chair) NHS Education for Scotland Medical Directorate (Co-chair) NHS Education for Scotland NMAHP Directorate
- Chief Medical Officer Directorate, Scottish Government
- Chief Nursing Officer Directorate, Scottish Government Chief Pharmaceutical Officer, Scottish Government
- Chief Allied Health Professions Officer, Scottish Government Scottish Association of Medical Directors
- Scottish Executive Nurse Directors Group
- Academy of Medical Royal Colleges and Faculties in Scotland Faculty of Physician Associates
- Association of Anaesthesia Associates
- General Medical Council
- NHS Scotland Regional Workforce Planners
- Centre for Sustainable Delivery (CfSD)
- Health Improvement Scotland
- NHS Scotland Directors of Human Resources
- Staff Side Representatives
You also requested any minutes of the Programme Board or latest minutes for the committee immediately responsible for the Programme.
While our aim is to provide information whenever possible, in this instance the Scottish Government does not have the information you have requested. The reason why we don’t have the information is because the Programme Board will have its first meeting end of February 2024. We are also not able to provide minutes for the committee immediately responsible for the Programme, as the MAPs Programme Board is responsible for overseeing the newly constituted MAPs Implementation Programme and as previously noted has not yet met.
- You also requested to be provided with a source for the percentage that responded to a consultation stating that the GMC would be the most appropriate body to carry out the regulatory function in relation to Physician Associates and Anaesthesia Associates.
The source for the figure is on page 36 of the following consultation: The regulation of medical associate professionals in the UK: consultation response (publishing.service.gov.uk)
- You furthermore requested confirmation whether the Scottish Government gave funding to the GMC to undertake this role (separate from the funds given to the GMC by DHSC for the same). If so, how much, and over what period of time.
It is a fundamental principle in maintaining the independence of statutory professional regulation that it is funded by registrants from the relevant professions. As the regulation of doctors is a reserved matter (and it is solely this group for whom the General Medical Council currently holds regulatory responsibility), it was a decision for Ministers of the Crown to fund the implementation of additional statutory responsibilities for the General Medical Council. The GMC will come into devolved competence of the Scottish Parliament only once the Order has come into force, and the Scottish Government has not been responsible for funding this work.
- You requested copies of, or references to, two or three key pieces of evidence (articles, studies or similar) that have been used to guide the Scottish Government’s approach to the expansion of MAP roles within NHS Scotland.
Throughout 2021 and 2022 NHS Education for Scotland (NES) took forward an extensive programme of evidence gathering and engagement in order to understand the potential opportunities associated with expanded deployment of Medical Associate Professionals (MAPs) across Scotland. This work was designed to support the Scottish Government in arriving at an informed view on the potential opportunities associated with any future expansion of these roles and informs our approach going forward. You can find the report here. Furthermore, the MAPs TURAS page provides more information and updates on the progress of the work regarding MAPs in Scotland that is jointly led by Scottish Government and NHS Education for Scotland.
- You requested minutes of the latest meeting the Cabinet Secretary for NHS Recovery, Health and Social Care held with the GMC.
The Cabinet Secretary for NHS Recovery, Health and Social Care met with the General Medical Council on 19 September 2023. You will find a copy of the minutes enclosed.