Charlie Massey, Chief Executive of the GMC, talks about the importance of Medical Associate Professionals (MAPs) and how their regulation may help strengthen our health system.
Growing patient demand and workforce pressures have rightly sparked changes in the way we deliver healthcare.
Perhaps the most meaningful change has been the growth of new roles designed to work alongside doctors. A more diverse workforce, made up of old and new roles, could be one way to deal with these challenges.
Physician associates, surgical care practitioners, physician’s assistants (anaesthesia) and advanced critical care practitioners – Medical Associate Practitioners (MAPs) – could provide invaluable support to doctors who we know are continuing to feel the strain of relentless demand. They could also improve continuity of care for patients.
The Department of Health (England) is asking on behalf of all the UK countries whether these four medical associate roles should be covered by statutory regulation. We believe they should – indeed we have argued this for some time.
It’s vital that patients, employers and other health professionals are assured that those providing care can practise safely within appropriate professional standards. This is what gives them their accountability as professionals to the public.
Realising their full potential
The Government’s consultation describes each of these four roles as a profession. We strongly feel that MAPs should be considered as a single umbrella profession made up of four areas of practice. This would future-proof the profession; enabling the development of roles in other areas of practice and allowing a more coherent and co-ordinated approach to regulation.
The Government’s consultation also asks which professional regulator should accept responsibility for these roles – us or the Health and Care Professionals Council (the body which regulates a number of professions including clinical scientists, speech and language therapists, and arts therapists). We have said we would be prepared to regulate MAPs. Let me explain why.
MAPs work closely with doctors and their work is aligned to the medical model. So, while there are a number of options for regulating them, there is a strong logic that one regulator – the GMC – should be responsible for both doctors and medical associates. It makes sense given their related roles that they should work to similar professional standards, for example.
That said we know such a proposal might spark concerns among some doctors that our focus could be diverted away from our programme of reforms, for example.
Doctors may also be concerned that the growth of these roles, following regulation, could lead them to fill staffing gaps better suited to doctors or take away training opportunities that doctors in training need.
How MAPs are employed and trained is a matter for workforce planners and local employers. But again, we think there’s a good case here for one regulator to have oversight of both professions and their training systems in particular to ensure appropriate standards of training are met.
The question of which body is best-placed to regulate these roles is one that must be answered by the Department of Health in consultation with the health departments of the other three UK countries. And while we are open to doing this, we do have some conditions.
Ensuring successful regulation
First, the Government would have to fund the costs of developing a regulatory model for these four roles. We have made it clear in our consultation response that doctors should not subsidise either the set-up costs or ongoing regulation of these roles.
Second, we would need a flexible, future-proofed legal framework. It would be wrong to tack these new roles onto our existing law, which as everyone knows is in desperate need of reform.
Third, as mentioned, these four roles should be seen as a single profession containing different scopes of practice. That is how we can provide more future-proofing and ensure we maximize the contribution of these professionals to the NHS.
Finally, we would expect the Government to agree a sensible timeline for bringing these roles into regulation. We believe introducing these four roles in stages, rather than all at once, is the right way to proceed.
We expect the Government will make a decision early this year on which regulator – the GMC or the Health and Care Professions Council – should take responsibility for these roles. Whoever they decide is best suited to this challenge faces a big task. Meticulous planning will be necessary to ensure its success.
However, we see MAPs playing an increasingly valuable role in our health services in years to come. So, while their regulation may be a challenge, it’s one that is worth pursuing. And for the GMC it’s one more way that we can make a difference to the challenges facing healthcare, and the pressure on doctors in particular, while improving care for patients at the same time.