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HCSA warns doctors will be punished due to regulatory weakness around associate professionals

HCSA has warned proposed rules for regulating medical associate professionals (MAPs) will see doctors punished unfairly, risk patient safety and hand employers a “blank cheque” on their deployment in hospitals.

The warning came in response to a consultation by doctors’ regulator the General Medical Council (GMC), which has now also been handed oversight of MAPs.

HCSA expressed fears that the regulator is washing its hands of responsibility for setting out the scope of the MAP role at a time when there is no clear national policy. Yet the GMC is nevertheless attempting to draw up rules and standards governing them — an approach HCSA’s president has labelled “nonsense”.

The union also highlighted a lack of clarity over how associate professionals are overseen in hospitals, stating that without clear guidelines it is inevitable supervising doctors will end up being unfairly held accountable for MAPs’ mistakes.

And it warned that trainee doctors were being left in the dark about how a surge in associate professionals will impact their own training.

HCSA President Dr Naru Narayanan said: “The GMC cannot go on ignoring the issue of scope of practice.

“It is a nonsense to develop standards without a universal understanding of what physician associate and anaesthesia associate roles involve.

“The regulator should take ownership for benchmarking the standard, with input from doctors.

“There should be a national system for recording the competencies of individual MAPs.”

HCSA has had multiple reports from members who work alongside MAPs with no clarity on whether they are personally responsible for supervision.

The union has tabled a series of proposals to the GMC designed to safeguard doctors responsible for supervising MAPs:

  • Employers should be required to identify capacity for supervising MAPs ahead of beginning the recruitment process and halt the process where this is not possible

  • Supervisors must be appropriately senior, ie consultant or SAS, and have willingly agreed through a job planning process, with time ring-fenced and appropriate renumeration

  • There must be clear limits on appropriate number of MAPs and junior doctors under an individual supervisor and clarity on what happens on a day-to-day basis including when named supervisor is not available

  • The GMC register for MAPs should include the named supervisor and the MAP required to provide the name of supervisor when required

HCSA’s submission highlighted the concerning lack of answers on how medical education will be protected while MAP courses are rolled out, such as access to simulation time, laboratory rooms and resources.

Read the full submission