AC-2024-LON-003354 - [2025] EWHC 2270 (Admin)

Fecha: 05-Sep-2025

Conclusions

Conclusion

175.

I dismiss this claim on all grounds.

176.

I add by way of postscript that the Leng Review was published on 16 July 2025 and forwarded to me by the defendant. The report does not propose a national scope of practice for associates, nor does it recommend that the defendant produces any further or different guidance on supervision or consent. The report recommends a defined national initial job description for PAs in primary and secondary care and for AAs when they first qualify and opportunities for further training through a national “credentialing programme” approved by new faculties for associates and supported by host Royal Colleges. The review recommends that PAs should not see undifferentiated patients except within clearly defined clinical protocols. The report does not however say that the defendant should enshrine this restriction in its regulatory framework.

177.

I received short submissions as to its relevance from the parties on 24 and 25 July. In summary only:

(a)

The defendant submits that the report is fatal to the claimants’ outcome irrationality grounds. The scope of the inquiry was wide-ranging and the evidence considered far more extensive than that which I have seen. The report did not conclude that there should be a national scope of practice for associates, save that they should not see undifferentiated patients. There is no suggestion that the defendant should have, or should going forward, incorporate this restriction into its rules. The procedural challenges are now academic.

(b)

The claimants submit that I should put the conclusions of the report to one side. The report is by a different person and for a different function. It cannot affect the legality or not of the defendant’s actions. It does not address the core question raised by this claim which is whether the defendant has acted unlawfully in its regulation of associates. At most it goes to relief.

(c)

Ms Richards submits that the Leng review and its conclusions do not affect the claim one way or another. She also submits that because the Leng review is undertaken by someone other than the public body whose actions are under challenge and which post dates the matters under challenge, the conclusions of the review cannot render an unlawful decision or action lawful. She points out that the review is a “mixed bag” and that there are a number of comments and findings which are consistent with submissions made by the BMA before me.

178.

I agree with Mr de la Mare and Ms Richards. The contents of the report are not relevant to the issues which I must decide. It was a report prepared by a different person for a different purpose. It is not directed to ascertaining the lawfulness or otherwise of the defendant’s regulation of associates. The evidence before the review was more extensive than that before me. In these circumstances I have had no regard to the report in reaching the conclusions which I have set out in this judgment.

179.

I thank all counsel and their legal teams involved in this case. I have received a great deal of assistance from them. Each team presented their client’s case skill and care.