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

Pursuant to its powers under the MA 1983 and the 2024 Order, the defendant amended GMP, its existing guidance and advice, and materials posted on its website. There is one set of unified guidance for all regulated professions. GMP contains high level guidance on ethics and conduct.

Associates are prohibited from undertaking certain categories of work by legislation (eg. prescribing, requesting ionising radiation, signing death certificates). They are unable to work other than under supervision. The defendant has not issued policy or guidance further limiting the practice of associates by reference to the types of work that associates can perform. The standards set by the defendant require associates to act within their competence. Practice and actions which contravene those professional standards will be dealt with through the fitness to practise disciplinary process. As part of a five-year revalidation process, associates will keep up to date with any changes to those professional standards and guidance which is issued by the defendant (and any other relevant bodies including their employers). These expectations are set out in GMP.

Page 7 of the GMP is titled ‘The duties of medical professionals registered with the GMC’ and states that ‘[Y]ou must … meet the standards expected of you in all four domains’. Domain 1 is titled ‘Knowledge, skills and development’ and the first standard is to ‘[p]rovide a good standard of practice and care, and work within your competence’ (emphasis added).

In the more detailed guidance for Domain 1, GMP provides as follows under the subheading ‘Being competent’:

Domain 2 of GMP, ‘Patients, partnership and communication’, says this under the subheading ‘Supporting patients to make decisions about treatment and care’

“24.

All patients have the right to be involved in decisions about their treatment and care, and be supported to make informed decisions if they are able to. You must start from the presumption that all adult patients have capacity to make decisions about their treatment and care.

25.

You must be satisfied that you have consent or other valid authority before examining or treating patients, or involving patients or volunteers in teaching or research. More detail about this is given in our guidance on Decision making and consent which you must follow.

26.

You must be aware of your legal and ethical duties relating to consent and capacity. This means you must:

a.

be aware of the relevant law on capacity and mental health

b.

have regard to relevant codes of practice

c.

follow our guidance on Decision making and consent

(…)

28.

The exchange of information between medical professionals and patients is central to good decision making. You must give patients the information they want in a way they can understand.”

As to how associates should approach how they introduce themselves and their role to a patient, GMP Domain 4 (‘Trust and professionalism’) states: “You must always be honest about your experience, qualifications and current role. You should introduce yourself to patients and explain your role in their care.”

As GMP makes clear, the words “you must” are used for “a legal or ethical duty you’re expected to meet (or be able to justify why you didn’t.)” Whereas “you should” is used for “duties or principles that either: may not apply to you or the situation you’re currently in, or you may not be able to comply with because of factors outside your control.”

Guidance on PAs and AAs in practice (published 16 December 2024) contains a section on “Introductions”. It sets out that associates have a responsibility to communicate clearly who they are and their role in the team. It continues:

“GMP requires….you should introduce yourself to patients and explain your role in their care. For example this includes PAs and AAs

(i)

Using and explaining their title in full before using any abbreviations

(ii)

Taking time to explain their role during clinical interactions

(iii)

Remembering that role titles may not always be immediately clear to others

(iv)

Offering patients and staff the opportunity to ask for more information about their role and taking sufficient time to explain.”

The Decision Making and Consent guidance was updated on 13 December 2024. It is addressed to doctors and associates. It sets out a framework for decision making and the underlying principles of decision making. It does not require doctors or associates to provide information about their level of skills, qualifications or experience as a condition of informed consent.