Partha Kar: The Leng review offers pragmatism along with lessons for the NHS (BMJ, 21 July 2025)

Summary

One fundamental question that Gillian Leng’s review had to answer was whether the roles of physician associates (PAs) and anaesthesia associates (AAs) could continue in the NHS without any changes. Leng’s recommendations make it clear that substantial changes are needed in how the roles operate and are identified.

This calls into question NHS England’s workforce team’s implementation strategy,2 the passivity of the medical royal colleges responsible for upholding standards, and the General Medical Council’s function as the medical regulator. Altogether, more should have been done to protect patient safety, writes Partha Kar in this BMJ opinion piece.