Research
What providers should do
The survey asks about documented local practice. Agreement with DAUK is not part of the response. The prompts below are the same questions used in the instrument. National wording differs, so read the national positions below before applying an England document elsewhere.
National positions
England
- Published position
- Government accepted all 18 Leng recommendations. NHS England expects employers to review local arrangements. Its August 2025 FAQ is interim employer guidance, not legislation, and several national protocols and standards were still in development.
- Implementation
- NHS England publishes implementation guidance. Trust boards, medical directors, workforce teams, services and named supervisors apply it locally.
- Survey treatment
- Measure current local implementation of the relevant Leng recommendations, NHS England guidance, GMC requirements and professional standards. Keep current controls separate from future proposals.
Sources The Leng review, an independent review into physician associate and anaesthesia associate professions; Independent review of physician associate and anaesthesia associate roles; Response to the recommendations of the Leng Review; Leng Review, NHS England FAQs on actions for NHS organisations; Supervision of physician associates and anaesthesia associates
Wales
- Published position
- Welsh Government accepted all recommendations in principle on 3 September 2025. An implementation group was assessing how they should operate in NHS Wales. Acceptance in principle does not prove that a health board or trust has completed each action.
- Implementation
- Welsh Government, NHS Wales and each health board or trust through its own clinical and employment governance.
- Survey treatment
- Ask which measures have been put into practice locally, when they took effect and what document authorised them. Do not substitute NHS England wording for Welsh policy.
Sources Written statement on the Leng Review; The Leng review, an independent review into physician associate and anaesthesia associate professions; Supervision of physician associates and anaesthesia associates
Scotland
- Published position
- No official Scottish decision adopting the Leng recommendations was located by 23 August 2026. Existing Scottish material describes close supervision, a designated supervising doctor and local board governance.
- Implementation
- Scottish Government, NHS Scotland boards and employing services retain the Scottish policy and local governance roles.
- Survey treatment
- Treat Leng-derived items as local adoption questions, not Scottish compliance tests. Apply UK GMC regulation and ask separately about existing Scottish supervision arrangements.
Sources Physician associate supervision information released under FOI 202400441146; NHS Education for Scotland public board papers; Supervision of physician associates and anaesthesia associates; Regulation of physician associates and anaesthesia associates begins
Northern Ireland
- Published position
- No Department of Health Northern Ireland decision adopting or rejecting the Leng recommendations was located by 23 August 2026. UK GMC regulation still applies.
- Implementation
- Department of Health Northern Ireland and each Health and Social Care Trust govern local deployment, alongside UK regulation and applicable professional standards.
- Survey treatment
- Treat England-only Leng implementation items as not nationally adopted unless a trust provides a local decision. Ask separately about UK registration, local scope, supervision and patient identification.
Sources Supervision of physician associates and anaesthesia associates; Regulation of physician associates and anaesthesia associates begins; Health and Social Care Trusts
Survey questions
Does this organisation employ physician associates?
Include permanent, fixed-term and bank staff. Do not include anaesthesia associates.
How many physician associates work in this organisation?
Give headcount and full-time equivalent figures if you know them. Estimates can be marked as uncertain.
Has the organisation formally reviewed physician associate deployment since 16 July 2025?
A formal review may be recorded in a policy, board paper, workforce decision or clinical governance record.
Local adoption only in Scotland and Northern Ireland.
What is the main title this organisation uses for the role?
If titles differ, enter the most common one and list the others in the factual note.
Local adoption only in Scotland and Northern Ireland.
Does each physician associate have a documented scope of work?
The document should describe permitted tasks, limits and routes for escalation.
Local adoption only in Scotland and Northern Ireland.
Does each physician associate have a documented competence review?
Record whether the review is current and linked to the work the person undertakes.
Local adoption only in Scotland and Northern Ireland.
Does each physician associate have a named senior doctor responsible for supervision?
Record whether this is documented and who covers when the named doctor is unavailable. Do not give an individual's name.
Is a supervising doctor available whenever physician associates are working?
Include nights, weekends and remote or community settings.
Are physician associates prevented from seeing undifferentiated patients unless a defined protocol applies?
An undifferentiated patient has not yet had the presenting problem clinically assessed and triaged into an agreed pathway.
Local adoption only in Scotland and Northern Ireland.
Are any first-contact duties governed by a named national or local clinical protocol?
Give the protocol title, owner and date in the evidence fields.
Local adoption only in Scotland and Northern Ireland.
Does the organisation use documented measures to identify physician associates to patients and distinguish them from doctors?
Consider introductions, badges, lanyards, clothing, booking systems, letters, websites and staff information.
Local adoption only in Scotland and Northern Ireland.
Are patients told the role and limits of a physician associate?
Use published information or an agreed local process as evidence.
Are patients told how to ask for a doctor?
Record the patient information or local process that explains this choice.
Do local systems prevent physician associates from prescribing?
Physician associates cannot currently prescribe. Consider electronic permissions, paper processes and requests to doctors.
Are requests involving ionising radiation restricted to locally authorised referrers?
Record the local policy and whether physician associates have any authorised referral role.
Has the organisation documented how it will check GMC registration from 13 December 2026?
Include checks for new and existing staff and the escalation process for incomplete registration.
Can local safety reports and reviews identify physician associates as a staff group?
Consider incident systems, complaints, never events, coroners' reports and board reporting.
Local adoption only in Scotland and Northern Ireland.
Do supervising doctors receive training for the role?
Record the training provided and how completion is monitored.
Local adoption only in Scotland and Northern Ireland.
Do supervising doctors have protected time for the role?
Use job plans, workload reviews or another documented allocation as evidence.
Local adoption only in Scotland and Northern Ireland.
Were affected staff consulted about material role changes?
This includes changes to title, job description, duties, pay band or deployment.
Local adoption only in Scotland and Northern Ireland.
Were local trade unions consulted about material role changes?
Record the consultation route and the changes it covered.
Local adoption only in Scotland and Northern Ireland.
Must newly qualified physician associates complete two years in secondary care before primary care or mental health deployment?
This is a Leng recommendation for England and was accepted in principle in Wales. Elsewhere, report only a documented local decision.
Local adoption only in Scotland and Northern Ireland.