In July 2025, the government published the findings of an independent review into physician associates (PAs) and anaesthesia associates (AAs) — the roles created to support doctors but which, in practice, many patients have found indistinguishable from them. The review was led by Professor Gillian Leng and was commissioned after a series of high-profile cases in which patients believed they had been seen by a doctor when they had not.
A year on, and with NHS England now working through its response, it’s worth setting out plainly what the review actually found — because the confusion it describes is precisely the problem Dr Pages exists to address.
What the review recommended
The Leng Review’s recommendations focused on one theme above all others: patients need to be able to tell who is treating them.
On titles. The review recommended renaming the roles — physician associates to “physician assistants,” and anaesthesia associates to “physician assistants in anaesthesia” — specifically to “more accurately reflect their supportive position within medical teams and reduce patient confusion.” The word “physician” was kept, but the intent was to make clear these are assistant roles, not independent medical ones.
On supervision. PAs should work under the oversight of a named senior clinician acting as their formal line manager, with national standards for supervision, training and credentialling to be developed jointly with the medical royal colleges.
On scope of practice. Newly qualified PAs should spend at least two years in secondary care before moving into primary care or mental health settings, and should not see patients presenting with undifferentiated symptoms unless those patients have already been triaged by a doctor. In anaesthesia, continued and specific safety monitoring was recommended.
On identification. Perhaps the most concrete recommendation: PAs and AAs should “wear clearly distinguishable uniforms and identification” so patients can see, at a glance, who they are dealing with.
Why this matters beyond PAs and AAs
It would be easy to read the Leng Review as a story about one specific role. It isn’t. It’s a symptom of a wider structural problem: the GMC register now contains categories of professional who are not doctors, and the public has had no reliable, independent way to tell the difference short of asking directly and hoping for a straight answer.
That’s the gap a voluntary, verified directory of medically qualified practitioners is built to close. A uniform helps in a hospital corridor. It does nothing for a patient searching online, in advance, to check who they’re about to see.
Where things stand
The government accepted the Leng Review’s recommendations in full on publication, 21 July 2025, and NHS England instructed trusts and practices to adopt the new titles immediately. NHS England’s own response (issued that July, updated in August) described the review as “a pivotal moment,” while noting that a number of the longer-term recommendations “require further engagement and collaboration to inform a medium to longer term implementation plan.” In plain terms: the direction has been fully agreed, the title change and uniform requirements should already be in effect, but some of the deeper structural changes are still being worked through.
We’ll continue to track this as it develops.
Sources:
- The Leng review: an independent review into physician associate and anaesthesia associate professions — GOV.UK
- NHS England: Response to the recommendations of the Leng Review
- Policy Connect: The Leng Review and the Physician Associate Role — A System Under Strain
- Healthwatch Haringey: Government accepts recommendations of Leng report on physician associates