The Anaesthesia Associates and Physician Associates Order 2024

• Citation: S.I. 2024/374
• Sections: 87

Section 1 Citation and commencement

(1) This Order may be cited as the Anaesthesia Associates and Physician Associates Order 2024.

(2) Article 19 (1) (b) comes into force on 13th December 2026.

(3) The remaining provisions of this Order come into force on 13th December 2024.

Section 2 Interpretation

(1) In this Order—

“ approved qualification ” means a qualification approved under article 4 (1) (a) (ii) ;

“ associate ” means—

anaesthesia associate, or

physician associate;

“ case examiner ” means a person who carries out case examiner functions under articles 10 and 13 on behalf of the Regulator;

“ court ”, except in the terms “county court” and “relevant court”, means—

in the case of a person whose address is shown in the register, or would have been so shown if the person were registered, as being—

in Scotland, the Court of Session;

in Northern Ireland, the High Court of Justice in Northern Ireland, and

in any other case, the High Court of Justice in England and Wales;

“ Final Measure ” means a requirement set out in article 10 (10) and imposed under article 10 (3) (b) (i) or (5) (b) (ii) or 14 (3) (c) ;

“ fitness to practise proceedings ” means proceedings and decisions which relate to consideration of whether a person’s fitness to practise as an associate is impaired;

“ Interim Measure ” means a requirement set out in article 11 (8) and imposed under article 11 (1) or 12 (4) (c) ;

“ the MPTS ” means the Medical Practitioners Tribunal Service established under section 1(3)(g) of the Medical Act 1983 ;

“ Panel ” means a panel constituted pursuant to rules made under paragraph 6 of Schedule 4 which has functions under this Order;

“ the register ” means the register referred to in article 5 (1) (a) ;

“ registrant ” means a person registered under article 6 ;

“ the Registrar ” means the Registrar appointed under paragraph 1 (b) (i) of Schedule 1 ;

“ registration ” means registration in the register and “registered” must be construed accordingly;

“ the Regulator ” means the General Medical Council .

“ specified state qualification ” means a qualification comparable to that as an anaesthesia associate or physician associate, granted in one of the states specified in Schedule 1 to the Recognition of Professional Qualifications and Implementation of International Recognition Agreements (Amendment) Regulations 2023 ;

(2) Any reference in this Order to—

(a) fitness to practise being impaired is a reference to impairment by reason of—

(i) inability to provide care to a sufficient standard, or

(ii) misconduct;

(b) a member of the Regulator is to a person appointed under paragraph 1A(2) of Schedule 1 to the Medical Act 1983 .

Section 3 Standards

(1) The Regulator must determine standards applicable to associates.

(2) The standards must relate to—

(a) education and training,

(b) knowledge and skills,

(c) experience and performance,

(d) conduct and ethics,

(e) proficiency in the English language, and

(f) such other matters as the Regulator may prescribe in rules made under paragraph 2 (2) (a) of Schedule 4 .

(3) Before determining a standard, the Regulator must consult such persons as the Regulator considers appropriate.

(4) The Regulator—

(a) must keep the standards under review, and

(b) may vary or revoke a standard.

Section 4 Approval of education, training, etc.

(1) For the purposes of enabling a person to attain the standards determined under article 3 , the Regulator may—

(a) approve—

(i) education or training provided;

(ii) a qualification conferred;

(iii) an examination or assessment provided,

inside or outside the United Kingdom;

(b) approve a person who provides education or training inside or outside the United Kingdom;

(c) determine that—

(i) education or training provided;

(ii) a qualification conferred,

by an institution other than one established in the United Kingdom, is acceptable for practising as an associate in the United Kingdom.

(2) The Regulator may—

(a) attach a condition to an approval;

(b) limit the time for which an approval is to have effect;

(c) vary or revoke an approval.

(3) The Regulator may coordinate the stages of education and training approved under paragraph (1) .

Section 5 Register

(1) The Registrar must—

(a) keep—

(i) a single register of persons registered under article 6 , and

(ii) that register correct in accordance with the provisions of, and made under, this Order, and

(b) take steps to guard against, and facilitate the discovery of, falsification of the register.

(2) The Registrar—

(a) must divide the register into—

(i) one part for anaesthesia associates, and

(ii) one part for physician associates, and

(b) must not divide the register into further parts.

(3) The Registrar must record in the register in respect of each registrant—

(a) a registration number and date of most recent registration;

(b) the person’s name and such contact details as are prescribed in rules made under paragraph 1 (3) of Schedule 4 ;

(c) such other information in respect of the person’s identity, inclusion of which in the register the Regulator is satisfied serves the purpose of protection of the public;

(d) information in respect of any—

(i) warning under article 10 (3) (a) (ii) or (5) (a) (ii) ,

(ii) Interim Measure or Final Measure, or

(iii) decision under article 16 (5) or article 17 (6) ;

(e) such other information in respect of the person’s practice as an associate, inclusion of which in the register the Regulator is satisfied serves the purpose of protection of the public.

(4) The Registrar may record information in the register other than that mentioned in paragraph (3).

Section 6 Registration

(1) Except where paragraphs (2) or (3) apply, the Registrar must register a person who applies for registration (“ the applicant ”) if the applicant—

(a) meets the standards determined by the Regulator under article 3 (1) as being required for registration,

(b) has provided the Registrar with the information specified in paragraph (4) , and

(c) has complied with—

(i) any procedural requirements prescribed in rules made under paragraph 4 (1) (a) of Schedule 4 , and

(ii) such other requirements as the Registrar may direct.

(2) Where the applicant’s entry in the register has been removed due to the imposition of a Final Measure, the Registrar must register an applicant if—

(a) such a person or Panel as is prescribed in rules under paragraph 2 (1) (a) of Schedule 4 is satisfied in respect of the matters specified in paragraph (1) (a) to (c) , and

(b) a Panel has determined that the applicant’s fitness to practise is not impaired.

(3) Where the applicant’s entry in the register has been removed other than due to the imposition of a Final Measure, the Registrar must register an applicant if—

(a) such a person or Panel as is prescribed in rules made under paragraph 2 (1) (b) of Schedule 4 is satisfied in respect of the matters specified in paragraph (1) (a) to (c) , and

(b) in such cases as may be prescribed in rules made under paragraph 2 (2) (d) of Schedule 4 , such a person or Panel as is prescribed in rules made under paragraph 2 (1) (c) of Schedule 4 has determined that the applicant’s fitness to practise is not impaired.

(4) The information referred to in paragraph (1) (b) is—

(a) proof of the applicant’s identity;

(b) evidence to demonstrate that the applicant has in force, or will have in force by the date on which the applicant begins to practise in the United Kingdom—

(i) an indemnity arrangement,

(ii) an insurance policy, or

(iii) a combination thereof,

which provides appropriate and adequate cover in respect of the applicant’s practice as an associate.

Section 7 Periodic assessment

The Regulator must carry out a periodic assessment as to whether a registrant continues to meet the standards determined under article 3 (1) .

Section 8 Conditions on practice as an associate

The Regulator may impose conditions on the practice of such descriptions of associate as may be prescribed in rules under paragraph 2 (2) (e) of Schedule 4 .

Section 9 Removal of an entry

(1) The Registrar, as soon as reasonably practicable, must remove an entry from the register where—

(a) the Registrar is satisfied that the person to whom the entry relates has died,

(b) a Final Measure is imposed requiring the removal of the entry, or

(c) the person to whom the entry relates has a conviction for an offence listed in—

(i) paragraphs 1 to 8 of Schedule 2 , or

(ii) any other paragraph of Schedule 2 in respect of which a custodial sentence has been imposed,

which was committed on or after the date on which this article comes into force.

(2) The Registrar may remove an entry from the register where—

(a) registration was procured fraudulently or made incorrectly,

(b) a registrant does not meet the standards determined by the Regulator under article 3 (1) pursuant to an assessment made under article 7 , or

(c) the person to whom it relates—

(i) has requested the removal, or

(ii) has not—

(aa) complied with an assessment procedure prescribed in rules under paragraph 4 (2) (c) of Schedule 4 ,

(bb) paid a fee in accordance with rules made under paragraph 8 of Schedule 4 ,

(cc) an indemnity arrangement, insurance policy or combination thereof in force which provides appropriate and adequate cover in respect of their practice as an associate,

(dd) maintained an effective means of contact with the Registrar,

(ee) provided information in accordance with a requirement of, or made under, this Order, or

(ff) complied with a condition on registration imposed under article 8 .

Section 10 Steps which may be taken where a question as to fitness to practise arises

(1) Where the Regulator considers that a question has arisen as to whether an associate’s fitness to practise is impaired, the Regulator must—

(a) carry out an initial assessment, and

(b) where the Regulator considers appropriate, refer the matter to a case examiner.

(2) The case examiner to which a referral is made under paragraph (1) (b) must take one of the steps specified in paragraphs (3) and (4) .

(3) The step specified under this paragraph is for the case examiner to determine whether the associate’s fitness to practise is impaired and—

(a) where the associate’s fitness to practise is found not to be impaired—

(i) take no further action, or

(ii) issue the associate with a warning;

(b) where the associate’s fitness to practise is found to be impaired—

(i) subject to paragraph (8) , impose a Final Measure, or

(ii) refer the matter on to a Panel.

(4) The step specified under this paragraph is for the case examiner to refer the matter on to a Panel.

(5) A Panel to which a referral is made under paragraph (3) (b) (ii) must satisfy itself as to whether, and under paragraph (4) must determine whether, the associate’s fitness to practise is impaired and—

(a) where the associate’s fitness to practise is found not to be impaired—

(i) take no further action, or

(ii) issue the associate with a warning;

(b) where the associate’s fitness to practise is found to be impaired—

(i) take no further action, or

(ii) impose a Final Measure.

(6) The case examiner may withdraw a referral to a Panel if the Panel has not yet satisfied itself as to whether, or determined whether, fitness to practise is impaired.

(7) Paragraph (5) does not apply to a referral which is withdrawn under paragraph (6) .

(8) If a case examiner determines that an associate’s fitness to practise is impaired, the case examiner may only impose a Final Measure if the associate—

(a) has agreed to the Final Measure being imposed on the basis that—

(i) the associate’s fitness to practise is impaired, and

(ii) the associate has accepted the case examiner’s findings, or

(b) has been notified that the case examiner proposes imposing a Final Measure and a reasoned response by the associate has not been received by the case examiner within the period prescribed under paragraph 11 (1) (a) of Schedule 4 .

(9) A notification under paragraph (8) (b) must—

(a) request that the associate provide a reasoned response within the prescribed period, and

(b) inform the associate that a Final Measure may be imposed if the associate fails to respond.

(10) A Final Measure imposed under paragraph (3) (b) (i) or (5) (b) (ii) may require that an associate’s entry in a part of the register (into which the register is divided under article 5 (2) (a) ) be—

(a) subject to condition,

(b) suspended, or

(c) removed.

Section 11 Interim Measures

(1) Where a question has arisen in accordance with article 10 (1) as to whether an associate’s fitness to practise is impaired, an Interim Measure may be imposed upon that associate by a Panel, pending—

(a) the conclusion of an assessment under article 10 (1) (a) ;

(b) a determination by a case examiner under article 10 (3) ;

(c) a determination by a Panel under article 10 (5) ;

(d) a determination by the Regulator under article 14 (2) ;

(e) a decision under article 16 (5) in respect of articles 10 (3) (b) (i) , 13 (1) or 14 (3) ;

(f) a decision under article 17 (6) in respect of articles 10 (3) (b) (i) or (5) (b) (ii) , 11 (1) , 13 (1) or 14 (3) ,

where the Panel considers that such an Interim Measure is necessary for the protection of the public, or is otherwise in the interests of the public or the associate.

(2) A Panel which imposes an Interim Measure under paragraph (1) must specify the period for which the Measure is to remain in force.

(3) The Panel may not specify a period longer than 18 months.

(4) The Regulator may—

(a) where it is carrying out—

(i) an assessment mentioned in paragraph (1) (a) , or

(ii) a determination mentioned in paragraph (1) (b) or (c) , and

(b) before the expiration of the period for which the Interim Measure to which the assessment or determination relates is to remain in force,

apply to the court for an extension of the period.

(5) On an application under paragraph (4) , the court may only extend the period if it is satisfied that the current period will not allow such time as is reasonable in the circumstances of the case for the assessment or determination to conclude.

(6) The court may not extend the period for longer than 12 months on each application.

(7) For the purposes of paragraphs (4) to (6) , reference to a period for which an Interim Measure is to remain in force includes a period as previously extended under those provisions or in accordance with article 12 .

(8) An Interim Measure imposed under paragraph (1) may require that an associate’s entry in a part of the register (into which the register is divided under article 5 (2) (a) ) be—

(a) subject to condition, or

(b) suspended.

Section 12 Interim Measures - review

(1) In respect of an Interim Measure which remains in force in respect of an associate, the Regulator must carry out—

(a) a first review of the Measure before the end of a period of six months beginning with the date on which it first had effect, and

(b) subsequent reviews of the Measure before the end of a period of six months beginning with—

(i) the date of the previous review, or

(ii) where a court has, since the previous review, extended the period for which the Measure is to remain in force, the date on which the order to extend is made.

(2) A failure to conduct a review in accordance with paragraph (1) does not affect the validity of the Interim Measure.

(3) The Regulator may at any time review an Interim Measure which remains in force, including where a question arises as to whether an associate is complying with a condition on their registration.

(4) On a review under this article , the Regulator may—

(a) extend the period specified for the Measure to remain in force,

(b) vary a condition to which an associate’s entry is subject,

(c) revoke an Interim Measure and impose a different Interim Measure in respect of an associate,

if, in the opinion of the Regulator, an Interim Measure remains necessary for the protection of the public or remains in the interests of the public or the associate upon whom the Measure is imposed.

(5) Where the Regulator imposes a different Interim Measure under paragraph (4) (c) , it must specify the period for which the Measure is to remain in force.

(6) Article 11 (8) applies to a different Interim Measure imposed under paragraph (4) (c) .

(7) The Regulator may not exercise the power under paragraph (4) so as to provide that an associate is subject to an Interim Measure or Measures in respect of the same matter for a period of longer than 18 months.

(8) On a review under this article , the Regulator may only revoke an Interim Measure without imposing a different Interim Measure if, in the opinion of the Regulator, the Interim Measure is no longer necessary for the protection of the public or is no longer in the interests of the public or the associate upon whom the Interim Measure is imposed.

(9) Where—

(a) an appeal is brought under article 16 or 17 against a decision or a part of a decision, and

(b) the decision, or part of it, is revoked or revised under this article before the appeal is determined,

the appeal (or the part of the appeal which relates to the revoked or revised part of the decision) will lapse.

Section 13 Final Measures

(1) A case examiner who imposes a Final Measure under article 10 (3) (b) (i) , or a Panel which imposes a Final Measure under article 10 (5) (b) (ii) , must specify the period for which the Final Measure is to remain in force.

(2) The case examiner or the Panel may not specify a period of longer than 12 months.

(3) This article does not apply where the Final Measure imposed is for an associate’s entry to be removed from a part of the register.

Section 14 Final Measures - review

(1) The Regulator may at any time review a Final Measure which remains in force in respect of an associate where that associate’s entry in the register is subject to a condition or is suspended, including where a question arises as to compliance with a condition on that associate’s registration.

(2) On a review under this article , the Regulator may revoke a Final Measure if, in the opinion of the Regulator, the fitness to practise of the associate in respect of whom the Final Measure is imposed is no longer impaired.

(3) On a review under this article , the Regulator may—

(a) extend the period for which a Final Measure is to remain in force,

(b) vary a condition to which an associate’s entry in the register is subject,

(c) revoke a Final Measure and impose a different Final Measure in respect of an associate,

if, in the opinion of the Regulator, the fitness to practise of that associate remains impaired.

(4) For the purposes of paragraph (3) (a) , the Regulator may only extend the period—

(a) specified under article 13 (1) , or

(b) previously extended under paragraph (3) (a) ,

by a period not longer than 12 months on each occasion.

(5) Article 13 applies to the Regulator in imposing a different Final Measure under paragraph (3) (c) as it applies to a case examiner and Panel.

(6) Article 10 (10) applies to a different Final Measure imposed under paragraph (3) (c) .

(7) Where—

(a) an appeal is brought under article 16 or 17 against a decision or a part of a decision, and

(b) the decision, or part of it, is revoked or revised under this article before the appeal is determined,

the appeal (or the part of the appeal which relates to the revoked or revised part of the decision) will lapse.

Section 15 Revision of decisions

(1) The Regulator may revise such decisions under this Order as are prescribed in rules under paragraph 3 of Schedule 4 .

(2) A decision may be revised if—

(a) the decision was based on an error of fact or law;

(b) except in respect of a determination under article 10 (2) to (5) and (8) and article 11 (1) , a material change in circumstances has occurred since the decision was made.

(3) The Regulator may not revise a decision in order to—

(a) extend the period for which a Final Measure or an Interim Measure is to remain in force;

(b) vary a condition to which, by virtue of a Final Measure or an Interim Measure, a person’s entry in the register is subject.

(4) For the purpose of any rule as to the time allowed for bringing an appeal under article 16 or 17 , the decision revised under this article is to be deemed as made on the date on which it is so revised.

(5) Where—

(a) an appeal is brought under article 16 or 17 against a decision or part of a decision, and

(b) the decision, or part of it, is revised under this article before the appeal is determined,

the appeal (or the part of the appeal which relates to the revised part of the decision) will lapse.

(6) A decision prescribed in accordance with paragraph (1) includes such a decision—

(a) as previously revised under this article , and

(b) as amended following an appeal under article 16.

Section 16 Appeal to a Panel

(1) In respect of a provision listed in the first column of the following table, a decision of the decision maker listed in the corresponding entry in the second column may be appealed to a Panel by a person listed in the corresponding entry in the third column.

(2) A person who wishes to appeal under paragraph (1) must seek permission to do so from the Regulator within 28 days beginning with the date on which the decision was notified to the person listed in the third column of the table.

(2A) Where an applicant has applied for registration in reliance on a specified state qualification, and the Regulator has failed to notify the applicant of its decision under article 6(1) within four months beginning with the day after the date of receipt of the complete application by the Registrar, the applicant may appeal to a Panel.

(2B) A person who wishes to appeal under paragraph (2A) must seek permission to do so from the Regulator within 28 days beginning with the day on which the time period referred to in paragraph (2A) ends.

(2C) For the purposes of paragraph (2A), an application is a complete application where the applicant has complied with the requirements of article 6(1)(b) and (c).

(3) Following receipt of an application for permission to appeal, the Regulator must—

(a) grant permission,

(b) refuse permission, or

(c) where the rules under paragraph 3 of Schedule 4 permit, revise the decision under article 15 .

(4) Rules made under paragraph 12 of Schedule 4 may prescribe other persons who may appeal against a decision made under a provision listed in the first column of the table in paragraph (1) .

(5) On an appeal under this article , the Panel may—

(a) dismiss the appeal;

(b) quash the decision under appeal;

(c) substitute for the decision under appeal a decision that could have been made;

(d) remit the matter to be disposed of in accordance with directions.

(6) No appeal under paragraph (1) lies against a decision made solely on the ground that the person has not—

(a) applied for registration under article 6 in accordance with rules made under paragraph 4 (1) (a) of Schedule 4 , or

(b) paid a fee payable in accordance with rules made under paragraph 8 of Schedule 4 .

(7) Reference to a decision under paragraph (1) includes a decision—

(a) as previously revised under article 15 , and

(b) as amended pursuant to article 17 (6) (d) .

Section 17 Appeal to a court

(1) In respect of a provision listed in the first column of the following table, a decision of the decision maker listed in the corresponding entry in the second column may be appealed to the court by a person listed in the corresponding entry in the third column.

(2) In respect of a provision listed in the first column of the following table, a decision of the decision maker listed in the corresponding entry in the second column may be appealed to the relevant court by a person listed in the corresponding entry in the third column.

(3) For the purposes of paragraph (2) , the “ relevant court ” means a county court or, in Scotland, the sheriff in whose Sheriffdom is situated the address—

(a) which is shown in the register as the address of the person listed in the third column of the table, or

(b) which would have been so shown if the person were registered.

(3A) Where an applicant has applied for registration in reliance on a specified state qualification, and the Regulator has failed to notify the applicant of its decision under article 6(1) within four months beginning with the day after the date of receipt of the complete application by the Registrar, the applicant may appeal to the relevant court.

(3B) For the purposes of paragraph (3A)—

(a) an application is a complete application where the applicant has complied with the requirements of article 6(1)(b) and (c);

(b) the “ relevant court ” means a county court or, in Scotland, the sheriff in whose Sheriffdom is situated the address—

(i) which is shown in the register as the address of the applicant, or

(ii) which would have been so shown if the applicant were registered.

(4) Where an appeal lies against a decision by virtue of article 16 (1) or (2A) , such an appeal may not be commenced under this article unless—

(a) permission to appeal has been refused under article 16 (3) (b), or

(b) the Panel has disposed of the appeal in accordance with article 16 (5) .

(5) Where a person wishes to appeal to the court, county court or sheriff under this article , the appeal must be commenced within 28 days beginning with the later of the date on which—

(a) the decision,

(b) a revision of the decision under article 15 ,

(c) a refusal of permission to appeal under article 16, or

(d) the determination of an appeal ... under article 16 ,

was notified to the person listed in the third column of the table in paragraph (1) or (2) , or where an appeal is made by virtue of paragraph (3A), the applicant .

(6) On an appeal under this article , the court, county court or sheriff may—

(a) dismiss the appeal;

(b) quash the decision under appeal;

(c) substitute for the decision under appeal a decision that could have been made;

(d) remit the matter to be disposed of in accordance with directions.

(7) The court, county court or sheriff may make any order as to costs or, in Scotland, expenses as it thinks fit.

(8) No appeal under this article lies against a decision made solely on the ground that the person has not—

(a) paid a fee payable in accordance with rules made under paragraph 8 of Schedule 4 , or

(b) applied for registration in accordance with rules made under paragraph 4 (1) (a) of Schedule 4 .

(9) Unless the context otherwise requires, reference to a decision in this article includes a decision—

(a) as revised under article 15 , and

(b) as amended following an appeal under article 16 .

Section 18 Opportunity to make representations

(1) Subject to paragraph (2) , a decision may not be made under—

(a) article 4 (2) (a) or (c) unless the person who applied for the approval under article 4 (1) has been given an opportunity to make representations beforehand, or

(b) article 12 (4) , article 13 (1) , or article 14 (3) nor may a Final Measure be imposed unless the person affected has been given an opportunity to make representations beforehand.

(2) A case examiner may not refer a case under article 10 (4) unless the person whose fitness to practise is in question has been given an opportunity to make written representations beforehand.

(3) Where practicable, representations made by an associate will be considered prior to a decision being taken under article 11 (1) or (2) .

Section 19 Offences relating to registration etc.

(1) A person commits an offence who, with intent to deceive—

(a) falsely represents anyone, including themselves, to have an approved qualification, or to be registered,

(b) uses the title of anaesthesia associate or physician associate without being registered as such,

(c) makes a false representation as to the content of the register, or

(d) procures, or attempts to procure, the inclusion of information in, or exclusion of information from, the register.

(2) A person who is guilty of an offence under paragraph (1) is liable—

(a) on summary conviction in England and Wales, to a fine;

(b) on summary conviction in Scotland or Northern Ireland, to a fine not exceeding level 5 on the standard scale.

Section 20 Schedules 1 and 3 to 5

Schedule 1 and Schedules 3 to 5 have effect.

Section 1 Appointment of Registrar etc.

The Regulator, for the purposes of this Order—

(a) may make such appointments as it may determine, and

(b) without prejudice to the generality of sub-paragraph (a) , must appoint—

(i) a Registrar, and

(ii) members of a Panel.

Section 2 Delegation

(1) Subject to paragraph 8 of Schedule 3 to the Health Act 1999 , the Regulator may delegate functions under this Order to—

(a) a member of the Regulator;

(b) a Panel or the MPTS;

(c) any other person if—

(i) the Regulator considers that the delegation is likely to lead to an improvement in the exercise of its functions, and

(ii) the person has agreed to the terms of the delegation.

(2) The functions that may be delegated under sub-paragraph (1) do not include any function of making rules under Schedule 4 .

(3) The functions that may be delegated under sub-paragraph (1) (b) and (c) do not include the power conferred by that paragraph.

(4) A function may be delegated under sub-paragraph (1) —

(a) wholly or partly;

(b) generally or only in specific circumstances;

(c) unconditionally or subject to specific conditions.

(5) A delegation does not—

(a) prevent the Regulator from exercising the function or making other arrangements for its exercise;

(b) affect any liability or responsibility of the Regulator for the exercise of its functions.

(6) The Regulator may discharge a function delegated to it by another person.

Section 3 Objective, matters to which the Regulator must have regard and co-operation

(1) The Regulator, in addition to its objectives and duties set out in section 1(1A) and (1B)(a) of, and paragraph 9A(1)(b) of Schedule 1 to, the Medical Act 1983 —

(a) has the objective of promoting and maintaining—

(i) public confidence in, and

(ii) proper professional standards and conduct for members of,

the anaesthesia associate and physician associate professions,

(b) must have regard, in exercising its functions under this Order, to—

(i) the interests of persons using or needing the services of associates in the United Kingdom,

(ii) any differing interests of different categories of anaesthesia associates and physician associates, and

(iii) the principle that regulatory activity should be targeted only at cases in which action is needed,

(c) must discharge its functions under this Order in a way which is transparent, accountable, proportionate and consistent, and

(d) must co-operate insofar as is appropriate and practicable, with persons concerned with the employment (whether or not under a contract of service), education or training of associates or the services they provide.

(2) In carrying out its duty to co-operate under sub-paragraph (1) (d) , the Regulator must have regard to any differing considerations relating to practising as an associate which apply in England, Scotland, Wales or Northern Ireland.

Section 4 Default powers of the Privy Council

(1) If it appears to the Privy Council that the Regulator has failed to perform any functions under this Order which, in the opinion of the Privy Council, should have been performed, the Privy Council may notify the Regulator of its opinion and require the Regulator to make representations to it.

(2) The Privy Council may, having considered such representations, give such directions to the Regulator as the Privy Council considers appropriate.

(3) If the Regulator does not comply with a direction given under sub-paragraph (2) , the Privy Council may give effect to the direction.

(4) Subject to sub-paragraph (5) , for the purpose of sub-paragraph (3) , the Privy Council may—

(a) exercise any power of the Regulator or do any act authorised to be done by the Regulator, and

(b) do, of its own motion, any act which it is otherwise authorised to do under this Order at the instigation of the Regulator.

(5) The Privy Council may not under this paragraph make, amend or remove an entry in the register in respect of an individual, nor refuse to do so.

(6) The powers under sub-paragraphs (1) and (2) may be exercised by a person authorised or designated by the Privy Council for that purpose.

Section 5 Incidental powers

(1) The Regulator may do anything which appears to it to be incidental or conducive to the purpose of, or in connection with, the performance of its functions other than its functions under the Medical Act 1983 including—

(a) paying members and staff of the Regulator and Panel members such remuneration, pensions, expenses, allowances or gratuities as it may determine,

(b) paying a person to whom it has delegated a function in accordance with paragraph 2 for the discharge of that function, and

(c) borrowing.

(2) The Regulator must arrange for the provision of such advice, assistance, accommodation, services and other facilities for a Panel as the Regulator thinks necessary or expedient for the proper performance of the Panel’s functions.

(3) Arrangements under sub-paragraph (2) may include arrangements with the MPTS.

Section 6 Grant-making power

(1) The Secretary of State, the Scottish Ministers, the Welsh Ministers and the Department of Health in Northern Ireland may make a grant to the Regulator for the purposes of its functions under this Order.

(2) A grant under sub-paragraph (1) may be made unconditionally or subject to condition.

Section 1 Listed offences

Murder.

Section 2 Listed offences

An offence under the following provisions of the Sexual Offences Act 2003 —

(a) section 1 (rape);

(b) section 2 (assault by penetration);

(c) sections 5 to 8 (rape and other offences against children under 13);

(d) sections 9 to 12 (child sex offences);

(e) sections 30 to 33 (offences against persons with a mental disorder impeding choice);

(f) sections 47 to 50 (sexual exploitation of children).

Section 3

An offence under sections 9 to 12 of the Protection of Children and Prevention of Sexual Offences (Scotland) Act 2005 (sexual services of children and child pornography).

Section 4

An offence under the following provisions of the Sexual Offences (Northern Ireland) Order 2008 —

(a) article 5 (rape);

(b) article 6 (assault by penetration);

(c) article 12 (rape of a child under 13);

(d) articles 13 to 15 (assault in relation to children under 13);

(e) articles 16 to 19 (sexual offences against children under 16);

(f) articles 37 to 40 (abuse of children under 18: payment for sexual services and involvement in indecent images);

(g) articles 43 to 46 (offences against persons with a mental disorder impeding choice).

Section 5

An offence under the following provisions of the Sexual Offences (Scotland) Act 2009 —

(a) section 1 (rape);

(b) section 2 (sexual assault by penetration);

(c) sections 3 to 6 (sexual assault and other sexual offences) committed against a person who is, by virtue of section 17 of that Act (capacity to consent: mentally disordered persons), treated as incapable of consenting;

(d) sections 18 to 26 (young children);

(e) sections 28 to 33 (older children).

Section 6

An offence under the following provisions of the Modern Slavery Act 2015 —

(a) section 1 (slavery, servitude and forced or compulsory labour);

(b) section 2 (human trafficking).

Section 7

An offence under either of the following provisions of the Human Trafficking and Exploitation (Scotland) Act 2015 —

(a) section 1 (offence of human trafficking);

(b) section 4 (slavery, servitude and forced or compulsory labour).

Section 8

An offence under the following provisions of the Human Trafficking and Exploitation (Criminal Justice and Support for Victims) Act (Northern Ireland) 2015 —

(a) section 1 (slavery, servitude and forced or compulsory labour);

(b) section 2 (human trafficking).

Section 9

Extortion (in Scotland).

Section 10

An offence under section 21 of the Theft Act 1968 (blackmail).

Section 11

An offence under section 20 of the Theft Act (Northern Ireland) 1969 (blackmail).

Section 12

An offence under section 3 of the Sexual Offences Act 2003 (sexual assault).

Section 13

An offence under article 7 of the Sexual Offences (Northern Ireland) Order 2008 (sexual assault).

Section 14

An offence under section 3 of the Sexual Offences (Scotland) Act 2009 (sexual assault).

Section 1 Disclosure of information

(1) Subject to sub-paragraph (2) , the Regulator may disclose information about any matter, regardless of when or where it arose, relating to its functions under this Order.

(2) The Regulator must not disclose information—

(a) which relates to a particular associate’s fitness to practise, or

(b) related to fitness to practise in respect of every—

(i) associate, or

(ii) associate of a particular class,

unless it considers it to be in the public interest to do so.

(3) For the purposes of sub-paragraph (2) (b) , the Regulator need not consider whether it is in the public interest to disclose the information in question in respect of each individual to whom it relates.

Section 2 Notifications

(1) The Regulator must notify—

(a) a decision under—

(i) article 4 , in respect of an approval or determination under that article, to the person who applied to the Regulator for that approval or determination;

(ii) article 6 (1) to (3) to the person who applied for registration under that paragraph;

(iii) article 7 to the registrant;

(iv) article 8 to the person whose registration is subject to a condition under that article;

(v) article 9 (2) , other than paragraph (2)(c)(i) or (ii)(dd), to the person whose entry is removed under that paragraph,

and such notification, where appropriate, must inform the notified person that they may apply for permission to appeal to a Panel under article 16 or appeal to a court under article 17 ;

(b) where it considers appropriate, a person in respect of whom an assessment is carried out under article 10 (1) (a) —

(i) that it is carrying out the assessment;

(ii) as to the outcome of the assessment;

(c) a person (“P” in this paragraph and the next) of a decision in respect of P under articles 10 , other than paragraph (1)(a), and 14 (3) , such notification being accompanied by—

(i) a statement of the reasons for the decision, and

(ii) information in respect of any right of appeal against the decision;

(d) a decision under articles 7 , 9 (2) (b) , 10 (3) to (6) , 13 and 14 , other than a decision to refer a matter to a Panel, to—

(i) any person by whom P is employed, or with whom P has an arrangement, to provide medical services (where known),

(ii) any regulatory body with which P is registered (where known), and

(iii) the complainant (if any);

(e) a revision under article 15 to anyone who was notified of the decision that has been revised;

(f) a decision under article 16 (3) to the person applying for permission to appeal;

(g) a Panel’s decision under article 16 (5) to the parties to that appeal.

(2) The Regulator must include in a notification under sub-paragraph (1) (a) reasons for the decision except where the decision is to grant an application without a condition.

(3) The Regulator must notify a removal of an entry and the date of removal under article 9 (1) (c) to—

(a) the person (“ R ”) whose entry in the register has been removed under that provision, and

(b) where known, any—

(i) person by whom R is employed, or with whom R has an arrangement, to provide services as an associate, or in respect of such services, and

(ii) any regulatory body with which R is registered.

(4) The Regulator must notify a person whose entry in the register has been removed under article 9 (1) (c) that they may appeal to a court under article 17 .

Section 3 Power to publish

(1) The Regulator may publish—

(a) information related to fitness to practise in respect of every—

(i) associate, or

(ii) associate of a particular class,

if it considers it to be in the public interest to do so;

(b) the findings of any assessment under paragraph 7 (1) (a) in respect of an approval under article 4 and any warning the Regulator may give in consequence of the findings;

(c) a removal under article 9 (2) ;

(d) an assessment under article 7 ;

(e) the reasons for the determination of an appeal under this Order if it considers it to be in the public interest to do so;

(f) information relating to former registrants which was previously published under paragraph 4 ;

(g) guidance about the exercise of functions under this Order.

(2) For the purposes of sub-paragraph (1) (a) , the Regulator need not consider whether it is in the public interest to publish the information in question in respect of each individual associate to whom it relates.

Section 4 Duty to publish registration information and certain decisions

(1) The Registrar must publish, together, in respect of each registered person—

(a) that person’s name, registration number and date of most recent registration,

(b) in which part of the register the person is registered, and

(c) information publication of which the Regulator is satisfied serves the purpose of protection of the public.

(2) The Regulator must, as soon as practicable, publish in addition—

(a) a removal under article 9 (1) (c) ,

(b) a warning under article 10 (3) (a) (ii) or (5) (a) (ii) ,

(c) a decision under article 10 (5) (b) (i) ,

(d) an Interim Measure or a Final Measure, and

(e) a decision under article 16 (5) or article 17 (6) ,

until the Regulator is satisfied that such publication no longer serves the purpose of protection of the public.

Section 5 Duty to publish other matters

(1) The Regulator must publish—

(a) any rules made under this Order,

(b) standards determined under article 3 (1) ,

(c) a list of approvals given under article 4 (1) ,

(d) any condition or revocation of approval under article 4 (2) (a) and (c) , and

(e) guidance as to what amounts to impairment of fitness to practise.

(2) The Regulator must keep guidance under sub-paragraph (1) (e) under review.

Section 6 Information to be included in a report under section 52A of the Medical Act 1983

The Regulator must include in a report under section 52A (annual reports, statistical reports and strategic plans) of the Medical Act 1983 produced on or after the date on which this paragraph is commenced a description of—

(a) the arrangements which it has put in place to protect members of the public from registrants whose fitness to practise is impaired, together with its observations on the report, and

(b) the likely impact of any change made during the period covered by the report to fees set under paragraph 8 of Schedule 4 , in particular in respect of—

(i) the workforce of the health service in the United Kingdom,

(ii) associates, and

(iii) the Regulator.

Section 7 Evidence gathering

(1) The Regulator must take such steps as it considers necessary for the purpose of assessing whether—

(a) standards determined under article 3 (1) are met at any point in time, or

(b) a person’s fitness to practise as an associate is impaired.

(2) The steps taken under sub-paragraph (1) (a) —

(a) must include requiring prescribed persons to supply prescribed information, at prescribed intervals in such manner as may be prescribed, to the Regulator, and

(b) may include setting examinations.

(3) In sub-paragraph (2) (a) , “ prescribed ” means prescribed in rules under paragraph 14 of Schedule 4 .

(4) Subject to sub-paragraph (5) and paragraph 8 , the Regulator may require a person, including an associate in respect of whom the information or document is sought, to supply information or produce a document which the Regulator considers the person is able to supply and which appears to the Regulator to be relevant for the purposes of its functions under this Order.

(5) The Regulator may not require, for the purposes of fitness to practise proceedings, an associate to provide it with material produced by that associate—

(a) for the purposes of professional development, or

(b) in the course of reflecting on their professional practice in order to improve it.

(6) If a person fails to supply any information or produce any document within 14 days of being required to do so under sub-paragraph (4) , the Regulator may seek an order of the county court or, in Scotland, the sheriff in whose Sheriffdom is situated the address which—

(a) is shown in the register as the address of the person concerned, or

(b) the last known address of the person concerned,

requiring the information to be supplied or the document to be produced.

Section 8 Further provision as to disclosure

(1) Nothing in article 18 or this Schedule requires or permits the making of a disclosure which contravenes the data protection legislation.

(2) Paragraph 7 (4) does not apply in respect of the supply of information or the production of a document which a person could not be compelled to supply or produce in court.

(3) Where, for the purposes of paragraph 7 (4) , information is held in a form which is not disclosable by reason of the data protection legislation because the information is capable of identifying an individual, the Regulator may require that information be put into a form which is not capable of identifying that individual.

(4) In this paragraph , “ the data protection legislation ” has the same meaning as in the Data Protection Act 2018 (see section 3(9) of that Act (Terms relating to the processing of personal data)).

Section 9 Proceedings before a Panel

(1) For the purposes of fitness to practise proceedings before a Panel in England and Wales or Northern Ireland, a Panel may—

(a) administer oaths, and

(b) issue a writ of subpoena ad testificandum or subpoena duces tecum.

(2) Any such writ must not compel a person to produce any document which they could not be compelled to produce on the trial of an action.

(3) Section 36 of the Senior Courts Act 1981 (subpoena issued by High Court to run throughout United Kingdom) or section 67 of the Judicature (Northern Ireland) Act 1978 (which provide a special procedure for the issue of such writs so as to be in force throughout the United Kingdom) applies in respect of fitness to practise proceedings before a Panel in England and Wales or, as the case may be, in Northern Ireland as those provisions apply in respect of causes or matters in the High Court or actions or suits pending in the High Court of Justice in Northern Ireland.

(4) For the purpose of fitness to practise proceedings before a Panel in Scotland, the Panel may administer oaths and the Court of Session will on the application of any party to the proceedings have the like power as in any action in that court—

(a) to grant warrant for the citation of witnesses and havers to give evidence or to produce documents before the Panel and for the issue of letters of second diligence against any witness or haver failing to appear after due citation,

(b) to grant warrant for the recovery of documents, and

(c) to grant commissions to persons to take the evidence of witnesses or to examine havers and receive their exhibits and productions.

(5) No person shall be compelled under any of the provisions in this paragraph to produce any document described in paragraph 7 (5) .

Section 1 Rules as to the register

(1) The Regulator may make rules as to the form and keeping of the register.

(2) Subject to sub-paragraph (3) and paragraph 4 , the Regulator may make rules as to the entering, amendment and removal of information in the register.

(3) The Regulator must prescribe in rules which contact details, including addresses, of associates must be recorded in the register under article 5 (3) (b) .