A public interest judicial review challenging the General Medical Council’s failures in regulation of Physician Associates and Anaesthesia Associates (“associates”) will be heard on Wednesday 14 and Thursday 15 May at the High Court in London by Mrs Justice Lambert.

The case has been brought by doctors’ advocacy group Anaesthetists United alongside Marion and Brendan Chesterton, whose daughter Emily died because she was repeatedly misdiagnosed by an associate who she believed was a GP. It is supported by the doctors’ union, the BMA.

Grace Benton, solicitor at Bindmans representing the claimants, says:

The GMC is fighting this case because it wants to be a regulator that regulates only at the most superficial level and not in response to the most serious risks. Our clients are determined to change that.

Richard Marks, a co-founder of Anaesthetists United said today:

This extraordinary case has had to be brought because the GMC has just not listened to doctors’ calls for their own regulator to roll up its sleeves and take decisive action to protect patients. Over 6,000 doctors and patients have donated money to make this possible. We are very grateful to them. Their contributions are a measure of the level of concern there is amongst the public and profession about the lack of proper standards.

Associates are not doctors; they undertake two years’ training in order to work as part of a team under supervision in GP surgeries or hospitals.

However, there is substantial evidence of associates taking on doctors’ responsibilities, patients not being told or knowing the person treating them is not a doctor, and associates making unsafe clinical decisions without adequate supervision. This has resulted in a number of fatalities. Since 2023, in addition to the record of inquest in Emily Chesterton’s case, there have so far been three alarming ‘prevention of future deaths’ reports issued by coroners following detailed investigations into the deaths of patients treated by associates.

It was against a backdrop of widespread concern about patient safety that the GMC was appointed as the regulator for associates starting from December 2024. In their case, Anaesthetists United and Mrs and Mrs Chesterton argue that despite many warnings the GMC has nonetheless failed to address those risks, or take the necessary steps to safeguard patients and maintain public confidence.

For its part, the GMC has decided that it will regulate associates in the same way it does for doctors, despite the professions being fundamentally different and the associate role being poorly understood by patients and the general public.

The claimants in this case argue that the GMC’s decision-making on associate risk, supervision and patient consent is unlawful.

In order that no further patients come to harm, they seek a regulatory framework where:

• clear, enforceable, national limits are set on what associates can and cannot do in practice;
• Associates are required to introduce themselves and explain their role to the patient to ensure that patients fully understand and can therefore consent to who is treating them; and
• guidance is produced and enforced by the GMC on the proper supervision of associates, and delegation to them.

The claimants are represented by Grace Benton, John Halford and Kaya Saccheri of Bindmans, barristers Tom de la Mare KC and Naina Patel KC of Blackstone Chambers and Emily Mackenzie of Brick Court Chambers.

1. The hearing will last two days.
2. At an inquest, a coroner must identify systemic deficiencies that pose a risk to life in the future. The Chief Coroner’s Revised Guidance No.5 states the Prevention of Future Death (PFD) reports “are vitally important if society is to learn from deaths… a bereaved family wants to be able to say: ‘his death was tragic and terrible, but at least it’s less likely to happen to somebody else.’ PFDs are not intended as a punishment; they are made for the benefit of the public.”
3. Besides the critical comments made at the inquest into the death of Emily Chesterton (20 March 2023, by Mary Hassell, Senior Coroner for Inner London) [CB/D/20/330] there have been three PFD reports about fatalities involving associates.

• Benedict Peters PFD report (16 May 2023, Chris Morris, Area Coroner for Manchester South).
• Susan Pollitt PFD report (31 July 2024, Joanne Kearsley, Senior Coroner for Manchester North).
• Pamela Marking PFD report (24 February 2025, Dr Karen Henderson, Assistant Coroner for Surrey).