Pharmacy: supervision loosened and prescribing at registration
Most new UK pharmacists now register as independent prescribers, and a 2025 law lets pharmacists authorise pharmacy technicians to supervise dispensing from December 2026.
Country
United Kingdom
Where right-touch regulation began and, in our view, where the rapid expansion of physician associates became a cautionary tale.
Reforms
Physician associates: expansion, regulation, and the Leng review
Planned to grow to 10,000, physician associates came under GMC regulation in 2024. After coroners' findings and an independent review, the roles are to be renamed and restricted, but not abolished.
"Psychologist" remains an unprotected title
Only qualified titles such as "clinical psychologist" or "registered psychologist" are protected in the UK. Much of the wider psychological workforce is assured through voluntary registers rather than a statutory regulator.
No United Kingdom reforms for this profession yet.
Explainers & analysis
Four countries, one direction: the layered psychology workforce
In Australia and Ontario, the route to the protected psychologist title is set to get shorter. New Zealand has created a registered assistant tier, and the UK assures a wider psychological workforce through voluntary registers. We have found no outcome evidence for any of it yet.
Permanent before evaluated
In Australia, pharmacy scope reforms have been made permanent before any independent evaluation was published. In the UK, physician associates were scaled up with no study of safety incidents. We think that is the strongest, evidence-based criticism of these reforms.
The case for top-of-scope reform
The strongest version of the argument for letting nurses, pharmacists and others do more, written from the reformers' own sources.
What is right-touch regulation?
Where the idea came from, what it actually says, how governments use it, and the strongest criticisms. A primer in plain English.
Nothing written for this profession yet.
Library
BMA v General Medical Council [2026] EWCA Civ 143
The Court of Appeal dismissed the BMA's challenge to the GMC's use of the term 'medical professionals' for both doctors and physician and anaesthesia associates in Good Medical Practice. A separate judicial review by Anaesthetists United, seeking national limits on scope of practice, was dismissed by the High Court in September 2025.
Why it matters: The courts found the GMC acted lawfully on both terminology and scope of practice. In our view, change will have to come through policy, not litigation.
Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research
Reviewed UK research on physician and anaesthetic associates published from 2015 to January 2025. Of 29 studies meeting its inclusion standard, none examined safety incidents and only one directly observed clinical competence.
Why it matters: In our view, a clear statement of the evidence gap: the authors warn that absence of evidence of safety incidents is not evidence that the roles are safe. Co-author Martin McKee was BMA president in 2022-23.
The Leng review: an independent review into physician associate and anaesthesia associate professions
An independent review found the evidence on the roles weak and based on observational data. It made 18 recommendations, including renaming the roles 'physician assistant' and 'physician assistant in anaesthesia', and requiring a named supervising doctor for each physician assistant. The government accepted all of them.
Why it matters: In our view, a template for how a government re-tightens a role after scaling it ahead of the evidence.
Susan Pollitt: Prevention of Future Deaths report
A senior coroner found that an ascitic drain, which a junior doctor had decided to place, was not clinically indicated. The physician associate who inserted it was unaware of local guidance, left it in for 21 hours and directed that it be clamped, which the coroner found was unwarranted. The report also raises the absence of a regulator at the time, title confusion, and a competency sign-off that covered only the technical skill of inserting the drain, not consent, risk factors or aftercare.
Why it matters: Its first concern was that there was then no regulator at all, so it does not show that proportionate regulation fails; its other concerns (training, supervision, the title, competency sign-off) remain relevant under regulation.
Right-touch regulation (third edition)
The current version of the framework. It keeps the six principles and eight elements, sets out a broad definition of harm (including psychological harm, financial loss and damage to trust), accepts that deregulation can be warranted where risk is well managed, and aligns with the UK's 'Smarter regulation' agenda.
Why it matters: The primary source. Worth quoting directly, including its own warnings about false assurance, and that regulation should only be called 'risk-based' where risks have actually been quantified and qualified.
No library items for this profession yet.