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Surgeons Call on UK Government to Reconsider Regulation of Surgical Care Practitioners

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21 Jun 2019

The Royal College of Surgeons of Edinburgh (RCSEd) and the Federation of Surgical Specialty Associations (FSSA) have written a robust letter to Secretary of State for Health and Social Care Matt Hancock calling on him to introduce statutory regulation for surgical care practitioners (SCPs).

RCSEd President Mike Griffin said: “Despite our strong arguments in response to the Department of Health and Social Care (DHSC) consultation that SCPs must move towards statutory regulation along with the other associate professions, the UK Government continues to ignore how the extended role of these practitioners increasingly places their practice outside their current regulatory body. This failure to take on board the clear evidence for regulation is why we have had to make this urgent call on the UK Government to move towards regulation now.”

The UK Government plans to introduce statutory regulation for physician associates (PAs) and physician assistants in anaesthesia (PAAs) following its review of the medical associate professions (MAPs). Surgical care practitioners and acute critical care practitioners were not included, despite responses to the consultation that revealed 71% were in favour of statutory regulation for SCPs, and a further 17% were in favour of some form of voluntary registration

However, the RCSEd and FSSA argue that this group of practitioners work on a daily basis with surgeons and have an increasingly broad range of practice. But that neither the Nursing and Midwifery Council (NMC) nor the Health and Care Professions Council (HCPC) have a unified approach to fitness to practise issues.

RCSEd Fellow and Chair of the Faculty of Perioperative Care (FPC) Charlie Auld explained that SCPs are increasingly moving towards a medical model of care, and that their clinical and educational supervisor is more likely to be a consultant surgeon than a senior nurse.

“Their surgical practice is so clearly outside of their current regulatory body, which presents a dilemma. Their role and practice is medical, not nursing, and overseen by surgeons. This is a situation that requires further consideration and review.”

The RCSEd and FSSA also heavily criticised the lack of a formal register and the potential impacts of this on patient safety and quality assurance, highlighting their serious concerns about the lack of consistency in education, training and standards setting.

Mr Auld highlighted the gross underestimate of the number of practitioners in practice across the UK: “The Professional Standards Authority submission of 200 SCPs working in the UK is a significant underestimate, when there are at least 300 SCPs alone in cardiac surgery. The colleges and specialty associations help to provide a structure to support and reassure the public and practitioners, but without a formal register it is impossible to monitor standards. These practitioners need regulation now to provide a common education and training pathway – which SCPs have long been calling for.”





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