From the Association of Anaesthesia Associates.
The Association of Anaesthesia Associates (AAA) welcomes the publication of the Leng Review and acknowledges the considerable effort undertaken to evaluate the current andfuture role of Anaesthesia Associates (AAs) within the anaesthetic workforce.
We strongly support the recommendation to establish a dedicated Faculty for Anaesthesia Associates within the Royal College of Anaesthetists (RCoA). This initiative will provide essential professional structure, support, and oversight for AAs. We look forward to working collaboratively with the RCoA to shape a Faculty that ensures safe practice, consistent standards, and clear opportunities for career development. We expect this to include a full review of the 2024 interim scope of practice to enable tangible role development in support of patient care and service delivery.
We welcome the review’s recognition of future opportunities, including statutory prescribing rights and clearly defined credentialing in advanced practice areas. These developments would enable AAs to contribute more fully and safely to patient care under robust clinical governance and supervision, as part of multidisciplinary anaesthesia teams.
We acknowledge the recommendation to adopt the title Physician Assistant in Anaesthesia as an action to aid patients in distinguishing between roles in medical teams. However, we note that this is not aligned to all of the medical associate professions and it is important to emphasise that Anaesthesia Associates are a distinct profession, with unique training, scope of practice, and supervision requirements that differ substantially from Physician Associates. We therefore recommend an open consultation with key stakeholders to ensure that the chosen title is clearly understood by both patients and healthcare professionals. Members and employers should discuss this with their relevant working groups in order to make appropriate changes within workplaces. The AAA will await a formal consultation until making the appropriate legal changes to its name and properties.
We are concerned about some of the language used in the review, which may unintentionally discourage prospective applicants and undermine the sustainability of AA training programmes. This could significantly impact the future pipeline of AAs. We are also disappointed by the RCoA’s initial response regarding the pause in student recruitment, which introduces considerable risk to higher education institutions and to the future development of the AA profession. A carefully managed and measured growth of the AA workforce is essential—prioritising quality, clarity of role, and strong governance to ensure safe and effective service delivery. While this may result in a slower pace of growth than projected in the Long-Term Workforce Plan 2023, it offers a more stable and sustainable foundation for the future. We look forward to the forthcoming update on the NHS workforce plan later this year.
We remain committed to working constructively with regulators, the RCoA, and wider stakeholders to implement the review’s recommendations. Our shared goal is to build a competent, stable, and well-integrated AA workforce that strengthens anaesthetic care across the UK.
Scott Hepburn, President AAA
