The Professional Standards Authority (PSA) has published its annual performance review of the General Medical Council (GMC), assessing how effectively it has regulated the medical profession during 2024/25 against the Standards of Good Regulation.

These reviews are a key component of the UK’s professional regulatory framework. They provide assurance that regulators are protecting patients, maintaining public confidence, and responding appropriately to emerging risks within healthcare delivery.

Strong Overall Performance by the GMC

For the 2024/25 review period, the GMC met all 18 of the 18 Standards of Good Regulation. This is a positive outcome and reflects consistent performance across core areas including registration, education and training, fitness to practise, governance, and equality, diversity and inclusion (EDI).

It is important to note, however, that meeting all Standards does not imply perfection. Rather, it demonstrates that the PSA is satisfied the GMC is performing well across each assessed domain, while still identifying areas where further improvement is expected.

Expansion of the GMC’s Regulatory Role: AAs and PAs

A major development during this review period has been the expansion of the GMC’s remit to include Anaesthesia Associates (AAs) and Physician Associates (PAs). Since December 2024, AAs and PAs have been able to register with the GMC, with mandatory registration coming into force in December 2026.

In preparation for this, the GMC has:

• Introduced new registration standards, guidance, and assessments for AAs and PAs
• Implemented quality assurance processes for education and training providers
• Published good practice guidance for doctors supervising AAs and PAs
• Completed in-person visits to all AA and PA course providers

For organisations employing or supervising AAs and PAs, these developments have significant governance and risk implications, particularly around supervision, delegation, and accountability.

Decision-Making Processes and Case Examiners

As part of its consultation on new regulatory processes, the PSA raised concerns about the GMC’s initial proposal to rely solely on single case examiners, without the option of paired decision-making. The PSA has confirmed that this feedback was addressed in the GMC’s final guidance, strengthening confidence in the robustness of decision-making in regulatory cases.

Regulatory Reform and Future Legislative Change

The legislation underpinning the regulation of AAs and PAs is intended to act as a template for a future revised GMC Order. The PSA expects the UK Government to consult on this early next year.

In July 2025, the PSA also published new guidance to support regulators in using reformed powers, including the use of accepted outcomes in fitness to practise cases. The GMC, along with other healthcare regulators, will be expected to take this guidance into account as reforms progress.

Managing Overseas Restrictions and Risk

In October 2025, The Times reported concerns that some doctors with restrictions on their practice overseas were working in the UK without equivalent limitations. In response, the PSA sought additional assurance from the GMC and other regulators about how this risk is being managed.

The PSA has recommended further steps for the GMC, including considering whether to extend the timeframe for requiring certificates of good standing from overseas regulators. This remains an area under close scrutiny, particularly for employers responsible for safe recruitment and ongoing workforce assurance.

Equality, Diversity and Inclusion (EDI)

The PSA introduced a revised approach to assessing the EDI Standard in 2024. Regulators must now demonstrate delivery against four high-level outcomes supported by a structured evidence matrix.

The GMC continues to perform well in this area. During the review period it:

• Collaborated with partners to develop EDI guidance for registrants
• Improved transparency around how diversity data is collected in fitness to practise concerns
• Committed to a further diversity data review to enhance data quality

Fitness to Practise: Timeliness and Risk Management

While overall fitness to practise timeliness improved slightly, the PSA noted an increase in older open cases. The GMC has reviewed its handling of cases involving third-party investigations and identified opportunities for improvement.

New guidance issued by the Medical Practitioners Tribunal Service (MPTS) in September 2025 aims to support tribunals in assessing risk and managing complex cases, including those involving sexual misconduct.

The PSA will continue to monitor:

• The volume and management of older open cases
• How risk is identified, recorded, and escalated within GMC processes

As in previous years, the PSA highlighted that the GMC could strengthen its internal controls by being clearer and more consistent about how staff identify and respond to evidence of risk.

Continuous Oversight, Not a One-Off Assessment

Finally, it is worth emphasising that PSA reviews are not static, annual events. Monitoring continues throughout the year, and areas identified for improvement are subject to ongoing scrutiny.

How HLTH Compliance Can Support You

For doctors, clinics, and healthcare organisations, regulatory change is constant—and expectations continue to evolve. Whether you are navigating GMC processes, supervising AAs or PAs, managing fitness to practise concerns, or strengthening governance and risk controls, the implications of reviews like this are very real.

At HLTH Compliance, we are always here to advise, guide, and support. Our team works closely with clinicians and healthcare providers to translate regulatory developments into practical, proportionate compliance strategies that protect patients and professionals alike.

If you would like to discuss what this review means for you or your organisation, or need tailored regulatory support, please get in touch with our team.