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 and
future 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.