Box 1.

Comparison of current regulatory regime by clinician group

GPs9Registered nurses10Physician associates11
RegulationMandatory: General Medical Council (GMC)Mandatory: Nursing and Midwifery Council (NMC)Presently voluntary:a Faculty of PhysicianAssociates (FPA)
AppraisalMandatory: annuallyRecommended: annuallyRecommended: annually
Revalidation frequency5-yearly3-yearly6-yearly for voluntary register
Individual responsible for recommending revalidationIndependently allocated: ‘responsible officer’9 (97%) or GMC-approved ‘suitable person’ (<1%).9
Otherwise for GMC assessment (2%)		Individual nurse choice: ‘confirmer’10 — normally line manager or NMC-registered individual.
Otherwise, any regulated healthcare professional		FPA checks compliance for those who are voluntarily registered
CPD (annual)50 hoursb11.7 hoursb50 hours for voluntary register
Feedback requirementsOnce every 5 years: patient and colleague surveysOnce every 3 years: five pieces of patient or colleague feedback: ‘formal or informal; written or verbal’10No requirement
Additional revalidation requirementsReviews of:

  • complaints and compliments

  • significant events

  • quality improvement activity; and

  • reflective practice

  • Five written reflective accounts and discussion about these with someone registered with the NMC

  • 450 hours of nursing practice

  • Recertification exam: 200 single best answer questions every 6 years. Exam not specific to specialty of practice

  • ↵a In October 2018 the Department of Health committed to developing mandatory regulation of physician associates.3

  • ↵b Mandatory average (mean) annual commitment. CPD = continuing professional development.