The Royal College of Physicians (RCP) has admitted that it ‘failed’ doctors on the issue of physician associates (PAs), following an independent review, and has promised to ‘do better’.
Earlier this year, the college experienced a strong backlash from its members over its handling of a debate on PAs at an extraordinary general meeting (EGM).
This led to more than 80 fellows declaring no confidence in the RCP, while its president was forced to step down in June.
As part of an apology to its members, the college commissioned an independent review into its governance which was conducted by The King’s Fund, a leading health think tank.
Today, The King’s Fund has published its report – which found a ‘range of collective failures in leadership across the College’ – and the RCP has accepted the recommendations in full.
College leaders recognised that members were not listened to, saying: ‘We fully accept these findings. We will do better.’
The RCP committed to ‘refocus on its core purpose and put physicians first’, with senior leaders admitting they had ‘failed [their] membership on a key issue’.
It also confirmed that the Faculty of Physician Associates (FPA), which runs a voluntary register for PAs in the absence of any professional regulation, will close on 31 December 2024.
From this point onwards, the GMC will regulate PAs and other medical associate professionals.
Concerns were raised by fellows and members of the RCP in March after a contentious EGM where officers presented data from a membership survey on the role clarity and supervision of PAs.
The main criticism around the survey was that the college did not present the full data and shared the results by grouping together ‘neutral’ and ‘positive’ responses to the impact of PAs.
The King’s Fund has found that the RCP’s approach to the survey was based on ‘organisational bias’, and warned that surveys ‘should not be carried out with the aim of proving a pre-determined point of view’.
‘When the evidence did not meet the aims of the survey or match the apparent pre-conceived views of those behind the survey, it led to the results being presented in a biased way,’ the report added.
The think tank also suggested that any ‘inappropriate’ or ‘unhelpful’ by college staff or officers at the EGM took place in the ‘context of significant organisational dysfunction’.
It identified ‘poor behaviours’ across the organisation, including the use of ‘intimidatory language on both open and closed social media’.
Recommendations included setting up a programme of work to develop a ‘trusting, collaborative and forward-looking’ culture, as well as a further review of the college’s governance.
In response, the RCP said it has already established a PA ‘oversight group’ as well as beginning to work to refresh its membership strategy which will ‘put physicians at the heart of college business’.
Acting RCP president Dr Mumtaz Patel said the report was ‘important and sobering reading’ and showed that they must ‘refocus’ on the college’s core purpose, which is ‘putting physicians first’.
She continued: ‘The report highlights an organisation that was neither listening, nor responding quickly enough, to the questions and concerns being raised by its fellows and members.’
On the decision to close the FPA at the end of the year, Dr Patel said: ‘After a challenging year, this is a clear way forward for PAs and doctors. Now we can move on from months of uncertainty.
‘The RCP is committed to supporting PAs as far as regulation and we will always work collaboratively with other professional groups to prioritise patient safety and ensure high standards of multidisciplinary care.’
RCP chief executive officer Ian Bullock said that The King’s Fund report shows the organisation has ‘lost touch with its membership’.
‘This is an important moment for the RCP and it’s right to admit that we have failed our membership on a key issue,’ he added.
