DAUK’s Dr David Nicholl says the Royal College of Physicians (RCP) failed to properly inform the Parliamentary debate around physician associates (PAs), letting down doctors and the public.
Dr Nicholl was speaking after the publication of a damning independent review into the RCP’s handling of an extraordinary general meeting (EGM) called to discuss PAs.
A group of RCP fellows, including Dr Nicholl, had called the EGM to challenge the college’s position on PAs, concerned about scope of practice, accountability, impact on doctors’ workloads and training opportunities, and patient safety.
Significant concerns were raised by several college members following the EGM about the presentation of information at the meeting and the conduct of people taking part.
In response, the King’s Fund, a health think tank, was commissioned to examine the events leading up to the EGM, the running of the EGM, and the relevant activities after the meeting.
Failure in leadership
Its report found ‘a range of collective failures in leadership’, ‘a clear lack of accountability and due process’, and ‘a pervasive lack of trust and confidence in the College’s governance’.
Dr Nicholl, a consultant neurologist, said: “The RCP failed to listen to the concerns of fellows over issues that DAUK was raising from last summer.
“At the time it was brushed off as social media noise but we know that’s not true.
“The delays in having the EGM meant that Parliament wasn’t properly informed when it passed legislation for the GMC to regulate PAs in March – without a vote, which is crazy.
“It’s a failure of governance at the RCP, but it’s also a failure to properly inform parliamentarians before they put a law through without a vote, which has hugely let down doctors and the public. It’s a mess.”
Dr Nicholl also responded to the report in an article in the BMJ, alongside RCP fellows Martin McKee, professor of European Public Health; Trisha Greenhalgh, professor of Primary Care Health Sciences; Asif Qasim, consultant cardiologist; and Nicholas S Hopkinson, professor of Respiratory Medicine.
Serious issue
They wrote: “Crucially, delays in setting up the EGM meant that by the time it was held, the Statutory Instrument had already been passed by Parliament.
“As the inquiry found, ‘had the EGM been held before that point, the concerns raised would have been fed into the parliamentary process and may have affected the passage of the legislation’ (page 18).
“The missed opportunity to influence Parliamentary discussion on the role and regulation of physician associates in a way that reflected the concerns of its membership is among the most serious issues faced by the college in its 500-year history.”
In response, the RCP said it accepts the report and recommendations in full.
Senior censor and vice president for education and training, Dr Mumtaz Patel, who is acting as RCP president, said: “This King’s Fund report is important and sobering reading for all of us at the RCP. It shows how, as a leadership team, we must refocus on our core purpose – putting physicians first. We must review the way that we work if we want to be a high-performing and responsive membership organisation for physicians in the future.
Honest and open
“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. It points to the need for improvements in our culture, governance, processes and the way that we represent physicians of all generations. It calls for a more honest and open relationship with our membership, and one that welcomes constructive challenge rather than avoiding it.
“Today is a moment for review, reset and refocus in all that we do. We owe this to our fellows and members, our staff and our volunteers. We hear loud and clear how we need to lead rather than respond to others’ agendas. The entire leadership team is committed to reflecting, changing and benefiting from external support to make these improvements happen.”
Read Dr Nicholls’s article in full.
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