Royal College apologises for handling of controversial PA debate

The Royal College of Physicians has announced an ‘independent review’ into its governance following a contentious meeting on physician associates (PAs) last month.

College leaders admitted they ‘should have been better’ at listening to members, and now need to ‘reset the organisation’ and ‘restore trust’, with RCP president Dr Sarah Clarke saying she is ‘sorry’ the college has ‘fallen short of the standards expected’.

Along with the review, the RCP will also break ties with the Faculty of Physician Associates (FPA), the professional body for PAs.

The RCP and FPA will ‘work together to develop a clear timeline for an independent faculty of PAs within 12 months’. 

Last month, the college faced outcry from its members due to its handling of a debate on the role of PAs, with two doctors resigning from their editorial positions on RCP journals.

At an extraordinary general meeting (EGM), the RCP presented data from a membership survey gathering views on the role clarity and supervision of PAs.

It was later revealed that the college had not presented the full data and shared results by grouping together ‘neutral’ and ‘positive’ responses to the impact of PAs.

Following strong criticism, the RCP has now commissioned an independent review by The King’s Fund, a leading health think tank. 

The review will examine the survey data management issues, the current leadership and internal processes of the RCP, and any improvements the organisation could make in these areas. 

Commenting on the independent review, Dr Clarke said: ‘We have without doubt fallen short of the standards expected of us by our members and I am sorry for that. 

‘Particularly in today’s challenging environment for our profession, our members need leadership and to trust in our ability to represent their interests.

‘We fully commit to learning from this review and working together, both to restore that trust and to be the professional organisation that our members should expect.’

At the end of last month, RCP members passed five motions on PAs, including their scope of practice, accountability, evaluation, training opportunities and caution in pace and scale of roll-out.

In a letter to members, Dr Clarke said college leaders now ‘need to deliver the mandate’ given to them via this ballot. 

‘And that’s to listen to your concern about the scope and pace and scale of the roll-out of the PA profession, and act on them quickly,’ she added.

As part of this, the RCP has now backed the FPA’s move to become an independent body within a year. 

In a recent statement, the FPA said: ‘The FPA Board recently discussed whether the physician associate profession should continue to be hosted by a medical royal college. 

‘In recognition of recent developments, the FPA and RCP will now work together to develop a clear timeline for an independent faculty of PAs within 12 months.’

‘Balancing the needs of doctors and PAs will be crucial as we develop a collaborative multidisciplinary team (MDT) approach,’ the FPA added.

The GMC is currently consulting on its plans for regulating physician associates, which is expected to commence from December this year.

To help doctors complete the consultation, which may ‘seem overwhelming’, the BMA has set out guidance which outlines the ‘broad concerns and themes’ that can be used to fill in the free text sections. 

Similarly to its recently published PA ‘scope of practice’, the union reasserted that PAs ‘must not see any undifferentiated patients’.

The guidance also encouraged doctors to tell the GMC that they must have ‘first right of refusal’ for all clinical and training opportunities.

‘This means that within a department, any procedure, senior doctor teaching, clinic opportunity, or other learning event must be offered to the doctors first. Only after all doctors have refused this opportunity, can it be offered to non-doctor staff,’ the BMA said.