New government | health and care review | PA update

The new government has laid out an ambitious vision for the nation and the NHS. This includes delivering the NHS Long Term Workforce Plan commitment to expand medical school and postgraduate training numbers, promoting prevention and tackling health inequalities with a new ‘mission delivery board’, and a shift towards more community-delivered care.

I was particularly encouraged by the King’s Speech, which committed to reintroduce the Tobacco and Vapes Bill and legislate to restrict junk food advertising to children. These are both important measures that the RCP has long championed and it’s heartening to see them reinforced right from the start.

After Wes Streeting was appointed as secretary of state for health and social care, I wrote to him publicly. I wanted to make it clear that the RCP stands ready to support the new government’s aims to improve the NHS, which the secretary of state has described as ‘broken’. We are committed to being the leading voice for physicians, advocating for an NHS that truly works for everyone.

I also outlined that one of my top concerns is the intense pressure facing our early career colleagues. Many are dealing with heavy workloads and are exhausted and demoralised – yet they are the future leaders of healthcare. We must do everything we can to help foster an environment now in which they can thrive and grow for the long term.

I know many of you share my deep concerns and commitment to improvements. You may have seen the news from the National Audit Office on Tuesday, that the NHS is facing challenges on an 'unprecedented scale' with an increasing number of organisations unable to break even financially. We will continue to call on the government to get the basics right for staff, including developing a strong focus on staff retention that places your interests at the heart of it. Hearing that negotiations have now started on addressing the pay of doctors in training is positive news.

In recent weeks, I’ve met with chief medical officer Professor Sir Chris Whitty and discussed the King’s Speech and the initial findings of the COVID inquiry. I also met with NHS England’s national medical director Professor Sir Steve Powis to discuss the new government’s priorities, the NHS Long Term Workforce Plan and to reiterate our concerns about 4-year medical degrees.

I also continue to meet frequently with key stakeholders, including the GMC, NHSE, Academy of Medical Royal Colleges and other college presidents. And I attended the RCP New Consultants and SAS Committee meetings as well as our Trainees Committee meeting yesterday, so it’s been a busy but very productive time. 

Letter to Lord Darzi

Along with the British Geriatrics Society and the Royal College of Physicians of Edinburgh, we have written to Lord Darzi, who you will probably know is undertaking a review of health and social care for the new government.

Together, we called for an evidence-based approach to the care of older people, training a specialist workforce, and integrating improvements in the NHS and social care systems. The review will conclude in September of this year, with its findings feeding into a new 10-year plan for the NHS.

Though no timings have been confirmed for the 10-year plan, many of you will have seen the HSJ article this week suggesting it will be published next spring. We will keep close to developments on this – there are so many areas of our health service that we know require radical attention and must be considered in this work.

The findings of our recent UK consultant physician workforce census further underscore the need for urgent change. They reveal the impact on staff of overwhelming workloads, declining job satisfaction, widespread vacancies and poor IT systems. This is important feedback from you and we will press this new government to listen. 

I want to sincerely thank everyone who responded to the census; your contributions are invaluable as we continue to make the case that widespread improvement is required.

The GMC National Training Survey results have been published today. These highlight important issues for trainees and trainers particularly around workload, time for supervision and burnout. We will continue to work with our colleagues in the Federation of the Royal Colleges of Physicians and key stakeholders to address these issues and drive improvements for sustained change.

Call the medical registrar

I was recently asked to sum up what truly inspires me at work, and upon reflection, I felt strongly that it is engaging with and supporting doctors near the start of their physician journey. 

It was a joy to chair the opening session of our recent ‘Call the medical registrar’ conference and hear Dr Khaled Abuelenain share his inspiring journey and tips on how to thrive during the ‘med reg’ years. This conference has proven to be a must-attend event for those preparing for the future in a medical specialty, covering everything from handling acute emergencies to developing professional and leadership skills.

Feedback has been hugely positive, with attendees calling it ‘one of the best online conferences – it’s highly recommended for all medical registrars’, and that it gives a ‘boost of knowledge and confidence.’

I know you will join me in wishing our aspiring registrars every success as they continue their development. 

Update on physician associates

You may have seen this week that a survey from Healthwatch England found that nearly one in four people do not know the difference between a physician associate (PA) and a doctor.

In line with these findings, Healthwatch published five recommendations for policymakers and health leaders to improve clarity for patients. Transparency for patients is absolutely critical and we support the recommendations, including that national bodies must be clear about the scope and content of training of PAs and their ongoing assessment. 

Following the RCP EGM on physician associates in March, we established a short life working group (SLWG), which brought forward 16 recommendations. 

I’m pleased to report that we have implemented or begun to implement the majority of these recommendations. We have started advocating for a limit on the expansion of the PA workforce and urged the NHS in our recent public statement to review the growth plans for PAs while your real and growing concerns about their scope of practice are addressed.

Our next step has been the establishment of a PA oversight group, chaired by RCP vice president for Wales Dr Hilary Williams, who also led the SLWG. This new group will ensure a consistent approach to PA-related work at the RCP, oversee the delivery of the remaining recommendations, support development of specialty-specific guidance for PAs, and guide the future of the Faculty of Physician Associates. The group’s terms of reference are currently being finalised and its first meeting happens next week. 

These steps represent our continued commitment to resetting the direction of the RCP on this issue, reconnecting with you as members and fellows, and ensuring that we are your representatives in this critically important national conversation.

Membership ceremonies

Since taking responsibility for the ceremonial duties of PRCP, it has been my privilege to support both membership and fellowship ceremonies over recent weeks. Every event has been such a joyous occasion, and it is hugely encouraging to see the ambition of our members and fellows realised as they reach a key milestone in their career. 

I am always encouraged to see new members and fellows share their achievement on social media. One such example is:

'This journey has been a rollercoaster of intense studying, sleepless nights and countless sacrifices. The MRCP exams are notoriously challenging, testing not just knowledge but also resilience and dedication. I owe my success to the unwavering support of my family and friends, who were beside me every step of the way. To those preparing, hard work and persistence are key. Never lose hope.'

We greatly value and appreciate your support. I hope you all manage to get some downtime over the summer and can enjoy the (albeit intermittent) sunshine.

With very best wishes,

Dr Mumtaz Patel

Acting as president (senior censor and vice president for education and training)