As nominations open to elect the next president of the Royal College of Physicians (RCP), Dr Omar Mustafa, registrar, reflects on the history of constitutional and governance reform at the college and outlines plans to modernise how we work in an ever – changing world.
The RCP has a legacy stretching back over 500 years, dating back to its royal charter in 1518. In the past couple of years, with new challenges facing the NHS and its people, the RCP has begun to explore how it could function more effectively, launching a thorough constitutional and governance review in consultation with fellows and members.
Our aim is to modernise and better align with what our fellows and members need from us, with a target to implement significant reforms ahead of our annual general meeting (AGM) in 2025.
We need to uphold the RCP's legacy while preparing our college for future challenges – in this blog post, and those that follow, I will describe the process of constitutional and governance review and provide you with key updates from the constitutional and governance review group (CGRG) and RCP Council.
The case for change
In September 2024, The King’s Fund published an independent learning review that was commissioned by the RCP following an extraordinary general meeting of fellows earlier in the year. This important report 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. RCP Council and its Board of Trustees accepted the report’s recommendations in full, a decision that was confirmed at the 2024 AGM.
Recognising the importance of these recommendations, the Board of Trustees and RCP Council have committed to modernising the RCP’s constitution and governance. The work, which began immediately, will involve input from members, fellows, and other stakeholders, and will be implemented under the guidance of external experts.
Understanding how we work
The RCP’s constitution is rooted in our royal charter (1518), various acts of parliament (in 1523, 1814, 1858, 1860, 1886, 1956 and 1960), and a set of bye-laws defining the organisation’s governance. We adhere to Charity Commission rules and regulations under charity law.
The Board of Trustees is the RCP’s governing body. It is responsible for agreeing the business plan, monitoring the progress of RCP affairs, ensuring effective management and administration. It can delegate charitable responsibilities to the RCP boards and committees and works closely with RCP Council.
RCP Council develops policy in relation to professional and clinical matters. It gives authority to RCP statements, publications and elections to the fellowship and membership, as well as of RCP officers. It also considers and acts on current professional practice and standards issues.
The bye-laws establish the powers of the RCP Council and RCP’s officers, while additional guidelines – known as regulations or standard operating procedures (SOPs) – clarify specific aspects of operations.
- Constitution: The fundamental principles by which the RCP is constituted and governed, set out in the royal charter and relevant legislation.
- Bye-laws: The rules governing how the RCP conducts its activities and defining the powers of RCP Council and officers. The last major revision was in 2020.
- Regulations and SOPs: Detailed instructions that clarify or supplement the bye-laws as necessary.
More information about RCP governance is on our website.
How we will do it
Healthcare is ever changing, and so must we.
Our bye-laws have evolved over time – they need to continue to be relevant and effective, to help the RCP support its fellows and members to deliver the best possible patient care.
In September 2024, Council agreed a ‘statement of intent’ to explore the following issues – which I also presented at the AGM the same day. We will:
- develop clear aims and objectives to achieve modern governance using external expertise and with a respected champion from the physician community in leadership.
- review the constituency of RCP Council and our Board of Trustees to ensure appropriate representation of the membership and effective leadership.
- review eligibility criteria for standing for president and vice presidencies.
- explore widening voting rights across the membership (currently restricted to fellows).
- improve how RCP Council functions.
- identify better mechanisms for the performance of senior officers and the president, including how to address challenges.
The table below provides examples of proposals for change and what this might involve. All of these proposed changes would need agreement to proceed from fellows.
|
Proposal for change |
Constitutional documents |
Mechanism for change |
|
Canvassing rules in elections |
Regulations and standard operating procedures |
Agreement by RCP Council on matters to clarify or supplement any bye-law |
|
Eligibility for senior officer roles (currently 5 years as a fellow for vice presidents and 10 years for PRCP) |
Bye-laws |
Proposals recommended by RCP Council and voted on by fellows at a general meeting. This should include prior consultation on the change |
|
To extend voting beyond the fellowship. From a legal perspective, unless the 1860 Act is amended, the RCP president may only be elected by RCP fellows. |
Medical Act 1860 |
Instruct a parliamentary agent (a specialist lawyer licensed by the Houses of Parliament) on behalf of the RCP to petition the Houses of Parliament via a private bill containing relevant amendments to the 1860 Act |
|
Changing the requirement for the annual election of the president |
Royal Charter 1518 |
Request to Privy Council (following legislative amendments to the Medical Act) |
The way forward
Immediately after The King’s Fund released its report, the RCP began work to deliver on its 10 recommendations. A comprehensive action plan is being developed, focused on leadership, management, culture, governance review, structure, processes and staff support.
Some changes will involve amending the current bye-laws, while others may require legislation to update the 1860 Medical Act. We hope to implement many of the proposed changes by the next AGM in September 2025, subject to wider consultation and engagement, with approval by RCP Council, our wider fellowship and the Board of Trustees.
Some of the proposed changes will take longer, and are subject to external forces, including any changes to the royal charter or an Act of Parliament.
This reform phase marks a pivotal chapter in the RCP’s rich history. The RCP has evolved over centuries, and this current review offers a new chance to modernise the organisation for the modern day. As we chart this new course together, your input as fellows and members will be invaluable, ensuring that our governance structure best serves our patients’ needs.
I welcome feedback, comments and insights as we undertake this journey together. Please feel free to reach out at registrar@rcp.ac.uk. Stay tuned for further updates in future blog posts.
Dr Omar Mustafa
Registrar, global vice president / associate global director for Middle East and North Africa
