The Royal College of Physicians (RCP) has made an externally produced Leng review draft national clinical protocol for physician assistants (PAs) available to members behind the log-in. The document has not been developed, commissioned or endorsed by the RCP and does not represent college policy.
• Log in to the RCP website to read the draft protocol and share feedback
• Read RCP interim guidance for PAs working in the medical specialties
• Learn more about the Leng review: an independent review into PA and AA professions
The draft protocol has been developed by the Leng review as part of the process for implementing its recommendations. It focuses on teamworking and the circumstances in which PAs may see undifferentiated patients, including the supervision and governance arrangements that should apply.
The document is an external draft for targeted stakeholder consultation and does not represent agreed national guidance or RCP policy. The Leng review implementation process is seeking organisational responses from stakeholders, rather than individual submissions. The RCP is therefore gathering feedback from across its fellowship and membership to help shape a single, coordinated response.
The RCP is undertaking extensive engagement on the draft protocol through its established representative structures, including its network of more than 30 medical specialties, RCP Council, career-grade committees, networks and regional advisers. Collectively, these groups include hundreds of elected and appointed representatives from across the membership and fellowship.
To support wider engagement and transparency, the RCP has also made the draft protocol available to all fellows and members through its website and is inviting their views to inform an organisational response. More details can be found behind the membership log-in.
RCP president Professor Mumtaz Patel said:
‘We recognise the strength of feeling on this issue and the importance of ensuring that the views of our fellows and members are reflected in the RCP’s response to this draft protocol, which is being discussed widely through the college’s representative structures.
‘With permission from the Leng review, we are now also making it available on our website so that fellows and members can share their perspectives with us. All feedback received will be carefully considered before a final organisational response is agreed and signed off by RCP Council.’
Fellows and members can access the draft clinical protocol through the RCP website. Comments should be submitted by 5pm on Thursday 15 October 2026 to allow the RCP time to review the feedback, coordinate its organisational response and complete the necessary governance and sign-off process. Details of how to share feedback are set out behind the log-in.
The RCP will review all feedback received and use it to shape a single organisational response to the consultation. The final response will be signed off by RCP Council.
The RCP has asked the Leng review for an extension to the 6-week consultation deadline to allow time for fellows and members to consider the draft protocol, share their views and contribute to discussion, as well as for RCP Council to consider the college’s response. At the time of publication, this request has not been agreed. We will update fellows and members if the timetable changes.
The RCP does not own this draft protocol and has not been responsible for developing its content. Making it available to fellows and members should not be interpreted as RCP endorsement of the document or its recommendations. It remains a draft for consultation and does not represent agreed national guidance.