http://www.rcgp.org.uk/PDF/corp_Impact_report_2009 by Royal College of General Practitioners

IMPACT REPORT

2009

OUR MISSION â&#x20AC;&#x153;To encourage, foster and maintain the highest possible standards in general practice and for that purpose to take or join with others in taking steps consistent with the charitable nature of that object which may assist towards the same.â&#x20AC;?

CONTENTS 2

Report of the Chairman and Chief Executive

IMPACT REPORT

4 16 28 36 42 43 45 48 49 50 51 52 53

Professional Standards Professional Development Promotion of the Profession Individual Support Internal Structures and Corporate Governance Resources

Honorary Treasurer’s Report, 2009 Summarised Financial Statements Income and Expenditure, 2009 Membership, 2008–9 Patron, President & Members of the Council of the Royal College of General Practitioners, 2008–9 Queen’s Birthday and New Year Honours Lists Supporters

REPORT OF THE

CHAIRMAN AND CHIEF EXECUTIVE The last 12 months have been an eventful and successful period for the RCGP and the profession. With strong leadership on standards and quality of care for patients, we continue to build and develop the profile of our profession. Laying the foundation for the introduction of revalidation has been a major priority for the College this year. The launch of our RCGP Guide to the Revalidation of General Practitioners in April 2009 has set out for the first time our proposals for the evidence that will be required by GPs for revalidation. Over time this will evolve to become the definitive source of advice for GPs, assessors and appraisers, and their advisers across the UK.

Professor Steve Field FRCGP, Chairman of Council

We know that many GPs are concerned about what the process will look like, which is why we are continuing to consult GPs to ensure that the process is sensible and not too complex and bureaucratic. Pilot schemes have begun and we genuinely want to receive feedback from all GPs, regardless of where they practise and in what role. The big challenge for the College now is to listen, adapt our programme based on feedback, and support GPs through the process. The final details for revalidation will be signed off by the General Medical Council, and we are working hard with them and other stakeholders on this project. It is critically important that revalidation is driven by the profession rather than imposed on us by an outside agency with no understanding of who we are and what we do. We must show leadership to improve continually the standing of our profession and the quality of care we provide to our patients.

Hilary De Lyon, Chief Executive

GP education has certainly come a long way since the RCGP was formed in 1952 when there was no training available â&#x20AC;&#x201C; or even thought necessary by many. For the same reason we are continuing to advocate strongly for GP training to be increased to 5 years. After the current 3 years GPs are competent, but not as confident as they could be. A business case is currently being prepared by the RCGP to be presented to the Department of Health on this issue, but the financial constraints on the country mean, in the short term at least, that this will be an uphill battle. We are delighted with the results of the RCGP pilots on provider accreditation. Half of all practices involved scored 90% or above in achieving the core criteria, and particularly pleasing is the positive and enthusiastic feedback from practices involved. This is the way forward in further

improving the quality of care provided by practices, and it has the potential to satisfy the regulatory needs of the Care Quality Commission.

successful year ever in terms of media coverage. The RCGP has become a regular and respected voice in the media, both in defence of GPs and in giving advice on good patient care.

The RCGP is also involved at the ground level in the development of the Quality and Outcomes Framework (QoF). The College has won a joint bid, in partnership with Professor Helen Lester from the University of Manchester and the University of York, to renew and develop the National Institute for Health and Clinical Excellence (NICE) indicators – a great achievement. Our own College Treasurer, Dr Colin Hunter, has been appointed Chair of the QoF Advisory Committee. It is extremely important to have GPs involved and showing leadership in designing the system, rather than waiting for things to be imposed on us by others.

Once again our membership level has reached a record peak, with over 36,000 members, helped by the introduction of the nMRCGP and the Associates-in-Training (AiTs) scheme.

The College is proud to have won a major contract, led by Professor Nigel Sparrow, from the Department for Work and Pensions (DWP) to support doctors in managing patients with work and health issues to remain in and return to work. The National Education Programme for Health and Work will consist of around 100–150 educational workshops and will be delivered over a 2-year period through the College’s local and regional faculty offices. Professor Sparrow has also been instrumental in winning a grant from the Department of Health (England) to develop a pilot, modelled on the DWP project, to support GPs in their work with carers. This work is in partnership with the Princess Royal Trust for Carers and builds on the Supporting Carers guide jointly developed and launched in 2008. Six pilot workshops will be held in autumn 2009 and, if successful, will be rolled out in a similar way to the National Education programme through the faculty structure. This year has seen the emergence of the H1N1 influenza virus, which put great pressure on many of us in primary practice, but the College has been widely praised for our co-ordination and communication efforts. Honorary Secretary Dr Maureen Baker led the College pandemic influenza preparations in partnership with the General Practitioners Committee, and liaised with relevant authorities to ensure members were kept up to date. Daily updates were sent to GPs – even nonmembers – and regular teleconferences were held with RCGP representatives across the UK. Increasing awareness of the importance of the role of the GP, and primary care in general, has continued with our most

The year 2008 was dominated by Lord Darzi’s reforms and the spectre – in England at least – of polyclinics. We pushed hard for greater GP involvement at all levels in the healthcare system and – without the input of the RCGP – the review could have had a very different and much worse outcome. The College’s way of constructively challenging and providing solutions is appreciated, and is beginning to have a major effect on the development of the NHS. We have continued to strongly promote the federated model as our solution, with GP practices pooling resources and expertise to deliver better care for patients. In 2008 we published Primary Care Federations: putting patients first, a major report that outlined an approach of ‘health centres where appropriate, Primary Care Federations where possible’. We will continue to promote this model, and develop a toolkit to help with the legal and commissioning aspects of running a federated system. We must mention two senior office holders who are retiring this year: Dr Maureen Baker stands down after 10 years as Honorary Secretary, and Professor David Haslam finishes his term as President in November. These two have made an enormous contribution to both the College and to general practice – for which we are hugely grateful. We offer congratulations to their respective successors, Professor Amanda Howe and Dr Iona Heath. Thanks must also go to Dr Has Joshi and Dr Clare Gerada, the College’s two Vice-Chairs. Dr Gerada has been leading our work on ‘Teams Without Walls’ with the Royal College of Physicians, while Dr Joshi has been travelling around the country, representing the RCGP at faculty meetings. Of course, the College would be nothing without the hard work and contributions of members and staff. We would like to thank all those who have worked so hard for the College over the past 12 months and for your support in the future.

PROFESSIONAL STANDARDS OUR STRATEGIC OBJECTIVES: To make the College the standard-setting body for GPs trained in the UK To lead the development and implementation of professional standards for GPs in the UK To influence education policies with respect to general practice To develop the College’s vocational training policy and standards To involve patients in all aspects of College policy in professional standards To promote MRCGP International.

Setting the standards for GPs trained in the UK

THE NEW MRCGP ASSESSMENT The Royal College of General Practitioners (RCGP) has successfully developed, tested, refined and administered the new MRCGP assessment (or nMRCGP), which has been in operation since August 2007. It is an integrated assessment programme that includes three components: an Applied Knowledge Test (AKT), a Clinical Skills Assessment (CSA) and Workplace-Based Assessment (WPBA).

IMPACT ON STANDARDS FOR GENERAL PRACTICE The College’s new MRCGP (nMRCGP) examination is the single training and assessment system for UK-trained doctors Entry standard to the General Medical Council’s GP Register and for membership of the RCGP.

HIGHLIGHTS AT A GLANCE

• RCGP Guide to the Revalidation of General Practitioners produced and pilots established

Applied Knowledge Test

• Innovative training curriculum diary project established

The AKT is an assessment of the knowledge base that underpins independent general practice. The College delivered the AKT three times during the reporting year at Pearson VUE test centres. It is taken by candidates at various stages of specialty training for general practice, for certification purposes, and by others, including those completing the ‘old’ MRCGP or on general practice ‘returner’ schemes. The numbers of candidates sitting and passing during the year are shown below. Candidates sitting the Applied Knowledge Test Year ST1

Year ST2

Year ST3

Other candidates

All candidates

282

1163

May 2008 Sat

358

481

Pass

301

386

158

871

Pass rate %

61.9

84.1

80.2

56.0

74.9

Sat

115

1190

188

1501

Pass

1009

1179

Pass rate %

84.3

84.8

35.6

78.5

Sat

290

570

889

Pass

253

476

752

Pass rate %

92.9

87.2

83.5

66.7

84.6

October 2008

January 2009

Note: the pass rates for each year of training are not directly comparable because of the considerable variation in candidate numbers and the likelihood of the ST3 cohort containing a proportionately greater number of re-sitting candidates.

Candidates in year ST3 of their training who were sitting AKT for the first time had a pass rate of 88.7% compared with an overall pass rate for all candidates of 78.5%. Cumulative data suggests that the pass rate for ST3 candidates after three attempts at AKT is approximately 98%. Post-examination reports, published on the College’s website, provide detailed appraisal of the test itself and further statistical analyses.

• Review of curriculum and standards in training

• Increased patient perspective on College work • Development of standards for assessment abroad, tailored to local conditions

• 100th practice in Scotland receives quality award.

Clinical Skills Assessment The CSA is an assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice. Five sessions of CSA were held during the year. The January/February 2009 examination was the largest to date in terms of Clinical Skills Assessment Ce both candidate numbers ntre, Croydon. and duration (18 days). Here, 3049 candidates were examined, of whom 2392 (78.5%) were successful. The assessment involved 12 cases of which eight needed to be passed to achieve an overall pass. The numbers of candidates sitting and passing during the year are shown below. Candidates sitting the Clinical Skills Assessment April 2008

May 2008

October 2008

December 2008

Jan/Feb 2009

Sat (all candidates)

799

224

694

1238

Pass

646

147

534

1008

Pass rate %

80.9

65.6

76.9

81.4

Sat (ST3 only)

770

198

619

1231

Pass

631

134

484

1002

Pass rate %

81.9

67.7

78.2

60.6

81.4

PROFESSIONAL STANDARDS

Workplace-Based Assessment and the ePortfolio WPBA is an evaluation of a doctor’s progress in his or her performance over time, in those areas of professional practice best tested in the workplace.

‘Old’ MRCGP overall passes, 1998–2008 2500

2000

1500

The RCGP has created tools and downloadable resources to support trainees and their trainers. It has created a secureaccess web-based portfolio (ePortfolio) in which all GPs in training can record their learning experiences and manage their assessment, in a structured manner. Trainers and deaneries that oversee primary care education and training also have their own secure access to the ePortfolio, making nearly 20,000 users in all.

Future work The functionality of the ePortfolio has been improved through several iterations. A review of the priorities for WPBA development was started in January 2009 and it is expected that any resulting changes will be implemented in 2010.

‘OLD’ MRCGP EXAMINATION Ten years after its introduction in 1998, the old-style credit accumulation MRCGP came to an end in the winter of 2008. Record numbers of candidates sat the examination in 2007, but by 2008 virtually all of the applicants were completing components or re-sitting them. The last tranche of ‘single route’ videos for both summative assessment and College membership was assessed in May 2008. Here, 1006 candidates achieved an overall pass in the examination during the year and became eligible for membership of the College; 45 candidates achieved passes with Distinction, and a further 139 passes with Merit.

Growth between 1998 and 2008 The impact of the examination during the period 1998 to 2008 can best be illustrated by reference to the number of overall passes, which reached a peak of 2313 in 2007, immediately prior to the inception of the nMRCGP.

1000

500

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

Examiners The College would like to pay tribute to the efforts of all former Examination Board Chairs, the various convenors and the panel of examiners, for contributing to the longstanding success of the examination, and ensuring that the transition to nMRCGP has been achieved so effectively. The outgoing clinical leads – Drs Andrew Wilson (Convenor of the Panel of Examiners), Tom Boyd (Written Paper) and Paul Wilson (Oral Examination) – demonstrated exemplary leadership skills and worked tirelessly to maintain the quality of the examination during its final phase.

INTERIM MEMBERSHIP BY ASSESSMENT OF PERFORMANCE Interim Membership by Assessment of Performance (iMAP) has been designed for established GPs who did not become RCGP members at the end of their training. iMAP involves collecting a portfolio of evidence that documents aspects of standard GP practice, and an oral assessment. iMAP has been promoted to associate members and GP appraisers by the Collegeâ&#x20AC;&#x2122;s Membership and Development Directorate as part of a drive for wider RCGP membership. To date, 84 GPs have passed iMAP but this figure is likely to rise dramatically through the coming year as up to 300 candidates reach the oral assessment stage. Due to the popularity of the programme, the College Council has agreed to an extension to iMAP up to December 2009. A replacement scheme for established GPs is currently being considered.

IMPACT ON GP PARTICIPATION

RCGP CERTIFICATION UNIT The Certification Unit evaluates general practice training on behalf of the Postgraduate Medical Education and Training Board (PMETB). Between April 2008 and March 2009 the Unit passed recommendations for 1921 Certificates of Completion of Training (CCT) to the PMETB, with an average turnaround time of 6 working days. The Unit also evaluated 94 applications for a Certificate Confirming Eligibility for General Practice Registration (CEGPR). This certificate is awarded to doctors who wish to have their training, qualifications and experience assessed for eligibility for entry onto the GP register, but who have not followed the standard CCT route or completed a full PMETB-approved training programme. Since the introduction of nMRCGP, doctors have been able to apply online for their CCT through their ePortfolio. The Certification Unit also provides advice to doctors and deaneries regarding the content of training programmes and the documentation needed to apply for certification. During the coming year the Unit will be revising its guidance for trainees and deaneries.

Over 800 GPs have applied to participate in the programme â&#x20AC;&#x201C; almost three times the anticipated uptake Many candidates have stated that iMAP has improved their work as a GP.

PROFESSIONAL STANDARDS

Leading the development of specialist training policy and standards RCGP CURRICULUM FOR GENERAL PRACTICE TRAINING The RCGP introduced the first ever UK-wide specialty curriculum for general practice training in August 2007. The RCGP curriculum is a wide-ranging educational document that describes the competences needed to be a GP practising in the UK. The RCGP has developed a range of educational resources to help general practice trainers and trainees to understand and use the curriculum in day-to-day training. The first review of that curriculum has now been completed and minor changes were approved by the PMETB. Further revisions will take place annually.

IMPACT ON GENERAL PRACTICE The RCGP and the University of Birmingham are conducting a 3-year evaluation of the curriculum and its impact on general practice training Those involved in general practice training can record their experience with the curriculum by using an innovative electronic diary record; this diary project has been extended.

Dr Mike Deighan (centre) received the Presidentâ&#x20AC;&#x2122;s medal at the 2008 AGM in recognition of his contribution to the development of the new GP training curriculum. Also pictured are Dr Bill Reith, who read the citation, and RCGP President, Professor David Haslam.

QUALITY ASSURANCE OF GENERAL PRACTICE TRAINING Delivery of the curriculum to PMETB standards is the responsibility of the local deanery. The annual review or educational appraisal of the progress of trainees will be undertaken by a panel resourced by the deanery, but including RCGP and lay representation. Processes for managing these Annual Review of Competence Progression panels have been refined during the year and the Quality Management and Training Standards Committee has produced comprehensive guidance on the standards expected for general practice training. This guidance builds on and complements the PMETB generic standards for training. The RCGP has also submitted its first Annual Specialty Report to the PMETB. It comments on the current state of general practice training in the UK and is informed by trainer and trainee surveys, deanery annual reports, visit reports and feedback from the RCGPâ&#x20AC;&#x2122;s External Assessor team. The College made its second submission to the PMETB in November 2008 as part of the approval process for nMRCGP. A comprehensive Annual Report on nMRCGP for the period August 2008 to July 2009 will be published later in the year.

University of Cambridge collaboration to improve standards in training The RCGP is working in collaboration with the University of Cambridge to establish a research partnership that

will focus on assessment in UK postgraduate medical education and, in particular, general practice training and assessment. Although at a very early stage, this is an exciting opportunity for the RCGP to work with a worldclass university to conduct leading-edge research, which will ultimately lead to improved standards in general practice training.

Review of specialty training in the UK The Department of Health has commissioned the RCGP to investigate the business case for extending GP specialty training to 5 years, as recommended by the Tooke report. A wide range of stakeholders including patients, the NHS, governments in the four home countries, and the medical profession has given almost unanimous support to this proposal. If the proposal to extend training is accepted by the Department of Health, work on implementation will begin with a view to introducing the new training programmes from 2012.

IMPACT ON GENERAL PRACTICE TRAINING A report on extending GP specialty training to 5 years is being prepared for the Department of Health.

Leading accreditation and assessment abroad MRCGP INTERNATIONAL The College continues to promote and develop MRCGP International and the international category of membership. This supports the worldwide development of general practice/family medicine, and assists in raising the standards of the discipline, being of equivalent academic rigour to the MRCGP in the UK. The International team oversees the development of postgraduate assessments delivered in different parts of the world, tailored to local culture, practice, education, and health systems. The Minister of Health of Brunei, accompanied by the Permanent Secretary and the High Commissioner of Brunei in London, visited the RCGP in May 2008 for discussions with representatives of the College. As a result, a Memorandum of Understanding strengthening the co-operation between the RCGP and Brunei on Continuing Professional Development (CPD) and Higher Specialist Training has been approved by His Excellency the Sultan of Brunei.

College Officers received Brunei health officials at the College in London.

PROFESSIONAL STANDARDS

The College has been pleased to accredit the family medicine residency training programmes at the Calcutta Medical Research Institution and Ramakrishna Mission. There will be regular visits to monitor the two programmes and provide support. A Memorandum of Understanding was signed by the RCGP and the Egyptian Minister of Health and Population to prepare the countryâ&#x20AC;&#x2122;s local examination for MRCGP[INT] accreditation.

Delegates attending an MRCGP International Development Day, May 2008.

IMPACT ON GENERAL PRACTICE INTERNATIONALLY Growing number of candidates taking the MRCGP[INT] examination each year Examinations held throughout South Asia and in Brunei, Kuwait, Dubai and Oman during the year

RCGP Chief Executive Hilary De Lyon at the signing of a Memorandum of Understanding with the Egyptian Minister of Health and Population, March 2009.

The annual MRCGP International Development Days provide a forum for exchanging experience and promoting the development of general practice/family medicine. They bring together family doctors from across the accredited examination sites, along with those from other countries that are involved or interested in the programme. The theme of the 2008 conference was CPD.

25% increase in candidates attempting the MRCGP[INT] South Asia examination at centres in Bangladesh, India, Pakistan and Sri Lanka A Memorandum of Understanding strengthening the co-operation between the RCGP and Brunei and the RCGP and Egypt signed.

Kuwait MRCGP[INT] graduates, November 2008.

Leading the development and implementation of professional standards for GPs in the UK REVALIDATION â&#x20AC;&#x201C; GUIDING AND SUPPORTING GPs THROUGH THE PROCESS It has become government policy that all doctors should be revalidated every 5 years with effect from the expected implementation date of April 2011. The RCGP has a mandate to develop and assure the standards for recertification of all doctors on the general practice register, as part of the process of revalidation. The College is committed to informing GPs, appraisers, local leaders and those working in Primary Care Organisations on how to prepare better for and to achieve an optimal system for revalidation. To this end, the College has produced the RCGP Guide to the Revalidation of General Practitioners that outlines the proposals for the processes and the evidence that will be required for revalidation, as well as supporting tools, available on the RCGP website. GPs and other stakeholders are encouraged to shape the scheme by use of an online comment form. The College also intends to support GPs working outside the conventional managed environment of the NHS, including the Medical Defence Forces, to ensure they are able to participate effectively in the revalidation process. The needs of groups such as those working in rural and remote areas and sessional doctors are also being taken into account.

and Stakeholder Group oversee the College scheme. Their work includes contributions to the work streams of the Academy of Medical Royal Colleges and initiatives on CPD, multi-source feedback and remediation. There is regular consultation with, among others, the General Medical Council, the General Practitioners Committee of the British Medical Association (BMA) and the Department of Health. Pilot studies are testing the feasibility of the collection of evidence for revalidation, including the possibility of using prescribing indicators in the evidence portfolio. An independent report was commissioned to identify a suitable multi-source feedback tool and to review the use of patient questionnaires. Work continues on developing an RCGP ePortfolio, which will be compatible with the RCGP trainee ePortfolio and the Welsh and NHS Appraisal Toolkits, and will enable GPs to house their CPD and revalidation evidence in one place. The College will also be developing a suite of tools to assist GPs in the collection and recording of their evidence.

Scottish National GP Revalidation Steering Group RCGP Scotland has reconvened its Scottish National GP Revalidation Steering Group, which brings together key organisations including the Scottish General Practitioners Committee of the BMA, the General Medical Council, NHS Education for Scotland and the Scottish Government Health Department. One of the priorities of the group is to communicate key messages regarding revalidation through stakeholder websites and newsletters.

IMPACT ON GPsâ&#x20AC;&#x2122; LICENCE TO PRACTISE The RCGP is leading on the standards for recertification of all practising GPs A definitive guide to GP revalidation and supporting learning tools is available through the RCGP website.

Professor Mike Pringle has been appointed as RCGP Medical Lead for Revalidation, and a Governance Group

PROFESSIONAL STANDARDS

Driving quality standards to improve patient care PRIMARY MEDICAL CARE PROVIDER ACCREDITATION The RCGP-developed Primary Medical Care Provider Accreditation (PMCPA) scheme is designed to enable healthcare providers to demonstrate their standard of practice and to encourage a focus on responding to patient needs. The scheme is professionally led and based on evidence from UK and international accreditation models. It involves a multidisciplinary accreditation visit that leads to a quality improvement plan for the whole primary care team. This year it was piloted in 36 practices and was shown to bring about improvements in patient safety and to create a sense of professional pride amongst providers.

QUALITY PRACTICE AWARD The Quality Practice Award (QPA) recognises excellence in patient care delivered by all members of the practice team. It engenders a real sense of team spirit and an improved understanding of how the team works together to create a better environment for patients and staff. Practices that undertake the assessment are encouraged to contribute to the development of the criteria for the award, to ensure they reflect the ongoing changes in general practice. To date, 212 practices have been accredited, including one in Wales, 95 in England, 102 in Scotland and 14 in Northern Ireland (NI). This number continues to grow with increasing interest from practices in pursuing this award. The criteria for the newest version of QPA reflect the differences in practice across the UK. A modular and flexible version of QPA, which should enable more practices to complete the award, is being developed.

The next stage of development will involve refining the criteria and evidence that make up the standards, further development of the assessment process and engaging with all stakeholders. Plans are being made to implement the full programme across England in the future.

IMPACT ON STANDARDS FOR PATIENT CARE The RCGP is leading an initiative to introduce accreditation for GP practices to assure patients of high standards in GP care.

Dr Ken Lawton, Chair of RCGP Scotland, presenting the 100th Quality Practice Award plaque to the Bruntsfield Medical Practice, Edinburgh, November 2008, the second time that the practice has been awarded the QPA.

Discussions have taken place with the Scottish Prison Service about adapting the new, modular QPA for secure environments. New Hall Prison in Wakefield has negotiated funding to work towards an adapted version of modular QPA and will be commencing the pilot in 2010.

Lurgan Medical Practice receiving their RCGP NI Practice Accreditation Award from Dr John Oâ&#x20AC;&#x2122;Kelly at the Northern Ireland Celebration Evening.

Quality programmes in Northern Ireland Four practices in NI achieved accreditation in 2008, bringing the total number to 27. The RCGP NI Out-of-Hours Programme measures the quality of services offered by out-of-hours providers, including responsiveness, communication and external relationships. In December 2008, Dalriada Urgent Care achieved its accreditation (pictured right). This year the criteria have been reviewed to make them applicable to the Republic of Ireland and the first out-of-hours co-operative from the Republic is expected to complete the programme in 2009.

Quality and Outcomes Framework in Scotland RCGP Scotland has been awarded a contract to deliver training for QoF reviewers. The training has included use of the QoF Data Analysis tool, which will allow practices and reviewers to take an in-depth look at clinical indicators, referring dates and prescribing data. As part of this project, the QoF manual and website have been updated.

Dalriada Urgent Care Northern Ireland receiving their RCGP NI Out-of-Hours Quality Award.

PROFESSIONAL STANDARDS

The patient perspective PATIENT PARTNERSHIP GROUP

Ailsa Donnelly, Chair of the Patient Partnership Group.

Patient views are represented in all aspects of College policy on professional standards.

Projects carried out by the Group in 2008 include: • a publication setting out the standards that patients should expect from their local practice entitled What Sort of Practice? • securing lay representation on a range of College groups, including groups on medical ethics, nominations, awards and professional development • e-learning modules on shared decision-making and patient partnership • an induction booklet for new members of the Group.

The Patient Partnership Group, chaired by Ailsa Donnelly, offers the patient perspective on important areas of College work. The Group had a particularly strong presence at the 2008 RCGP Annual Conference in Bournemouth, attracting delegates to their project stand with daily topical debates. Several members were also involved in the delivery of conference workshop streams.

Perfect partnership: Dr Susan Potter, Bryan Caldicott, Chairman of Moss Grove Surgery Patient Panel John Hopkins, and Practice Manager Sonia Clark with RCGP President Professor David Haslam at the presentation of the RCGP Patient Participation Award to the West Midlands surgery.

PATIENT PARTICIPATION THROUGHOUT THE UK Patient Partnership in Practice (P3), the patient participation group of RCGP Scotland, recruited four new lay members last year, giving it a member in each of the RCGP Scotland faculties. Two new GP members were also appointed. The P3 ‘Virtual Network’ has been formed to strengthen the patient voice by linking as many people as possible with an interest in health care and the NHS throughout Scotland. The Virtual Network is a pool of patients and members of the general public who will feed in electronically to the work of P3 and RCGP Scotland. A workshop entitled ‘Make the Connections: the value of involving your patients?’ attracted 60 delegates from all over Scotland. The theme was how to encourage GP practices to develop patient groups; Graham Box, Chief Executive of the National Association for Patient Participation, gave the keynote speech. The RCGP NI Patients in Practice (PiP) group held its first public conference in January 2009 on a similar theme.

RCGP NI Chairman Dr David Johnston with Patients in Practice Chairman Paul Archer, members of PiP and speakers at the RCGP NI PiP conference.

The RCGP Wales Patient Group – Patient Partnership in Practice (PPiP) – is developing well. Regular quarterly meetings have been held and the group now consists of three lay representatives, two GPs and the RCGP Wales Manager. The Patient Group took on the responsibility of drawing up the shortlist for the RCGP Wales Patient Nomination Award and subsequently attended the gala dinner.

RCGP Scotland Chairman, Dr Ken Lawton, and delegates from RCGP Scotland’s Patient Participation Group at the ‘Make the Connections’ workshop.

Dr Tony Jewell, CMO for Wales, patient Rosemary Brown and the winning GP Dr Martyn Davies at the Patient Nomination Gala Awards evening.

PROFESSIONAL DEVELOPMENT OUR STRATEGIC OBJECTIVES: To support the professional development of GPs throughout their careers To ensure GPs have access to timely, evidencebased guidance on clinical practice To ensure effective communication of clinical advances and research relevant to general practice To facilitate and promote the development of an effective infrastructure for research in primary care.

Supporting the professional development of GPs throughout their careers

CONTINUING PROFESSIONAL DEVELOPMENT CREDIT-BASED SCHEME The CPD policies of the College are overseen by the Professional Development Board. This year the Board has given priority to supporting the revalidation needs of GPs, including major pieces of work on an innovative CPD Credits Scheme and policy work to support the quality assurance of appraisals and personal development plans. The College has started to pilot its CPD Credits Scheme in ten deaneries. The scheme encourages GPs to reflect on the impact of their learning and provides an easy-to-use and flexible framework for the collection of evidence of CPD. This can also be used for revalidation purposes. A minimum of 50 credits will be required each year, and a broad range of general practice must be covered over a 5-year cycle. The scheme, and associated learning resources, will continue to be developed in the coming year. GPs getting to grips with the intricacies of minor surgery, at a workshop at the College in London.

HIGHLIGHTS AT A GLANCE RCGP ONLINE LEARNING

• Innovative CPD credit scheme created and piloted • RCGP online learning platform in development

• Ambitious e-GP learning packages developed • 8750 trainees currently access the nPEP online learning tool developed by RCGP Scotland • National health and work programme rolled out

e-Learning for General Practice (e-GP)

• nMRCGP and professional development courses run to full capacity

• International development programme expanded to China

• New Clinical Innovation and Research Centre champions clinical research • College journal ranked leading European primary care journal.

e-GP is an ambitious collaborative project between the RCGP and the Department of Health’s e-Learning for Healthcare (e-LfH) initiative. This online interactive learning resource is aimed at GP trainees, trainers and also practising GPs, and will underpin GP training for all NHS GPs to support revalidation. The learning in e-GP consists of a range of interactive learning sessions and ‘virtual consultations’. Over the next 2 years e-GP will deliver approximately 200 separate e-learning sessions, providing a comprehensive and free-to-access resource for all NHS GPs. Approximately 3500 qualified GPs have requested access to date. The feedback gathered from trainees has been very positive. Over the next year, the College will be pushing forward an implementation strategy to raise awareness and encourage learner engagement on a deanery-by-deanery basis.

IMPACT ON LEARNING FOR GPs All 9000 trainees undergoing specialty general practice training have been registered for e-GP access by the College In the first 2 months since e-GP roll-out began, 2000 sessions of curriculum-based e-learning have been completed From May 2009 every session completed by a GP trainee is automatically being recorded in his or her ePortfolio learning log Access will be free for all NHS GPs.

How to access the e-GP e-learning modules Access to e-GP is available free to UK NHS GPs, GP specialty trainees and GP educators. More information, and access to e-GP, can be found on its dedicated website: http://e-lfh.org. uk/projects/egp/index.html.

PROFESSIONAL DEVELOPMENT

Other e-learning programmes The RCGP has also added to its e-learning packages with a module to support the delivery of the Improving Access to Psychological Therapies (IAPT) programme. This aims to ensure that a stepped-care model for treating mental health conditions is implemented in every Primary Care Trust in England. A further e-learning programme on Referrals and Patient Pathways is planned.

SUBSTANCE MISUSE COURSES FOR GPs The RCGP Substance Misuse Unit (SMU) is now firmly established as a self-financing, England-wide network of practitioners providing primary care treatment for substance misusers. The Certificate in the Management of Drug Misuse Part One was completed by 1508 candidates in 2008. This qualification continues to be the required minimum training for practitioners who wish to participate in Locally Enhanced Service shared-care schemes. The Certificate Part Two was completed by 155 individuals. This year 210 candidates are undertaking the course, organised into 13 tutor groups across England. A thriving network of Regional Clinical Leads, based on Strategic Health Authorities, provides a point of contact for past certificate holders, current course candidates, course tutors, and local strategic providers.

Lord Layard joined RCGP Chairman Professor Steve Field and representatives from mental health organisations at the launch of the consensus statement on Improved Access to Psychological Therapies for patients. The RCGP is developing an online educational model to support the IAPT programme.

In a wider context, the College is implementing a learning delivery platform that will ultimately host all of the College’s e-Learning CPD resources, ensuring consistency of delivery and greater user-friendliness and impact.

nPEP (Personal Education Planning) nPEP, an online self-assessment learning tool developed by RCGP Scotland and based on the nMRCGP methodology, is currently being developed into a modular format for release in early summer 2009. It is hoped that nPEP will be included in GPs’ ePortfolios to support revalidation. Currently, 8750 AiTs have access to nPEP through their membership subscription.

The SMU continues to work closely with the National Treatment Agency and various Department of Health teams, including the Alcohol Policy Team and the Prison Health Team, and is intending to launch several new training courses in 2009. The Unit has attracted international interest through a presentation at the Australasian Professional Society on Alcohol and Other Drugs Conference in Sydney, and it is undertaking development work with the RCGP International Department to franchise its courses to Malaysia.

RCGP Certificates in the Management of Drug Misuse During 2008–9 RCGP Scotland continued to deliver the Certificate in the Management of Drug Misuse in Primary Care. Funding from the Scottish Prison Service made possible a 2-day course specifically designed for Secure Environment staff in Scotland. Funding was also received for three training events on Identification and Management of Alcohol Problems in Primary Care, with capacity for 150 candidates. RCGP Wales has secured £85,000 from the Welsh Assembly Government to run the Certificate in the Management of Drug Misuse. Last year 53 candidates passed Part One of the course in Wales and 17 passed Part Two. The RCGP Management of Alcohol Misuse Certificate will be rolled out in Wales from April 2009, also with support from the Welsh Assembly.

NATIONAL EDUCATION PROGRAMME FOR HEALTH AND WORK In 2007 the College piloted a group of workshops under the national education programme for enhancing professional standards in the area of health and work in general practice. This was aimed at changing GP attitudes and behaviour to health and work, and providing them with the knowledge and resources to manage health and work issues more effectively. This year, following a very positive independent evaluation, the College was invited to roll out the programme nationally. The half-day workshops are funded by the Department for Work and Pensions and will be delivered by a GP and an occupational health physician over the next 2 years.

The Courses and Conferences website has been revised, making it easier for members and others to search for and book onto courses.

RCGP LEADERSHIP PROGRAMME The RCGP Leadership Programme is designed to develop the understanding, self-awareness, self-confidence and skills needed for a range of leadership roles, including leaders of health care, leaders of new career pathways and leaders of the profession. The programme is delivered by a team drawn from a consortium made up of the Centre for Leadership Studies at the University of Exeter, the OD Partnership Network and the Peninsula Medical School Postgraduate Health Institute. The 1-year programme has been successfully completed by 36 participants and is now in its third year, with 33 participants enrolled on it.

RCGP COURSES AND CONFERENCES The Courses and Conferences Department has had a particularly successful year. The nMRCGP preparation course has been very popular, with ten 2-day events being run to full capacity. The number of Minor Surgery courses has increased from four to six per year and the Consulting Skills Masterclass, led by Dr Roger Neighbour, has grown from two to four per year. As the MRCGP examination was being replaced by the new system of assessment, the Courses and Conferences team offered specifically designed 1-day preparation courses for the remaining candidates wishing to obtain their membership through the old system. This increased activity and consequent revenue was the result of a continued promotional drive through email and other communication channels across the College. The team has also developed several new standalone courses, including Personality in Practice, Disease Mongering and Neuro-Linguistic Programming in Clinical Practice. A series of educational evenings on clinical topics, called the Supper Seminars, is also being planned. The New Business Skills for GPs courses covered non-clinical aspects of running a practice and attracted a maximum number of delegates for each event.

RCGP Leadership Programme graduates with Floella Benjamin OBE, alongside RCGP President Professor David Haslam, and RCGP Honorary Secretary Dr Maureen Baker.

IMPACT ON PROFESSIONAL DEVELOPMENT FOR GPs RCGP courses in the management of drug misuse, health and safety at work, and developing leadership skills are enhancing educational standards in primary care.

PROFESSIONAL DEVELOPMENT

REGIONAL EDUCATIONAL INITIATIVES THROUGHOUT THE UK The constituent parts of the College continue to offer a range of activities, events tools and resources that support GP education and opportunities for networking.

Scottish Academic Forum The Scottish Academic Forum was created to bring together key organisations that have a significant role in the development, research, delivery and support of undergraduate and postgraduate education and CPD for GPs in Scotland. A Working Group chaired by Professor Lewis Ritchie produced a paper on Academic General Practice in Scotland: securing the future, which was presented to Nicola Sturgeon, Cabinet Secretary for Health and Wellbeing.

Education Providers Accreditation Scheme (Scotland) The Education Providers Accreditation Scheme (Scotland) (EPASS) offers quality assurance of postgraduate educational activities so that GPs and other primary care professionals are reassured that activities they undertake or events they attend are relevant to their learning needs and of the highest standard. Local champions of general practice were recognised at the RCGP Midland Faculty awards evening held in June. RCGP President Professor David Haslam joined Dr Mike Fisher, Midland Faculty Provost (second from left), and Dr Kay Mohanna, Midland Faculty Chair (centre) at the awards ceremony.

RCGP Scotland is keen to work with and support all EPASS providers to ensure the highest standards in education are delivered. A ‘sharing best practice’ day is held each year. RCGP Scotland continues to work with NHS Education for Scotland to ensure that GP appraisers are aware of EPASS and the significance of an EPASS-accredited event within a doctor’s appraisal folder.

IMPACT ON EDUCATIONAL ASSURANCE FOR GPs RCGP Scotland’s EPASS scheme provides quality assurance to GPs of educational activities undertaken Accredited activities are directly relevant to GPs’ learning needs Over 60 educational providers are currently accredited New ways to support revalidation through the scheme will be explored in 2009.

CARE Measure CARE Measure is RCGP Scotland’s validated online patient questionnaire, giving instant GP feedback. It offers a peer review facility that enables GPs to compare their score with other GPs across the country. CARE provides a detailed report with a breakdown of performance and a certificate. Sales have risen since its inclusion in the iMAP programme this year.

Local educational events Faculties have provided a wide range of local educational activities this year for GPs and other members of the practice team. Topics have included: dermatology, child protection, minor surgery, cardiology, paediatrics, palliative care, ophthalmology and many others. A new course on ‘Emergencies in General Practice’ in Wessex was particularly popular and changes in primary care were reflected in a session on ‘How to be Successful in Competitive Tender’ run by the Sheffield Faculty.

Support for nMRCGP

The Essence of General Practice The Essence of General Practice learning tools, comprising prompt cards and an explanatory booklet, were launched in February 2008 by RCGP Scotland. The cards communicate and capture the ‘Essence of General Practice’ from the viewpoint of both the GP and the patient. They aim to evoke original thought and prompt discussion on the future of general practice within the training environment. A paper written by Dr John Gillies, Professor Stewart Mercer and members of the Essence Steering Group, summarising the work of the initiative, has been accepted for publication in the British Journal of General Practice.

Northern Ireland Saturday Symposia RCGP NI took a departure from the traditional format of afternoon educational events when, in October 2008, they offered the first GP Saturday Symposium. The topic was the contentious and emotive subject of termination of pregnancy guidelines in NI and the keynote speaker was a local barrister, Professor Tony McGleenan.

IMPACT ON EDUCATION FOR GENERAL PRACTICE STAFF IN NORTHERN IRELAND RCGP NI ran 16 training days for general practice staff in 2008, which involved a unique series of blended learning sessions

Accredited nMRCGP courses were offered in a number of faculties, and South East Wales ran a 1-day remedial event for AiTs who were retaking their CSA. Wessex has issued a second edition of the Clinical Skills Assessment DVD. All faculties have developed training events, networking opportunities and careers advice for AiTs.

Support for iMAP Faculty support for iMAP has been an important factor in increasing its uptake. Wessex held an introductory event, attended by 42 GPs. Subsequently, six locality groups have been established to give mutual support to candidates. North East London held a study day that also linked participants into local support groups. South London ran a candidate study day, followed by an iMAP oral practice day. North East Scotland continues to facilitate iMAP fellowship support groups, and a meeting for GPs interested in iMAP was held by the East Scotland Faculty. The Vale of Trent continues to provide extensive support to iMAP candidates and Mersey has had over 150 attendees at various iMAP events.

Faculty support for national programmes Midland and Vale of Trent faculties hosted Certificate in Drugs Misuse Study Days. Wessex has been accredited as an official provider of theoretical modules for the Diploma of Family and Sexual Reproductive Healthcare. Thames Valley and North West England provided training for GP appraisers and the latter held two ‘train the trainer’ events. North East London facilitated an opportunity to work with the ePortfolio. The Unified Route to Fellowship by Nomination is being piloted in three faculties: Midland, South West Wales and North East Scotland. All faculties are actively involved in promoting fellowship of the RCGP.

‘A Toolkit for Practice Managers’ 1-day special event was held.

PROFESSIONAL DEVELOPMENT

COLLABORATIVE PROGRAMMES TO SUPPORT BEST PRACTICE IN PRIMARY CARE National Education Programme for Supporting Carers in General Practice The College continues to work with the Princess Royal Trust for Carers in developing resources to help GPs and practice teams support those who care for others. In 2009 the College will be piloting a series of workshops delivered by a GP and a carer. These aim to improve understanding of the needs of carers among GPs and primary care teams. The pilot is funded by the Department of Health.

EquIP Cymru – Wales EquIP Cymru, the RCGP Wales Disability Training Network, funded by the Welsh Assembly Government, offers workshops run by disabled people. Topics include the barriers to access to primary care services for those with visual and hearing impairments, mental health issues and learning disabilities, and how the Disability Discrimination Act applies to practices. The training package is accompanied by a website to support good practice and a self-assessment audit tool to help practices develop a disability equality action plan. The training was developed and delivered through a unique collaboration of voluntary organisations and patient groups, government bodies and RCGP Wales. It was incentivised in the GMS contract in Wales so that Local Health Boards were encouraged to commission training sessions.

IMPACT ON DISABILITY AWARENESS TRAINING IN WALES Representatives from almost every practice team in Wales have accessed disability training to incorporate the learning points in their practices Ways to extend the training to all NHS staff in Wales in an effort to reduce the health inequalities experienced by disabled people are being explored.

Creating Mental Wealth in Wales The RCGP Wales Mental Health in Primary Care network has secured funding from the Welsh Assembly to develop a Gold Standards Programme for Primary Care Mental Health in Wales – ‘Creating Mental Wealth in Wales’. This programme includes a number of projects that will support the mental health and general wellbeing of all people across Wales. A new website designed to promote good communication between healthcare professionals and health-related organisations in Wales was launched at the end of February 2009 (www.wamhipc.org.uk).

Living Better: Improving Mental Health & Wellbeing of People with Long-Term Conditions Working with the Scottish Development Centre for Mental Health and the Primary Care Research Unit at the University of Stirling, RCGP Scotland secured £550,000 funding from the Scottish Government for a new initiative, Living Better: Improving Mental Health & Wellbeing of People with LongTerm Conditions. The project will improve the detection and diagnosis of mental health in primary care among patients with long-term conditions, principally coronary heart disease and diabetes, and support appropriate interventions and treatments. The project is being run in partnership with voluntary organisations including Depression Alliance Scotland, the British Heart Foundation (Scotland) and Diabetes UK (Scotland), who will deliver training to GP practices.

Practice Managers’ Forum RCGP NI has been providing support to practice managers since 2003 and towards the end of 2008 a web-based Practice Managers’ Forum was established with the aim of enabling practice managers to identify common issues. Over 140 have joined the email distribution list.

Supporting international development and study

Ukraine Travelling Fellowship Award In 2008, RCGP Scotland launched the Ukraine Travelling Fellowship Award in conjunction with the Ukraine Association of Family Medicine. Dr Caroline Oates, a Glasgow-based salaried GP, was the first GP to be awarded the fellowship and travelled to Ukraine in spring 2009. RCGP Scotland was delighted to welcome the first Ukraine partner, Dr Oleg Kashtelyan, to Scotland in January 2009.

THE INTERNATIONAL DEVELOPMENT PROGRAMME The RCGP has received a number of visiting groups from China this year, including a delegation in October led by the Vice Governor of Zhejiang province, who renewed the Memorandum of Understanding with the College that allows for up to 30 study visits a year for the next 5 years. Four senior doctors from Shanghai visited the UK in March under the auspices of the World Health Organization (WHO) Asia Pacific region. The College will receive a highlevel delegation from the Shanghai Health Bureau in spring 2009 for an introduction to UK general practice. Several groups from Thailand have visited the UK and the College has also hosted delegations from developed countries, including Denmark, USA, Canada and Australia. Dr Garth Manning and Professor Val Wass of the RCGP International Committee were awarded Honorary Fellowships from the College of General Practitioners of Sri Lanka for services to family medicine in South Asia in general and Sri Lanka in particular. College members held meetings with the Libyan Board of Medical Specialties and RCGP International Development Advisers have visited Nigeria, Uganda and Ghana in recent months. International Travel Scholarships organised by the International Department assist GPs from around the world with personal study in any aspect of primary care. The successful applicants from the two rounds this year were from Brazil, Egypt, Thailand, the Philippines and the UK.

Dr Oleg Kashtelyan from Ukraine took the opportunity to view general practice from a Scottish perspective.

The International Department encouraged many faculties to send junior or trainee doctors to the worldwide Wonca Conference in 2008. For example, Severn Faculty sponsored Dr Fiona Doyle, a young doctor who had been in practice for less than 5 years, to attend the Vasco da Gama Conference.

IMPACT ON PROMOTING AN AWARENESS OF THE INTERNATIONAL CONTEXT OF PRIMARY CARE International travel scholarships enable GPs to undertake study abroad, relevant to their needs The International Department assists overseas family doctors to visit the UK to study aspects of primary care.

PROFESSIONAL DEVELOPMENT

Providing GPs with evidencebased guidance and innovative clinical updates ESSENTIAL KNOWLEDGE UPDATES Essential Knowledge Updates (EKU) is a structured learning activity that helps GPs to meet their CPD and revalidation commitments by assimilating and applying new and changing knowledge in clinical practice. It is supported by Essential Knowledge Challenge (EKC), an online selfassessment that tests knowledge of the Updates. Two EKUs will be made available each year and EKU will become part of the membership package in 2009. NonRCGP members will be able to access EKU/EKC through an annual subscription. Each Update will consist of approximately eight major peer-reviewed items and 12 briefings, and will take between 2 and 3 hours to complete. It will focus on key clinical areas and the latest information about changes to legislation or new ways of working, selected from a search spanning the previous 6 months. Content of the Updates is being mapped against the RCGP curriculum to ensure good coverage over the 5-year revalidation cycle.

Essential Knowledge Challenge The RCGP Applied Knowledge Test team has developed EKC to support EKU. The first pilot version of EKC, consisting of 50 multiple-choice questions with a downloadable certificate for those who pass, became available at the end of 2008. The second EKC pilot will be launched in April 2009 and the first non-pilot Challenge will be launched in October 2009.

COMPETENCE FRAMEWORKS FOR PRACTITIONERS WITH SPECIAL INTERESTS The RCGP continues to develop standards and clinical support systems for Practitioners with a Special Interest (PwSI). During 2008, the Clinical Innovation and Research Centre (CIRC) collaborated with RCGP Education, the Department of Health and the Royal Pharmaceutical Society of Great Britain to develop 16 updated PwSI competence frameworks. The skills and competences GPs are required to demonstrate in order to fulfil the PwSI role vary according to individual specialty and the nature of the locally commissioned service, and need to be met in order for GPs to continue to practise as a PwSI. The new frameworks can be downloaded from the College website: www.rcgp.org.uk/circ.

THE NATIONAL COLLABORATING CENTRE FOR PRIMARY CARE For 8 years, the RCGP-hosted National Collaborating Centre for Primary Care (NCC-PC) has been responsible for producing high-quality evidence-based primary care guidelines for NICE. The Centre completed guidelines on Lipid Modification, Familial Hypercholesterolaemia and Medicines Adherence during the reporting year. For details of the full programme, see: www.nice.org.uk/guidance. In April 2009 the NCC-PC merged with three other National Collaborating Centres to form the National Clinical Guideline Centre (NCGC), the largest guideline-producing centre in England. The College will continue to engage with NICE through a number of other routes. As well as representation on the board of the new National Collaborating Centre, the RCGP will maintain links with the Implementation Team at NICE and will have a presence on the new NHS Evidence Advisory Committee and on the Quality and Outcomes Framework Programme, which is transferring to NICE.

Publishing clinical advances and research relevant to general practice BRITISH JOURNAL OF GENERAL PRACTICE – LEADING EUROPEAN JOURNAL This year the British Journal of General Practice (BJGP) has expanded the services provided by the online journal, with the aim of making the eBJGP the definitive version. The majority of articles published in the print edition have additional information, such as expanded text or additional tables and figures, which is published online only. The BJGP also publishes articles online in advance of publication in the print journal. The BJGP archive, available through the PubMed Central database, has proven very popular, with approximately 60,000 downloads a month. It features past issues of the BJGP and its predecessors, going back to 1953. The issues from the current 12 months are available only to RCGP members and subscribers to the BJGP. The BJGP is available via the Health InterNetwork Access to Research Initiative (HINARI) scheme set up by the WHO. This means that it can be accessed by not-for-profit institutions in developing countries, such as national universities and research institutes, which are unable to subscribe to the BJGP. This year HINARI has launched further initiatives and the BJGP is now available in 30 countries in Sub-Saharan Africa.

IMPACT ON DEVELOPMENT OF GENERAL PRACTICE AS A DISCIPLINE Based on its current impact factor, the BJGP is the highest ranked family medicine journal in Europe.

CURRICULUM SUPPORT RESOURCES The project to develop resources to support the curriculum project continued during the year. The first issue of InnovAiT, the monthly journal for AiTs, was published in March 2008. It is available both in print and online as part of the membership package, and is proving to be immensely popular with this group. Trainers and College members are eligible for a discounted individual subscription price. The Condensed Curriculum Guide and the online curriculum map, which signposts to relevant resources, both continue to be popular. Management for New GPs, edited by Veronica Wilkie and Peter Spurgeon, is the first in a Curriculum for General Practice Series of textbooks, linked to individual curriculum statements. Future titles in this series for 2009 will focus on respiratory disorders, diabetes, and child health.

OTHER PUBLICATIONS Other key publications during the year include: • Delivering Mental Health in Primary Care: an evidencebased approach, edited by Alan Cohen • I Don’t Know What It Is but I Don’t Think It’s Serious (on confident decision-making), by Tim Crossley • the second edition of Good Medical Practice for General Practitioners • the report Addressing Health Inequalities: a guide for general practitioners, produced by the RCGP Health Inequalities Standing Group, and edited by Ayesha Ali, Nat Wright and Maggie Rae. Over 12,000 copies were distributed to practices and PCTs • Changing Partnerships, a discussion paper on partnerships and the rise of the salaried GP workforce, by Clare Gerada and Victoria Weeks.

PROFESSIONAL DEVELOPMENT

Supporting research in primary care CLINICAL INNOVATION AND RESEARCH CENTRE The CIRC Board, established last year, recommends the clinical priority areas for the College and supports 3-year programmes of innovative work in these areas. Each clinical priority area is led by an RCGP Clinical Champion who identifies opportunities for development and improvement, and spearheads partnership working with key stakeholders. Clinical priorities currently include: end-of-life care, urgent and emergency care, mental health and prescribing, ageing and older people’s health and wellbeing, musculoskeletal (osteoporosis and osteoarthritis), headache and respiratory disease.

RESEARCH PAPER OF THE YEAR The 2007 RCGP Merck, Sharp & Dohme (MSD) Ltd Research Paper of the Year was awarded in 2008 to the paper ‘Early treatment with prednisolone or acyclovir in Bell’s palsy’. The photo features Professor Nigel Mathers (Chair of CIRC), Professor Steve Field, Dr Paul Robinson (Medical Director, MSD), Professor David Haslam and Dr Greg Rubin (Chair of the RPY award panel) with the winning authors led by Dr Frank Sullivan at the Scottish School of Primary Care.

‘RESEARCH READY’ ACCREDITATION Research Ready self-accreditation is a guideline for practices wishing to engage in primary care research. This has been developed in conjunction with the UK Clinical Research Network and the Primary Care Research Networks.

Outputs from the first wave of Clinical Champions include: • a position statement on smoking and mental health • a consensus statement on ageing and mental health • a joint report from the RCGP and the Royal College of Psychiatrists entitled Psychological Therapies in Psychiatry and Primary Care • representation on the Editorial Steering Group of the NHS Clinical Knowledge Summaries • refinement of the RCGP End-of-Life Care Strategy

Research Ready self-accreditation is a basic-entry guideline to primary care research in England. It demonstrates a practice’s knowledge of the standards that are needed to undertake research and the facilities required to comply with research governance frameworks. A new accreditation level, which will be offered to practices with more research experience to assess and demonstrate their advanced research skills, is being planned.

IMPACT ON RESEARCH IN GENERAL PRACTICE

• successful application to the Department of Health for funding to develop a National Primary Care Audit Tool for end-of-life care

Nearly 300 practices have completed the initial research survey

• a presentation at the launch of the Urgent and Emergency Care PwSI Framework.

Over 150 are now accredited or in the process of becoming so.

European research funding In February 2009, CIRC submitted a research proposal under the Leonardo Da Vinci Partnership Project Programme, part of the European Commission’s Lifelong Learning Programme. Partners in Poland, Greece, Spain and Italy each submitted the proposal to their own national agency. If funded, a survey will be carried out on the management of diabetes and its co-morbid conditions in relation to shared decision-making

between patients and healthcare professionals. Decisions on funding will be announced in July 2009. CIRC also produces a bulletin of national and international funding opportunities in each of its clinical priority areas. This can be found on the website: www.rcgp.org.uk/circ/ funding_bulletin.

THE SCIENTIFIC FOUNDATION BOARD This year, the Scientific Foundation Board (SFB), which awards research grants on behalf of the College, has increased the maximum award given for any one research project to £20,000. This is to allow for funding for bigger projects and to increase national awareness of primary care research. The SFB is also following up previous grant holders and bringing together abstracts and published studies resulting from grant awards on the College website.

RCGP RESEARCH AND SURVEILLANCE CENTRE The RCGP Research and Surveillance Centre, formerly the Birmingham Research Unit (BRU), has been collecting and monitoring data from participating GPs for over 40 years. The Centre is best known for its work on influenza-like illness and other respiratory diseases.

EXPERT RESOURCE The Expert Resource initiative has been established by CIRC in order to ensure appropriate RCGP input into external work programmes and consultations, and to improve the collaboration between the College and its members. The Expert Resource is a database of College members with specialist skills and clinical interests. These GPs are used to support the College input to NICE guidance, provide GP representation on NICE Guideline Groups and Implementation Activities, assist with the peer review of care pathways for Map of Medicine, and to contribute to College consultations and educational projects. The initiative has been running since April 2008 and so far over 300 GPs have registered. Registration is free and online through: www. rcgp.org.uk/expert.

RCGP ARCHIVES The College Thesis Collection, a unique collection of primary care research by RCGP members, has been reviewed, updated and catalogued. It is proposed now that it should be prepared for digitisation so that it can be made available on the web, providing greatly improved access to and awareness of this valuable resource for the profession. Files added to the College Archives this year include a set of MRCGP examination papers from 1965–97 donated by Dr John Foulkes.

During 2008, the computer database and IT equipment have been updated. The new system enables staff to extract more information from the patient record whilst still retaining full anonymity. This in turn allows greater analysis of links between, for example, influenza vaccination and subsequent cases of influenza. A new post of ‘Practice Liaison Officer’ has been created as part of the Vaccine Effectiveness Study, a European Unionfunded study. This study has provided valuable feedback from participating practices, strengthening working relationships with them and ensuring the quality of data input. Among seven research papers published in 2008 was ‘Acute respiratory infections and winter pressures on hospital admissions in England & Wales 1990–2005’, published in the Journal of Public Health, which explores the links between hospital pressures and disease reported in the community.

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PROMOTION OF THE PROFESSION OUR STRATEGIC OBJECTIVES: To develop and influence policy affecting general practice, the generalist role and GPs To promote public understanding of the role of GPs To promote general practice as a career, including all special clinical, managerial, educational and research interests

COLLEGE VIEWS The College has responded to over 100 wide-ranging consultations during the year. The most significant of these included: • the NHS Constitution – in its response to the Department of Health consultation on the draft NHS Constitution, the College stated that this could provide a unique opportunity to reform the partnership between tax-payers, staff and patients. However, the College also pointed out that the effectiveness of the Constitution will depend on how it is implemented and interpreted in different areas of the NHS

To achieve recognition among the public of the College’s entry standards for GPs in the UK

• Responsible Officers – the Department of Health invited views on the role of Responsible Officers and their duties relating to the medical profession

To promote the College’s initiatives to members and external audiences.

• the pharmacy white paper – this sets out proposals to extend the role of pharmacists in healthcare promotion and prevention

Developing and influencing policy affecting general practice, the generalist role and GPs

• developing the QoF – the Department of Health sought views on proposals for a new independent process for developing and assessing indicators. Other topics on which the College commented included: the effectiveness of public health information in reducing health inequalities; the consequences of additional private drugs for NHS care; patients’ rights in cross-border health care; a national framework for assessing children and young people’s continuing care; child and adolescent mental health services; the future regulation of health and adult social care; the future of tobacco control; the national dementia strategy; child protection; prescription charges for those with longterm conditions; quality markers for end-of-life care and urgent care in general practice.

Implementation of the NHS Next Steps Review The RCGP has established a network of leads for the NHS Next Steps (Darzi) review to monitor the local delivery of the changes across England and to ensure that highquality patient care remains the priority. The leads have been encouraged to foster links with Primary Care Trusts and Strategic Health Authorities to ensure that the RCGP is kept abreast of developments and to collect information on the level of GP input into decision-making. The leads have also developed links between themselves, Local Medical Committees and College faculties.

HIGHLIGHTS AT A GLANCE Primary care federations The College has proposed a model of primary care federations in which general practices and primary care teams work together and share responsibility for developing high-quality, patient-focused services for local communities. The model would allow GPs to come together in associations to share back-office functions and deliver a range of additional services to patients. The consultation on this proposal attracted a great deal of support for the concept.

IMPACT ON PROMOTING THE FUTURE OF GENERAL PRACTICE Promoting a new model of primary care federations Developing a Federations Toolkit to advise and support practices Promoting the development of general practice and tackling health inequalities throughout the UK.

• RCGP responds to NHS Constitution consultation

• Implementation of the NHS Next Steps Review

• RCGP federated model proposed • Primary care roadmap for Wales launched • RCGP President addresses first international primary care conference in Oman.

INFLUENCING GENERAL PRACTICE POLICY AT REGIONAL LEVEL RCGP Wales has produced a major report that demonstrates how primary care, through a strengthened general practice, can provide solutions to many of the challenges facing the NHS in Wales. Entitled The Next Steps: the central role of general practice in the evolving health service in Wales, the report gives particular attention to health inequalities. It was launched at the Welsh Assembly Government Headquarters by Edwina Hart AM, Health and Social Services Minister, who welcomed its restatement of basic values. A series of roadshows are planned to promote the report.

The Next Steps Launch! From Left to right: Dr Huw Lloyd, Dr Mark Boulter, RCGP Wales Chair, Dr Bridget Osborne, Dr Helen Herbert, BMA Cymru Secretary, Dr Richard Lewis, Dr Tony Downes.

PROMOTION OF THE PROFESSION

The Northern Ireland General Practitioners Committee (NIGPC) of the BMA and RCGP NI have collaborated to develop a strategy to promote general practice in NI over the next 10 years. The primary aim of the strategy is to ensure that the core values of general practice are at the forefront of health care in NI. The strategy consultation can be viewed at: www.bma.org.uk. The College in Scotland has continued to respond to major health policy consultations including ‘Better Health, Better Care’, the Scottish Government’s programme to help people living in disadvantaged communities to sustain and improve their health. Alcohol misuse is a major healthcare issue in Scotland, so the College welcomed a major consultation on this topic. Growing concerns around health inequalities will be addressed in a paper for policymakers that argues that general practice can offer solutions to the problems posed by inequalities. Dr Sheena Macdonald, East Scotland Faculty, and RCGP Scotland Deputy Chair (Policy) Dr Bill Mathewson provide a GP voice on the Review of Nursing in the Community Programme Board. RCGP Scotland also responded to several consultations on postgraduate medical education and training for GPs. Details of all responses to consultation documents can be found on the RCGP Scotland website: www.rcgp-scotland. org.uk.

Working with regional government structures Work to strengthen further links with the Scottish Parliament has progressed well this year. Recommendations on pandemic influenza were well received by Cabinet Secretary for Health and Wellbeing Nicola Sturgeon. A number of meetings with parliamentarians and senior officials have provided excellent opportunities to build influential relationships; topics have included the new drugs strategy, care of the elderly, academic general practice in Scotland and the review of nursing in the community. At a Chair’s dinner with members of the Health and Sport Committee of the Scottish Parliament the main subject of discussion was the future vision for general practice in Scotland. The newly established General Practitioner National Specialist Advisory Group in Wales provides a forum to give professional advice to the Health Minister and her officers. It has been particularly concerned to voice comments on plans

to restructure the NHS in Wales, which appear to be focused around secondary care. RCGP Wales has also been consulted on the development of a Primary and Community Care Strategy for Wales. The Welsh Assembly Government has undertaken a palliative care review. Dr Helen Herbert of RCGP Wales was invited to chair a subgroup of the review on the implementation of palliative care in primary and intermediate care. She has drawn up a proposal for a Welsh end-of-life primary care strategy and RCGP Wales has been funded to develop an End of Life Care Network for Wales. The RCGP NI Council has continued to raise its profile with the NI Assembly through a series of political and public affairs initiatives, which include: • meetings with political party advisers on health and general policy • a briefing pack for members of the Health Committee • a fortnightly briefing on public affairs issues for all NI members • a paper on the position of all the political parties concerning health-related issues.

Local representation Faculties have continued to develop relationships with significant local organisations to promote general practice. Discussions have been held between faculties and Strategic Health Authorities, universities and deaneries, and have covered issues including postgraduate medical education, practice-based commissioning and GP-led health centres. Sheffield Faculty was pleased to play host to a round-table discussion with Nick Clegg MP, Leader of the Liberal Democrats.

Engaging with national and international bodies representing primary care The RCGP has continued to offer advice and expertise to international organisations. It provided a briefing for the UK delegation, led by the Chief Medical Officer, to the WHO Executive Board meeting in January 2009 and further briefings on primary health care were requested for the UK delegation to the WHO Assembly in May. The International department hosted visits from French and Portuguese officials to discuss practice accreditation and the QoF. The College took part in discussions with Iraqi policymakers on how the UK can assist Iraqi medical associations to update their medical education and training, and College representatives joined discussions at the London Deanery on training for overseas doctors in the UK, with a view to developing a College overseas doctors’ sponsorship scheme. Following on from Lord Crisp’s report Global Health Partnerships the Department of Health provided funds to evaluate a framework for UK healthcare professionals to work on international development programmes. The RCGP responded to Lord Crisp’s request for examples of how this could be done, using its international programmes as evidence. RCGP representatives also attended meetings led by the BMA to discuss barriers to UK health professionals taking up opportunities to work in developing countries.

Supporting Wonca Europe and the Vasco da Gama programme Wonca is the world organisation of family doctors. Over 4500 delegates attended the annual Wonca Europe conference held in Istanbul in September, with a large UK delegation led by the Chairman of Council and Chairman of the International Committee. The UK delegation included trainees and newly qualified GPs supported by the International Committee and College faculties to take part in the Vasco da Gama Movement (VdGM) programme and the main conference. There was considerable enthusiasm from this group for developing further links between the UK and the VdGM (young doctors) group, and it is hoped more UK delegates will be able to attend the Wonca conference in Basel, Switzerland, in September 2009.

Promoting public understanding of the role of GPs ENGAGEMENT WITH THE MEDIA This has been an outstanding year, during which the RCGP has significantly raised its profile in all national, international and regional print, broadcast and online media. RCGP Chairman Professor Steve Field has regular briefings with the medical correspondents of the national dailies as well as with journalists on the GP weeklies, and the College is now regarded as a first call on major public health stories such as influenza and MMR. Over the past year, the RCGP has featured on Radio 4’s flagship Today programme six times, the PM programme four times and Professor Field also secured an appearance on BBC Two’s Newsnight programme on out-of-hours cover. The outbreak of influenza and the common cold over the Christmas 2008 period resulted in over 100 interviews and 1000 mentions in national and local media around the UK. The New York Times and the best-selling newspaper in Toronto were among those picking up on the story.

IMPACT ON AWARENESS OF THE ROLE OF THE RCGP Increased media reporting of College responses to national health issues Increased media profile of the role of general practice and of GPs Preparing for pandemic influenza guidance issued to GP practices.

PROMOTION OF THE PROFESSION

Lord Darzi’s review of the NHS and the 60th birthday of the NHS presented many opportunities to promote positively the role of the GP and the contribution made by GPs to the health service. RCGP Vice-Chair Dr Has Joshi and PastPresident Sir Denis Pereira Gray were among the College members who appeared on national TV programmes commemorating the anniversary. College responses in the news can also provide the opportunity for collaborative work with other organisations, as demonstrated when a study by the University of Hull on the placebo effect of antidepressants attracted mass media attention. The College acted quickly to allay patient fears and worked with the Royal College of Psychiatrists to launch a joint leaflet on antidepressants. A joint campaign with the General Practitioners Committee of the BMA at the start of the year to help GPs prepare for an influenza pandemic proved very timely when the UK was hit with an outbreak of swine flu. In addition, RCGP Scotland’s campaign to extend the 10-minute consultation time and the ministerial launch of RCGP Wales Next Steps document by Edwina Hart AM at the Senedd in Cardiff also secured substantial media coverage for the College’s work around the UK. A new RCGP Scotland Communication Strategy covers internal and external communication activity. Four new media spokespeople and Support Officers have been trained, RCGP Scotland’s web structure and content are being reviewed, and hoolet, RCGP Scotland’s members’ magazine, will be redesigned. Press highlights in 2008 include an Evening News article on ethnic minority health, a Sunday Post feature on hay fever and a leading piece on revalidation, along with regular contributions to RCGP News. Relationships continue to be developed with the Scottish press and radio, in particular BBC Radio Scotland, the Herald, the Scotsman and the Sunday Times (Scotland). The RCGP NI Council has begun to build stronger links with both the national and local media. This has been achieved by liaising and briefing national and local health correspondents and editors on the position of the College within NI and the UK.

Dr Helen Herbert presenting the Practice Team Award to Mrs Sheila Booth, Vauxhall Practice, Chepstow.

LINKING WITH PATIENT ORGANISATIONS TO ENGAGE PATIENTS AT LOCAL LEVEL RCGP Wales Gala Awards Evening At the first RCGP Wales Gala Awards Evening patients were able to recognise and celebrate GPs who offered an exceptional level of care. The winner of the Patient Nomination Award was Dr Martyn Davies from Crwys Medical Centre, Cardiff, and the runners-up were Dr Carey Edmunds from Meddygfa’r Sarn, Llanelli, and Dr Rashid Hussain from the Mount Surgery, Pontypool. The winning practice administration team was the Vauxhall Practice in Chepstow. Dr Tony Jewell, Chief Medical Officer for Wales, and Dr Helen Herbert, Immediate Past Chair of RCGP Wales, presented the awards. The evening also raised funds for Ty Hafan, the Children’s Hospice for Wales.

RCGP Northern Ireland Celebration Evening Over 300 GPs, practice staff and invited keynote guests attended the Seventh RCGP NI Celebration Evening. The Belfast office had been inundated with nominations and applications for the Practice Manager of the Year Award, the Practice Administration Team of the Year Award and the GP Patient Nomination Award. Other awards presented on the night included membership and fellowship certificates, the top scoring MRCGP candidate and practices receiving quality awards.

Celebration pictured at the NI of RCGP NI (left), t os ov Pr Dr David st d Pa an , E, Primary Care NI Dr Denis White OB doubi, Director of Jen e tin ris Ch s Mr Evening with t). n of RCGP NI (righ Johnston, Chairma

RCGP Scotland Gala Awards Evening RCGP Scotland has created two new national awards this year, which are currently receiving nominations. For ‘GP of the Year’ (the first of its kind in Scotland) the public will be able to nominate and vote for its chosen GP through the local and national media as well as the internet in order to recognise the huge contribution Scotland’s general practice makes to health care. Second, the ‘Practice Team Award’ will be awarded to a self-nominated practice team who has demonstrated the provision of an excellent quality of service for the patient community. These awards, amongst others, will be presented at the first RCGP Scotland Gala Awards Evening in December 2009.

COMMEMORATING THE HISTORICAL ROLE OF GENERAL PRACTICE The 60th Anniversary of the NHS was commemorated by a special edition of RCGP News and an exhibition that, after being displayed in Princes Gate, was loaned out for regional events.

Memorial plaque to Dr William Pickles, Aysgarth Institute, erected 1971.

The Heritage Committee has gathered information on the memorials, plaques and statues of GPs that can be found across Great Britain, and it intends to encourage faculties and practices to identify prospective candidates and possible sites for further memorials. The RCGP President will be attending a ceremony to unveil a plaque for RMS McConaghey, the first editor of the College journal, in Dartmouth. The Heritage Committee, using sponsorship money from the Nuffield Trust, recorded seven new oral history interviews of senior members of the College. Four former Chairmen joined a filmed discussion, chaired by Dr Philip Evans, on the relationship of the College to government, 1990–8.

History of General Practice in Wales This project will establish a ‘virtual museum’ database of artefacts and manuscripts that throw light on the history of general practice in the Principality. Practices have been invited to submit old primary care team photographs in order to build a picture of family medicine as it has been practised in Wales.

PROMOTION OF THE PROFESSION

Promoting general practice as a career ‘Possibly the best job in the world’

REACHING OUT TO THE NEXT GENERATION The College has a number of initiatives to promote general practice as a career. The RCGP Careers Helpline acts as a resource not only for students, but also for GPs who wish to return to the profession or switch careers. The College’s student forum provides an online resource offering information and advice, and enables the College to engage with students, medical schools and universities. Currently, 825 forum members are registered and the number is growing. The RCGP is also regularly represented at careers fairs, both nationally and at faculty level. RCGP Scotland supports the Highland Schools Medical Mentor Scheme to encourage school pupils to consider medicine as a career.

Is there life after training? – Yes! The RCGP website has a dedicated careers page designed as a taster of the vast opportunities open to newly qualified and aspiring GPs, covering both clinical and non-clinical roles and career paths.

Promoting the work of the college MEMBERS AND EXTERNAL AUDIENCES Professor Field has regular meetings with key trade press journalists and this has generated several hundred stories in the past year on subjects including revalidation, provider accreditation, the Darzi review, GP federations, Good Medical Practice for General Practitioners, the Pharmacy in England White Paper and the launch of Professor Dame Carol Blackâ&#x20AC;&#x2122;s wellbeing and work report, Working for a Healthier Tomorrow. The RCGP has also successfully targeted Health Service Journal to reach a wider audience of health professionals and policymakers, and now features regularly. GP newspaper and Haymarket Publishing also supported the 2008 national RCGP Primary Care Conference as official media partner. They ran a series of pro-RCGP news stories and interviews in the run-up to the event as well as publishing a special conference edition each day.

Promoting public understanding relating to the nMRCGP The College regularly identifies positive stories on new members and fellows that will be of interest to regional media. GP newspaper also featured a series of articles authored by RCGP members to explain the transition to the new assessment and prepare trainees for the process.

INDIVIDUAL SUPPORT OUR STRATEGIC OBJECTIVES: To develop a strategy to promote the purposes of membership To develop opportunities for networking, mentoring and peer support To ensure effective communication to members of matters affecting general practice and the College To become the portal for members worldwide To strengthen the member focus of the College To enable individual members to fulfil their potential.

Supporting and promoting the purpose of membership ASSOCIATES-IN-TRAINING There are many benefits involved in being associated with the College, particularly for doctors in training. The College has created a membership package to support trainees through the specialty training programme. Trainee members of the College are known as AiTs. The College has a number of ways of supporting this important group of potential members. The New Professionals website has been designed as a â&#x20AC;&#x2DC;one-stop shopâ&#x20AC;&#x2122;

New members being welcomed to the College.

HIGHLIGHTS AT A GLANCE for AiTs to access all the services related to the assessment, certification, the curriculum and membership benefits (www.rcgp.org.uk/gp_training/new_professionals.aspx). The College also offers an AiT Helpline, ‘Meet the College’ events and organises elections for the increasingly active AiT Committee. A virtual tour of the Assessment Centre, which enables trainees to become familiar with the centre before they use it for examinations, has been well received. RCGP Scotland ran the eighth annual GP in Specialty Training (GPST) conference, entitled ‘Tomorrow’s GP’, which attracted nearly 100 GPSTs who heard moving presentations on current issues facing general practice. RCGP Scotland also facilitated a conference for GP trainers, in partnership with NHS Education for Scotland and the Scottish General Practitioners Committee of the BMA. This provided a welcome opportunity for GP trainers in Scotland to attend CSA workshops.

• AiTs and new members supported to prepare for the future • Over 1200 delegates attended the Second Annual National Primary Care Conference

• Regional and local events provide opportunities for networking

• Booklet addressing health inequalities published

• Collaborative mental health forum established • Rural GP network established in Wales • London Faculty journal launched.

The NI Council Fellowship Support Committee provides encouragement and support to members who are interested in fellowship and enables them to share experience through local networks.

PROMOTING MEMBERSHIP New-member ceremonies Four new-member ceremonies have welcomed 426 GPs to the College this year. These ceremonies have been a popular way of marking the transition to membership. A member-wide survey in July 2009 will enable the College to improve the ways in which it develops, promotes and retains members.

UK-wide promotion of membership The Membership Liaison Group continues to act as the voice of members in RCGP Scotland. Discussion topics during the year have included: the RCGP Faculty Review; implementing recommendations arising from the membership survey; and the three new RCGP Scotland awards to acknowledge excellence in general practice in Scotland. The Honorary Treasurers joined the meeting in November 2008 to discuss faculty finances and review the implementation of the new finance package.

Dr Fergus Donaghy (right) from NI receiving his commemorative fellowship certificate from Dr David Johnston, Chairman of RCGP NI.

INDIVIDUAL SUPPORT

Creating opportunities for networking and peer support RCGP ANNUAL NATIONAL CONFERENCE 2008 The College has established this conference as the most respected of its kind in UK primary care. The 2008 Annual National Primary Care Conference, entitled ‘Dynamic Practice: creating solutions for the future’, held in Bournemouth, attracted over 1200 delegates. Dr Don Berwick and Professor Allyson Pollock were among those who gave memorable and thought-provoking lectures and keynote speeches. There were 80 exhibition stands, 79 posters and a daily conference newspaper produced on-site in partnership with GP newspaper, which provided delegates with the opportunity to keep abreast

Dr Don Berwick, President and CEO, Institute for Healthcare Improvement, Cambridge (USA), delivering the John Hunt Lecture to delegates at the RCGP National Conference.

of current issues in primary care. In feedback, delegates said they had appreciated the opportunity to network with colleagues and to inform themselves about developments in primary care.

Helping GPs prepare for the future – central theme for 2009 conference The 2009 Annual Primary Care Conference – ‘Excellence in Practice: winning ways for primary care’ – will be held in Glasgow on 5–7 November. GP revalidation will be one of the central themes for 2009. It will also showcase the latest clinical and policy developments across the UK, include sessions aimed specifically at practice nurses and practice managers, and bring together an impressive range of national and international speakers.

COLLEGE GENERAL MEETINGS The James Mackenzie Lecture was given this year by Professor Martin Marshall, who spoke on ‘Practice, Politics and Possibilities’. The Annual General Meeting (AGM) also saw the presentation of a number of awards, fellowships and honorary fellowships. For the first time a number of new members received their membership certificates at the AGM, following their success in the College’s assessments. The formal business of the AGM included approval of an amendment to the Supplementary Charter of the College, enabling the College to register as a charity in Scotland. A new award, the John Horder Award, recognises staff members who have given exceptional service in promoting the objectives and values of the College. The inaugural award was presented to Jane Austin, former Director of Policy and Communications, who worked tirelessly for the College in a number of challenging roles.

Dr John Horder with Jane Austin and her family at the presentation of his eponymous award.

At the Spring General Meeting the William Pickles Lecture, entitled ‘30 Years on from Alma-Ata: Where have we come from? Where are we going?’, was given by Professor Trisha Greenhalgh.

NETWORKING AT LOCAL AND GROUP LEVEL RCGP faculties offer valuable opportunities for GP networking and peer support. These include meetings for retired members, new GPs and fellows, and a mentorship scheme run in Severn Faculty. The level of activity in faculties continues to grow and an increasing number of administrative and GP hours are funded by the faculties themselves. More collaborative working among faculties has also expanded the services that faculties can provide. As part of a review of faculties, three workshops were held to develop a vision of how the faculty for the future would operate.

Health Inequalities Standing Group The College’s Health Inequalities Standing Group, chaired by Dr Angela Jones, has produced a booklet: Addressing Health Inequalities: a guide for general practitioners. It offers practical examples of how GPs as practitioners, commissioners and community leaders can influence the health of their local population. A conference on the same theme enabled health professionals to share ideas on how to tackle health inequalities. A clinical handbook on health inequalities provides case scenarios that help students understand health inequalities within the context of real situations. The Group has also developed a statement on access to primary health care for failed asylum seekers and other vulnerable migrants, which highlights the impact on the rest of the population of the failure to treat these groups. RCGP Scotland has established a Short Life Working Group on Health Inequalities to respond directly to the growing concerns and higher levels of public awareness around the issue of health inequalities. The Group has produced a guidance/policy document that is tailored to Scottish needs.

Mental Health Forum The RCGP has built on its strong relationship with the Royal College of Psychiatrists to form a collaborative forum on mental health. The forum will bring together practitioners from both generalist and specialist health care, and will develop policy and produce guidance, fact sheets, education resources and articles on mental health. Among its first outputs are leaflets on smoking and mental health, debt and mental health, and asylum seekers.

INDIVIDUAL SUPPORT

Secure Environments Standing Group The RCGP multidisciplinary Secure Environments Standing Group promotes best practice in the provision of care to patients in secure environments. Clinicians, nurses, dentists, pharmacists and offender health managers from all parts of the UK are represented on the Group, which acts as a forum for discussion and a means for disseminating ideas. The Group’s current projects include: • establishing a master’s course on Perspectives in Healthcare in Secure Environments at the University of Lincoln • developing a report on Opiate Maintenance in the Criminal Justice System • a conference on ‘Clinical Substance Misuse in Secure Environments’. The Group has supported the development of a Clinical Network for Secure Environments in Wales, led by Dr Jake Hard. This will provide a forum for discussion and development in a Welsh context, and facilitate networking among GPs working in secure contexts.

Rural Practice Standing Group Under the chairmanship of Dr Malcolm Ward, the Rural Practice Standing Group has developed ways to better represent and engage rural GPs. It presented a model of intermediate care at the RCGP Annual Conference. An RCGP Wales Rural Network has been established to bring together like-minded GPs and other professionals to discuss the issues surrounding rural general practice. In March 2009, RCGP Scotland appointed Dr Susan Taylor to act as the RCGP Scotland representative for remote and rural affairs on the Membership Liaison Group.

Informatics Group Dr Libby Morris took over from Dr Paul Robinson as Chair of the RCGP Informatics Group (recently renamed from the Health Informatics Group). Members of the group represent the College on the Joint GP IT Committee, which includes members of the General Practitioners Committee of the BMA. This year the group has developed professional guidance for GPs on the Shared Record on behalf of the NHS Connecting for Health programme.

Communicating with members about matters affecting general practice and the College RCGP IN THE NEWS RCGP Chairman Professor Steve Field’s monthly e-newsletter to all members and fellows, in which he details his clinical and political activity, has been very well received and is proving a good mechanism for two-way communication. Targeted campaigns included the launch of Good Medical Practice for General Practitioners (2008), which coincided with publication of the Chief Medical Officer’s report on next steps on revalidation, providing the College with an excellent opportunity to convey its key messages of supporting revalidation in the interests of improving patient care. Resulting coverage included the lead story in The Times plus an opinion piece from Professor Field outlining the College stance that the process should be supportive to GPs. The monthly membership newspaper RCGP News is now firmly established as a key channel for communicating College developments. As well as carrying regular updates on CPD, revalidation and e-learning, it has featured interviews with Health Ministers Professor Lord Darzi and Ben Bradshaw MP, and Opposition Health Spokesman Andrew Lansley MP. RCGP Vice-Chair Dr Clare Gerada used the newspaper to launch a discussion paper on the lack of partnership options for younger GPs, which was picked up by the GP weeklies and resulted in Pulse magazine’s biggest ever response on its website. The publication has also seen a steady growth in contributions from individual members and fellows, and approaches from influential figures from the healthcare sector keen to use the College newspaper as a way of communicating their work to GPs.

RCGP INFORMATION SERVICES The RCGP provides specialist information services and resources to keep members updated on professional and clinical developments in general practice. The current series of RCGP information sheets is being replaced by shorter, more user-friendly versions that will be available on the RCGP website. The first new information sheets will shortly be launched and include: • The Value of General Practice • Training to be a GP • Practising as a GP • Statistics in General Practice • About the RCGP.

LOCAL NETWORK COMMUNICATION WITH MEMBERS Faculties continue to communicate regularly with their members by the use of e-bulletins. The three London faculties have launched the London Journal of Primary Care, which features articles both academic and practical in nature aimed at multidisciplinary professionals delivering primary health care. The inaugural edition included an interview with Professor Lord Darzi, and a podcast of the interview was made available on the College website. Severn Faculty has produced its first ‘green’ newsletter covering a range of environmental issues, including sustainable and renewable energy in general practice, and the impact of climate change on public health.

Summaries of the following key reports have been produced during the year and are also available on the website: • Medical Revalidation: principles and next steps (Chief Medical Officer’s report) • High Quality Care for All (NHS Next Stage Review) • Our Vision for Primary and Community Care (NHS Next Stage Review) • Primary Care Federations: putting patients first (RCGP consultation document) • The NHS Constitution (consultation document) • A High Quality Workforce (NHS Next Stage Review) • Health Informatics (NHS Next Stage Review). A progressive series of developments to the RCGP website is being implemented through the College’s new Digital Strategy. These include improvements to website navigation and presentation, and a redesigned homepage.

INTERNAL STRUCTURES & CORPORATE GOVERNANCE OUR STRATEGIC OBJECTIVES: To achieve effective decision-making while ensuring that the membership is appropriately represented To ensure that decisions are made and implemented at the appropriate level within the College.

CORPORATE GOVERNANCE REVIEW Last year’s Impact Report described the Corporate Governance Review. One of the key recommendations was for Council to establish a Trustee Board, which would be responsible for dealing with all trustee matters, leaving Council free to concentrate on strategic and policy issues. In February 2008 Council agreed to establish a Trustee Board as a pilot, and to review it after 2 years. During this time Council members will continue to retain their ultimate responsibilities as trustees. Members of the Council of the Royal College of General Practitioners, 2008–9.

HIGHLIGHTS AT A GLANCE

• Board of Trustees established • New Nominations Committee • Audit Committee to be established.

The Trustee Board was formally established at the AGM in November 2008 and Professor Mike Pringle has been elected as Chair, along with Professors Scott Brown and Jacky Hayden and Dr Helena McKeown as the Council member representatives. The Board will become fully operational from April 2009. An Audit Committee will also be established, which will report to Council via the Trustee Board. The new Nominations Committee, under the chairmanship of Dr Philip Evans, now oversees the process for the election of College Officers and the Chairs of the major committees, as well as ensuring that election and appointment processes used within the College are transparent and effective.

RESOURCES Corporate sponsors

OUR STRATEGIC OBJECTIVES: To ensure the College’s sound financial basis To develop a workforce to meet the needs of the College To provide accommodation fit for purpose To improve College-wide business processes and to ensure effective management of corporate data in line with legislation and best practice To ensure effective risk management processes across all College activities.

Sponsorship of awards and other activities has increased during the year and new links have been made with potential sponsors. It is expected that this income stream will continue to grow through a process of building relationships despite the slowdown in the economy. The formation of the American Friends of the Royal College is a particularly important development. This international affiliate of the College will be open to GPs and physicians from the USA and Canada who do not want to become full members of the College but who wish to support its work.

HUMAN RESOURCES – TO ENSURE COLLEGE EMPLOYEES CAN DELIVER THE STRATEGIC PLAN People Strategy agreed

FUNDRAISING AND SPONSORSHIP

In September 2008 the People Strategy was approved by Council to focus on:

It has been an exciting and formative year for the new Fundraising and Sponsorship Department, with a number of new income streams for the College being put in place.

• organisational development including learning and development

• culture and organisational design

• performance, reward and retention

Capital Appeal The Capital Appeal has been set up to generate funds for a new College building. Over the past 12 months planning for the Appeal has been completed; business contacts have been put in place and a strategy developed for raising funds quickly and cost-effectively once the new building is purchased and planning permission granted. The Capital Appeal will have its own website and information channels so that supporters and members can be kept up to date with the progress on the building.

Legacies This is a new area of fundraising for the College and has the potential to grow into an excellent way for members to help the College plan for the future whilst helping promote high standards in family medicine worldwide. Legacies also provide opportunities to celebrate the life and achievements of the donor. Full details are available from the fundraising department and the RCGP website.

• recruitment and selection. This shift to a more strategic approach has been supported by a restructuring of the HR team. A new HR director was recruited and the business partner model was introduced to encourage partnership between human resources professionals and the managers of the College’s activities. This has raised the expertise in the human resources team and improved the level of support and guidance that can be offered to managers and staff. The team has been able to take a more strategic approach to people management.

Performance, reward and retention In order to measure the retention of high-performance employees the College introduced an employee survey in September 2008. There was an excellent response of 82%, allowing the College to identify the key elements of their working lives that are valued by staff.

RESOURCES

It showed that employees are highly satisfied with their working relationships both with their colleagues and their managers. They were not as satisfied by the current reward package, which is now being analysed by a reward specialist in order to identify a strategy that will attract high-calibre people to the College and will retain high performers. This work includes a programme of job evaluation, an updated appraisal system and the design of a new pay structure. The work is due to be completed by April 2010. An Employee Assistance Programme has been introduced to provide advice on various concerns that employees may have, such as stress management, legal and financial advice and work-related matters.

Recruitment and selection As the College continues to grow successfully we have reviewed the recruitment and selection processes. The HR director has designed workshops for managers to ensure that they are all familiar with best practice, legislation and the College’s processes, and have the skills to recruit the best staff for the job. New guidance has been distributed to managers via the College’s intranet. Objectives for the coming year include an overhaul of induction programmes for new starters and analysis of selection methods and assessments.

Organisational development The College continues to raise the capability of its staff to deliver the College’s challenging goals. An organisational learning needs analysis was undertaken in June 2008. This identified the need for higher-level project management expertise. In response a pilot 3-day course on project management was commissioned. This was successful and led to the design of new project management methodology and initiatives for change management. Management development workshops are being delivered to all managers in the College and this programme will be developed further. A successful away-day for staff was held in June 2008 and again in 2009. It gave employees the opportunity to hear about the College’s strategic plans as well as providing development on a range of subjects, including a presentation from the Vice-Chair on healthy living. In response to the employee survey new initiatives for personal growth will form part of the College’s People Strategy for 2009–10.

Culture and organisational design The results of the employee survey demonstrated a need for a clearer management structure that will help to develop the ‘One College’ approach to integrated delivery of the College’s strategic initiatives. A new management team was introduced in January 2009 to enable us to sustain and enhance the growth in College activities and impact. This will support the organisation better by helping us to work across directorates and departments in a more cohesive and strategic way. The new management team will contribute to the development of strategy and take responsibility for the implementation of the operational plan. A leadership programme is being developed for the new management team, and action learning has been introduced to enhance problem-solving ability.

RISK MANAGEMENT A new, simpler risk management framework for the College has been agreed by the Finance Committee. It is designed to improve the reporting, prioritisation and mitigation of risk in line with best practice and recognised standards. The first round of risk reporting under the new system has been completed. The College has responded to concerns in the press about the security of personal, confidential and sensitive data by developing a new policy to minimise this risk. The responsibilities of officers, trustees, staff and contractors have been clarified. The Records Management Project has ensured that there is clarity on the retention periods for College files by creating retention schedules for each type of record. This should enable easier retrieval of important documents and ensure they are not lost to future users.

HONORARY TREASURER’S REPORT, 2009 INTRODUCTION I am pleased once again to present my report, which shows a very positive year for the College. The College continues to see a rise in membership. In addition activity from grants and other activities continue to contribute to the income of the College. We continue to operate tight financial controls and processes that help us manage expenditure effectively. A monthly management accounting system allows close monitoring for income and expenditure against budget. Once again our auditors have complimented the College’s financial management and systems of internal control. I am grateful to the Budget Managers for prudent financial management.

Dr Colin M Hunter OBE FRCPEd FRCGP FIHM Honorary Treasurer

MEMBERSHIP During the last financial year, College membership has increased from 33,775 at 31 March 2008 to 36,244 at 31 March 2009 (see graph on page 50). It is however very pleasing to note that the underlying trend in the number of members and fellows is upwards, with a clear increase in retention (see graph below). We continue to see a substantial growth in our membership and are now delighted to have 8769 Associates-in-Training (AiTs) as of 31 March 2009. The College offers a package to AiTs that includes costs of certification, InnovAiT (a monthly journal) and other benefits. The package, like the examination, is offered on a cost-neutral basis as agreed by Council. Membership excluding Associates-in-Training, 2006–9 30,000

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HONORARY TREASURER’S REPORT, 2009

FINANCIAL REVIEW FOR 2008–9

I would like to highlight a number of areas.

The College (including the results of its subsidiary) continues to be in an overall strong financial position. This is a significant achievement in the current financial climate. The College’s income has increased by £3.5m to £28.8m whilst net assets have increased by £1.4m to £14m, before an adjustment of £4.3m in respect of the deficit for the closed final salary pension scheme as required by the adoption of accounting standard FRS17. It is noteworthy that the FRS17 deficit, which reduced from £5.2m in 2007 to £2.1m in 2008, has increased to £4.3m in 2009.

1. Accommodation review – move to a new London headquarters building

The College moved from a final-salary pension scheme to a defined-contribution scheme in 2006. The present value of the scheme liabilities stands at £12.9m while the market value of the scheme assets stands at £8.6m. The net assets figure takes into account cash balances held by faculties at 31 March 2009, which stood at £1.7m. The College’s charitable expenditure for 2008–9 was £25.1m, which equates to 87.26% of the income. General funds (before the pension scheme deficit) at 31 March 2009 stood at £1,716k after new designations of £1,090k, and this represents 6% of total incoming resources. Our reserves at the year end are within the parameters set out in the College’s reserve policy. At 31 March 2009, free reserves (those unrestricted funds not invested in certain tangible fixed assets (£1,362k) (2008: (£1,523k)), designated for specific purposes or otherwise committed) stood at £355k (2008: £379k). Reserves will continue to be monitored by the Trustee Board. College Council had agreed a balanced budget for the General Fund of the College, excluding the faculties, for 2008–9 with a planned deficit of £8k. I am pleased to report that careful management of resources has led to a smaller deficit of £6k after designations of £1,090k on the General Fund excluding the faculties. The surplus has largely been achieved as a result of an increase in membership, greater than expected activity in iMAP, proactive management of surplus funds on short-term deposits by the Finance Department and prudent financial management throughout the College. There was a lower than expected uptake in relation to the MRCGP (old examination), which led to a deficit in income of around £600k.

Over the past year we have continued to look at a number of potential sites and buildings, working with our agents Knight Frank. Unfortunately, due to circumstances outside our control we have not been able to pursue any of our preferred acquisition opportunities. The current global financial situation has had a significant effect on property values in the residential super-prime market – which includes Princes Gate. Therefore, it has been challenging to find an attractive offer. However, the benefit of the current property market is that we are able to pursue a number of acquisition options. Our vision remains a modern, state-of-the-art building that will provide significant benefit to the College and its members. The College is still looking to buy a freehold of around 100,000 ft² and is actively considering a number of buildings and sites in zone 1 in Central London, close to major transport links. I am indebted to Officers and other members of the Decision-Making Group who meet fortnightly with our agents Knight Frank, and other professional advisers. A further designation has been made to the accommodation fund, which now stands at £2m.

2. nMRCGP I have previously reported the investment of £2.8m in the development of our high-quality examination. We have a policy to ensure that this development loan is paid off by 2010. A further designation has been made this year of £283k, resulting in a reduction of the deficit to £250k. A full re-costing of the nMRCGP will take place in the summer of 2009. Currently the examination continues to make a loss; a compounding factor in January 2009 was the closure of the Clinical Skills Assessment (CSA) for two days due to snow, with a consequent loss of around £100k, of which £25k was recouped from our insurance. Our insurance cover has been increased to £50k in line with the maximum permissible sum by our insurers.

3. Revalidation Work continues to develop the methodology for revalidation. In the forthcoming year the development and testing of an ePortfolio for revalidation will be a major area of expenditure. The principle is to apply for development funding for revalidation wherever possible, and in particular from the funds made available by Department of Health (England) to the Academy of Medical Royal Colleges.

4. IT and digital strategy We are developing an IT strategy and infrastructure to support current and future activities. This will be business resilient and transferable to our new accommodation. A sum of £300k has been designated to support this work. Digital delivery continues to develop at a pace in the College. A new post, Head of Digital Delivery, has been created to co-ordinate, plan and deliver the digital strategy across the College.

FACULTIES It is pleasing to note that the income from the faculties has increased by £0.4m to £2m. However, activity levels within the faculties vary considerably, with some faculties being highly effective at income generation, particularly through the provision of CPD. A strategy is being developed to further develop faculties as providers of CPD.

TRUSTEE BOARD Council has agreed to set up a Trustee Board with effect from July 2009 for a trial period of 2 years. The Trustee Board will include lay members with special expertise and knowledge, Council members, the Honorary Treasurer and the Honorary Secretary. It will subsume the responsibilities previously carried out by the Finance Committee.

CONCLUSION The College continues to be in a healthy position and in good shape to support the development and implementation of revalidation. We will continue to strive to increase income from sources other than membership fees. We hope in the next financial year to secure a new building that will support our development over the next 50 years. I wish to record my thanks to all the members of the Finance Committee for their invaluable contribution over a number of years as this is the last set of accounts they would have been involved with. I wish also to thank the independent advisers who give their services to the College voluntarily, and to budget holders and finance staff.

Dr Colin M Hunter OBE FRCPEd FRCGP FIHM HONORARY TREASURER

INVESTMENTS The market value of our investments, excluding cash held for reinvestment, has decreased by £830k to £2.7m mainly due to the current global economic crisis. Our fund manager Newton Investment Management Limited marginally under-performed our benchmark by 1.4%, i.e. 15.4% against the benchmark of 16.8%. We have had discussion with Newton on its strategy for the forthcoming months and the Trustee Board will be monitoring the performance on a regular basis.

SUMMARISED FINANCIAL STATEMENTS Statement of Financial Activities for the Year Ended 31 March 2009 Restricted Funds £

Endowment Fund £

Total 2009 £

Total 2008 £

INCOMING RESOURCES Incoming resources from generated funds: Voluntary income Activities for generating funds Investment income and interest receivable Incoming resources from charitable activities: Professional standards Professional development Individual support (includes Membership) Promotion of the profession

1,424 1,266,635 552,949

454,729 186,829 90,260

456,153 1,453,464 643,209

42,625 1,313,053 704,972

8,150,281 2,311,080 10,702,295 437,694

1,403,302 2,858,810 234,694 124,327

9,553,583 5,169,890 10,936,989 562,021

8,696,726 3,793,203 10,177,324 567,453

Total incoming resources

23,422,358

5,352,951

28,775,309

25,295,356

43,828 7,795

19,123

43,828 26,918

37,702 31,554

9,452,181 4,634,088 4,357,618 2,193,107

1,636,958 2,034,989 497,135 302,948

11,089,139 6,669,077 4,854,753 2,496,055

11,195,707 5,615,911 4,080,879 2,154,894

510,304

390,694

21,198,921

4,491,153

25,690,074

23,507,341

2,223,437 1,178,467

861,798 (1,178,467)

3,085,235 -

1,788,015 -

3,401,904 (263,749) (2,960,000)

(316,669) (648,725) -

3,085,235 (912,474) (2,960,000)

1,788,015 (249,560) 2,379,000

Net movement in funds Fund balances brought forward as at 1 April 2008

178,155 2,756,789

(965,394) 6,318,382

1,390,027

(787,239) 10,465,198

3,917,455 6,547,743

Fund balances carried forward at 31 March 2009

2,934,944

5,352,988

1,390,027

9,677,959

10,465,198

Fixed assets Current assets Creditors (amounts falling due within one year) Net current assets

2009 £ 5,522,864 12,550,489 (4,067,394) 8,483,095

2008 £ 6,624,168 10,553,601 (4,574,571) 5,979,030

Net assets excluding pension liability Defined benefit pension scheme liability Net assets including pension liability

14,005,959 (4,328,000) 9,677,959

12,603,198 (2,138,000) 10,465,198

1,716,339 (4,328,000) (2,611,661) 5,546,605 2,934,944 5,352,988

1,902,164 (2,138,000) (235,836) 2,992,625 2,756,789 6,318,382

1,390,027

9,677,959

10,465,198

RESOURCES EXPENDED Costs of generating funds: Fundraising and publicity Investment management fees Charitable expenditure: Professional standards Professional development Individual support (includes Membership) Promotion of the profession Governance Total resources expended Net incoming resources before transfers Transfers between funds Net incoming/(outgoing) resources before (losses)/gains on the revaluation and disposal of investments (Losses) on the revaluation and disposal of investments Actuarial (loss)/gain on defined benefit pension scheme

Balance Sheet as at 31 March 2009

Represented by: Income funds: Unrestricted funds: Free reserves Pension reserves Designated funds Restricted funds Capital funds: Endowment fund Funds

Unrestricted Funds £

INCOME AND EXPENDITURE, 2009 Trustees’ statement The summarised financial statements have been agreed by our auditors, Chantrey Vellacott DFK LLP, as being consistent with the full financial statements for the year ended 31 March 2009. These were prepared in accordance with the Statement of Recommended Practice 'Accounting and Reporting by Charities' 2005 and received an unqualified audit opinion. These summarised financial statements are not the full statutory financial statements and therefore may not contain sufficient information to enable a full understanding of the financial affairs of the Royal College of General Practitioners. For further information, the full financial statements and Annual Report of the Royal College of General Practitioners, and the Independent Auditor’s report should be consulted. The full financial statements were approved by the Members of Council on 23 July 2009 and have been submitted to the Charity Commission. Further information and the full accounts are available by contacting:

Auditor’s statement to the Trustees of the Royal College of General Practitioners We have examined the summarised financial statements set out on page 48.

Respective responsibilities of the Members of Council and Auditor The Members of Council are responsible for preparing the summarised financial statements in accordance with applicable United Kingdom law and the recommendations of the Charities SORP. Our responsibility is to report to you our opinion on the consistency of the summarised financial statements with the full annual financial statements and the Annual Report. We also read the other information contained in the summarised Annual Report and consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the summarised financial statements. We conducted our work in accordance with Bulletin 2008/3 issued by the Auditing Practices Board.

Head of Finance RCGP, 14 Princes Gate, London SW7 1PU mbirungi@rcgp.org.uk Telephone: 020 7581 3232

Opinion In our opinion the summarised financial statements are consistent with the full financial statements and Annual Report of the Royal College of General Practitioners for the year ended 31 March 2009.

Signed on behalf of Council Dr Colin M Hunter OBE FRCPEd FRCGP FIHM Honorary Treasurer, 23 July 2009

Chantrey Vellacott DFK LLP Chartered Accountants and Registered Auditor London, 23 July 2009

RCGP Total Income 2009

Individual support (includes Membership) Professional standards Professional development Activities for generating funds Investment income and interest receivable Promotion of the profession

RCGP Total Expenditure 2009

39% 34% 18% 5% 2% 2%

Professional standards Professional development Individual support (includes Membership) Promotion of the profession Governance

43% 26% 19% 10% 2%

MEMBERSHIP, 2008-9 Over 3000 new members joined the College in 2008–9, spread across all categories of membership. This brought the total membership of the College to 36,244 at the end of March 2009, the highest on record. This figure includes 8769 AiTs, 2835 fellows and 335 international members. The first cohort of successful iMAP candidates became eligible for membership this year, of which 52 applied for membership.

Total membership, 1999–2009

The annual renewal invitation has reminded members to update their email addresses. This facilitates speedy and costeffective interaction between members and other College departments, and supports the College’s environmentally friendly efforts. Further measures were taken this year to increase security of members’ details by showing only part of the user’s password for online access. As at 1 June 2009 a total of 22,704 doctors had renewed their membership. This figure does not include the 7876 AiTs whose membership has also been renewed to date.

38,000

MRCGP pass candidates taking up membership

36,000 34,000

Period

No. of passes

No. taking up membership

Remaining

% take-up

Summer 2000

476

418

87.8

Summer 2001

702

625

89.0

Summer 2002

648

601

92.7

26,000

Summer 2003

841

762

90.6

24,000

Summer 2004

971

865

106

89.0

Summer 2005

1010

699

311

69.2

Summer 2006

1077

928

149

86.2

20,000

Summer 2007

1391

1009

382

72.5

18,000

Summer 2008

679

528

151

77.7

Winter 2000

460

417

90.6

Winter 2001

531

493

92.8

Winter 2002

640

577

90.1

Winter 2003

683

616

90.1

Winter 2004

782

636

146

81.3

Winter 2005

881

446

435

50.6

Winter 2006

978

768

210

78.5

32,000 30,000 28,000

22,000

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

During the year, approximately 3000 new trainees embarked on GP training schemes and have become AiT members of the College, bringing this category to approximately 8800 in total. It is anticipated that an increase in funding for GP training will bring a further increase in the numbers of AiTs in 2009–10. Approximately 2200 AiTs were upgraded to full membership on completion of the nMRCGP, while 115 doctors passed MRCGP[INT] and subsequently applied for membership. Also, 380 lapsed members rejoined the College. The Membership Support Department has continued to provide a high standard of customer service to those joining the College and those enquiring about the benefits of membership. Personal contact has proven effective in reducing the number of members letting their membership lapse this year. An enhanced service is being planned for new international members to make subscriptions, benefits and membership application smoother and easier to understand.

Winter 2007

940

473

467

50.3

Winter 2008

332

229

103

68.9

PATRON, PRESIDENT & MEMBERS OF THE COUNCIL OF THE ROYAL COLLEGE OF GENERAL PRACTITIONERS, 2008-9 Patron HRH The Prince Philip, Duke of Edinburgh

MEMBERS OF COUNCIL The members of Council at 31 March 2009 were:

President and Officers President Prof. David Haslam CBE PRCGP

Chairman Prof. Steve Field FRCGP

Vice-Chairman Dr Clare Gerada MBE FRCGP

Vice-Chairman Dr Has Joshi FRCGP

Honorary Treasurer Dr Colin Hunter OBE FRCGP

Honorary Secretary Dr Maureen Baker CBE FRCGP

Other members Dr Kate Adams MRCGP Dr Janice Allister FRCGP Dr Tina Ambury FRCGP Dr Sati Ariyanayagam MRCGP Dr Paul Armstrong FRCGP Dr Ken Aswani MBE FRCGP Dr Tim Ballard FRCGP Dr Mike Bewick FRCGP Dr Sunil Bhanot FRCGP Dr Stuart Blake MRCGP Dr Howard Bloom MRCGP Prof. Scott Brown FRCGP Dr Malcolm Campbell FRCGP Dr John Chisholm CBE FRCGP Dr Frances Cranfield FRCGP Dr Paul Creighton FRCGP Dr Richard Darnton MRCGP

Dr Peter Davies MRCGP Dr MeiLing Denney FRCGP Dr Robert Dickie FRCGP Dr John Dracass MBE FRCGP Dr Jill Edwards FRCGP Dr Philip Evans FRCGP Dr Simon Gregory FRCGP Dr Janet Hall MRCGP Dr Kamila Hawthorne FRCGP Prof. Jacky Hayden FRCGP Dr Iona Heath CBE FRCGP Dr Alison Hill FRCGP Dr Steve Holmes FRCGP Dr Christine Johnson FRCGP Dr David Johnston FRCGP Dr Jean Ker FRCGP Dr Mike Knapton FRCGP Dr Rhona Knight FRCGP Prof. Mayur Lakhani CBE FRCGP Dr Ken Lawton FRCGP Dr Stephen Lynch FRCGP Dr Helena McKeown MRCGP Prof. Martin Marshall CBE FRCGP Prof. Nigel Mathers MRCGP Dr Kay Mohanna FRCGP Dr Robert Mortimer FRCGP Dr Steve Mowle FRCGP Dr Kate Neden FRCGP Dr Bridget Osborne FRCGP Prof. Mike Pringle CBE FRCGP Dr Bill Reith FRCGP Dr James Rodger FRCGP Dr Clare Seamark FRCGP Dr Mary Selby FRCGP Prof. Dame Lesley Southgate DBE FRCGP Prof. Nigel Sparrow FRCGP Dr Andrew Spooner FRCGP Dr Vik Tanna FRCGP Dr Noel Tinker MRCGP Dr Victoria Tzortziou MRCGP Prof. Valerie Wass FRCGP Dr David Wood FRCGP

Observers on Council Mrs Ailsa Donnelly Chair, Patient Partnership Group Prof. Amanda Howe FRCGP Society of Academic Primary Care (SAPC) Observer on Council – shared with Prof. Paul Wallace Dr David Jewell MRCGP Editor, British Journal of General Practice Dr Terry John MRCGP General Practitioners Committee Dr Malcolm Lewis FRCGP Committee of General Practice Education Directors (COGPED) Dr Alec Logan FRCGP Deputy Editor, British Journal of General Practice Dr Sabyasachi Sarker British International Doctors’ Association Col. RG Simpson FRCGP Armed Forces Group Dr Rafik Taibjee Deputy Chair, Associates-inTraining Committee Dr Clare Taylor Chair, Associates-in-Training Committee Dr Richard Vautrey MRCGP General Practitioners Committee Prof. Paul Wallace FRCGP SAPC Observer on Council – shared with Prof. Amanda Howe

QUEEN’S BIRTHDAY AND NEW YEAR HONOURS LISTS RCGP members honoured in the Queen’s Birthday Honours List, June 2008 ORDER OF THE BRITISH EMPIRE Member of the Order of the British Empire Dr Kumar Jayant Shamrao Kotegaonkar General medical practitioner For services to health care and to education in Bury

RCGP members honoured in the New Year Honours List, December 2008 ORDER OF THE BRITISH EMPIRE Commander of the Order of the British Empire Dr Patricia Anne Hamilton [former] President, Royal College of Paediatrics and Child Health For services to medicine

Officer of the Order of the British Empire Dr James Alan Harvard Cave General medical practitioner For services to health care in Berkshire

Member of the Order of the British Empire Dr Rosalie Dunn General medical practitioner For services to the community in Blantyre, Lanarkshire

Member of the Order of the British Empire Dr Alan William Thomas Melville General medical practitioner For services to health care in Fife

SUPPORTERS The Royal College of General Practitioners is most grateful to all those individuals and organisations who have continued to support the College and its activities during the year including: 3M Health Care Abbott Nutrition ACER Medical Technology Ltd Alchemy Pharma Allen & Hanburys AMA Services AmDel Amdipharm AMO UK Ltd Ashfield Healthcare Ashley House PLC Association of the British Pharmaceutical Industry (ABPI) Astellas Pharma Europe Ltd AstraZeneca Astron Clinica Barclays Bank Beecham Research Boehringer Ingelheim Boots BPAS Bristol-Myers Squibb Britannia Medicare British Heart Foundation BUPA Cardinal Health Lord Carter of Coles Central and North West London Mental Health NHS Trust Century Pharmaceuticals Ltd Cephalon Chest, Heart & Stroke Scotland Child Bereavement Charity Consort Healthcare Cost Cutters UK Department for Work and Pensions Department of Health Department of Health Research and Development Directorate Depression Alliance Scotland Dermal Laboratories Ltd Diabetes UK Doctor magazine Doctors.net.uk e-Learning for Healthcare Edinburgh Pharmaceuticals Eisai Eli Lilly & Company Ellman Euromed Ltd

Falcon Health Care The Forster Company Fresenius Kabi Galderma UK Galen Gemini GlaxoSmithKline GP newspaper Health Protection Agency Heart Research UK Helix Healthcare Ltd Hidden Hearing Innovex (UK) Ltd International Futures Forum Institute of Healthcare Management Janssen-Cilag UK Ltd Kirby Warrick LEO Pharma Leonard Cheshire Disability Linderma Lundbeck Map of Medicine MBNA MDDUS Medic to Medic Medical Defence Union Medical Insurance Consultants (MIC) Medical Protection Society (MPS) Menarini Merck, Sharp & Dohme Ltd MIA General Insurance Millennium Healthcare Munro & Forster Communications National Association for Patient Participation National Patient Safety Agency National Society for the Prevention of Cruelty to Children (NSPCC) Nexus Healthcare NHS Diabetes NHS Education for Scotland NHS Health Scotland NHS Information Centre NHS Networks NHS Quality Improvement Scotland Norgine North East Lincolnshire Care Trust Plus Novartis Novo Nordisk The Nuffield Trust

Nursing & Midwifery Council Oldham PCT Omega Trust Pasante Healthcare Pfizer UK Phoenix Medical Primary Care Mental Health and Education (Primhe) The Priory Group Procter & Gamble The Prostate Cancer Charity ProStrakan Provalis Healthcare Quantum Healthcare Reckitt Benckiser Recordati Reed Elsevier RNIB RNID Roche Products Ltd Royal Australian College of General Practitioners Royal College of Nursing Sandoz UK Sankyo Pharma UK Ltd Sanofi-Aventis Schering-Plough Scottish Development Centre for Mental Health Scottish Government Scottish NHS Boards Servier Laboratories Ltd Shire The Society for Academic Primary Care (SAPC) Solvay Healthcare Takeda UK Ltd Tanita UK Ltd Teva UK Ltd Trinity-Chiesi Pharmaceuticals Typharm Ltd UCB Pharma Ltd UK Association of Physician Assistants WeightWatchers Welsh Assembly Government West Midlands Deanery West Midlands NHS Trust (NIHME) World Health Organization Wyeth UK

Promoting excellence in family medicine

14 Princes Gate, Hyde Park, London SW7 1PU Tel 020 7581 3232 Fax 020 7225 3047 Email: info@rcgp.org.uk www.rcgp.org.uk Registered Charity Number 223106 ISBN 978-0-85084-327-9