Consultations update: latest RCR responses

RCR responds to the NHS Constitution 10-year review, the Public Accounts Committee’s consultation on modelling behind the Long-Term Workforce Plan, and the GMC’s consultation on the regulation of medical associate professions

The RCR has responded to the Department of Health and Social Care’s call for evidence as part of its 10-year review into the NHS Constitution. 

The consultation covered a wide range of topics that the previous Government had indicated they wished to include within the NHS Constitution. We worked with our Education, Diversity and Inclusion Committee to formulate our response.

We supported the addition of pledges aimed at providing information to patients and loved ones and listening to their concerns, reducing healthcare disparities, promoting clinical research, and recognising the importance of unpaid carers and volunteers. We made the case for medical professionals in leadership roles, which has a positive effect on patient safety and service efficiency. We opposed pledges to alter the NHS Constitution with regards to how it speaks about sex and gender reassignment for reasons of non-necessity, unclarity and impracticality. All patients deserve to receive the care they need and to feel confident and comfortable with how that care is being provided.

The RCR has submitted a response to the Public Accounts Committee’s consultation into the NHS England’s modelling for the Long-Term Workforce Plan (LWTP).

In our response, we highlighted the urgent need for the NHS to improve staff retention – this being an under-developed aspect of the LTWP’s first iteration – by improving working conditions, ensuring sufficient time for training and development, and enabling flexible working arrangements. 

We also pointed to the current gap between the LTWP’s plan to expand the number of medical school places and the lack of detail on whether and how foundation and specialty training places will be expanded. These need expanding commensurately to avoid exacerbating the already acute training bottlenecks that some specialties, including radiology, face.

The election of a new government presents an opportunity to look again at the LTWP and to address some of the first iteration’s shortfalls, before presenting an update to Parliament and the country.

In December 2023, the government asked the GMC to begin to regulate physician associates (PA) and anaesthesia associates (AA). The GMC have now developed draft principles and frameworks for that regulation and have opened a consultation to gather feedback on those principles. The RCR has now submitted its consultation response to the GMC. 

We noted that the GMC’s proposals create extra responsibilities for trainers – often consultants or junior doctors – for the training and supervision of PAs. This is a cause for concern, because we know from RCR censuses that our members already do not have enough time to train. Moreover, we know that one factor contributing to the fact that not all expansion training posts in clinical radiology have been taken up is the fact that training programmes already lack the time and resources to take on additional trainees. 

We called for much greater detail on how junior doctors’ training will be protected, and for more information on how PAs will receive specialty-specific training. Ultimately, neither junior doctors nor PAs will be well served by expecting the same, already over-stretched trainer workforce to do more training with fewer resources. 

We were also gratified that the GMC are now proposing to include a prefix to the GMC number for PAs. We believe this should provide the necessary distinction, provided the prefix makes it clear to the layperson that PAs are not doctors. 

The JRF and OFR said: 

"We are pleased to see the RCR taking the important issue of MAPs seriously and the impact this will have on training. We will continue to work together with the RCR and ensure we advocate the national trainee voice. The training of our future radiologists and oncologists must always be protected and remain a priority across the UK." 

Dr Priyanka Singhal Chair of the Junior Radiologists' Forum and  
Dr Alexander Pawsey Chair of the Oncology Registrars' Forum