Royal College of Physicians of Ireland
Governance Implementation Programme
With over 11,000 trainees and members, a history going back to 1654 and governing charters granted by royal decree, modernising the governance of Royal College of Physicians of Ireland was always likely to be a challenging task.
In 2017, the Council of the RCPI commissioned external consultancy firm, EY, to carry out an independent review of governance within the College and to make recommendations on the changes required to bring the College governance in line with best practice.
The implementation programme, which stretched over three years, commenced with establishment of a Governance Oversight Group. Five key projects and working groups were established, meeting on a quarterly basis to oversee implementation of specific projects as detailed:
- Governance Improvements: Included a full review of RCPI Council, establishing an Executive Board and a new Institute of Medicine
- Committee Reorganisation: Involved review and rationalising over 150 committees within the College and implementing a series of policies relating to committee governance. As part of this review, a number of committees were merged or dissolved and new committees established as required
- Clinical Framework: Under this workstream, the College reviewed all roles held by clinicians – both paid and voluntary – to ensure that there were clear and transparent appointment procedures, role descriptions and better engagement with our members in improving the standard of training and education of doctors in Ireland
- Operating Model: To ensure that the College’s operations and services were aligned with the governance structures and to implement new departments within the College, such as Health and Wellbeing.
- Training Site Presence: This project is underway to launch RCPI offices across Ireland to ensure local support to our trainees and trainers. To date, RCPI offices have been launched in Cork, Galway, Limerick and Dublin.
A number of significant changes have been implemented within RCPI as part of this programme. Most notably, the full review of RCPI Council:
RCPI Council – review and restructure:
The EY review and subsequent implementation programme highlighted issues relating to the structure and composition of the College Council. These included:
- Membership too large and not fit for purpose.
- Council had no clear terms of reference and there little understanding from trainees, members and staff as to what their role was.
- The volume of committees with a direct line into Council was excessive (39). The EY review recommended establishing an Executive Board, with delegated responsibility from Council for operational and financial management of the College.
An action plan for the reform of Council, including significant changes to College By-Laws, was approved by RCPI Council in 2019 and implementation commenced earlier this year. The key changes implemented include:
- A reduced Council membership from 38 to 22 members.
- Council membership is now focused on elected representation, with seats available to representatives of each Faculty of the College and increased trainee representation.
- A full review of the role of the President has been conducted, with an updated role description approved on time for the 2020 election of the new President.
- A full list of matters reserved and delegated was approved, providing clarity over approval levels within Council and the Executive Board.
- Implementation of an Executive Board, Governance and Nominations Committee and Finance, Audit and Risk Committee.
In addition to the Council review, other initiatives have been implemented to improve on governance within RCPI, including:
- Development and launch of the Institute of Medicine – Ireland’s newest postgraduate medical training body to oversee training, education and examinations across 17 clinical medicine specialties.
- Developed a series of policies including conflict of interest and code of conduct
- Developed and organised induction for Council members.
- Commenced reviews of the governance within each of the Faculties. This work is ongoing but significant progress has been made.
- Conducted a call for expressions of interest from members of the public to join RCPI Boards and Committees. Approximately 20 new committee members (who are not doctors) will be appointed in 2020 to provide advice and expertise from a public perspective.