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Changing RCEM in response to the Charity Governance Code

30 July 2020

The Royal College of Emergency Medicine is a registered charity and is therefore bound by all the various rules and regulations surrounding charities.

It is a body incorporated by Royal Charter and so its governance arrangements, similar to the other medical Royal Colleges are rather unique. At the moment the Trustees of the Charity are the Officers of the College, the national VPs and regional chairs, the Lay Chair, and some other committee chairs. Together they are responsible for how the College is run. The Trustees are also responsible for the College employees, managed by the Chief Executive. The College staff do a brilliant job ensuring that the organisation runs smoothly and effectively.

Charities are regulated by the Charity Commission and the Office of the Scottish Charity Commission. Being a Trustee comes with significant responsibilities. These have been brought into focus with some high-profile failures in other organisations recently. Within the current arrangements the Council of Trustees has to concern itself with the governance of the College as well as the development of the specialty of emergency medicine. It’s a big ask to expect emergency physicians with full time jobs to do it well. At the same time we’ve had some concerns that our governance at RCEM could be improved. Whilst we have worked hard to get it right, it was felt that we needed to refresh the way we operate and become even more rigorous in accordance with current best practice guidance for Charitable bodies. This in no way means that we have done anything wrong: our financial stewardship has been excellent and we don’t believe we have any significant undetected problems.

Charity Governance Code
Recently the Charity Governance Code for larger charities was published. It’s not a legal requirement to follow this code but it is good practice and is recommended by the Charity Commission. This gave us an opportunity to review our own our own governance against some published standards, and we have done so. We are in good company. Many other Royal Colleges have gone down a similar path. The RCEM review, co-chaired by Ian Higginson as the former Registrar, and Carole Gavin the current VP Membership, with excellent support from Gordon Miles our CEO, has now made its recommendations. The recommendations need to be expressed as changes in our Charter, Ordinances and Bye-Laws. This means they need to go through the Privy Council because we are a Royal College. Now seems to be a good time to brief our membership on our proposals, because eventually they will need to be agreed by all of us, as Fellows and Members of the College. The proposals will be formally tabled at the AGM this year.

Central to the aim of the Code, is to reform Trustee Boards so that they are smaller in size, with an optimum size of 12 being described. Other medical Royal Colleges have tackled this by separating their Council (which concerns itself with specialty matters) from their Trustee Board (which then concerns itself with the strategy and governance of the College). This is then made workable by creating a bridge between the two by appointing roles which sit on both, to give continuity.

Changes we are making
At their heart the proposals we are making, after careful deliberation, are relatively simple and similar to those adopted by other Colleges. We are proposing to establish a board of Trustees who will assume responsibility for the effective running of our College. The board will consist of 12 people, of whom four will be lay, four will be College Officers, and four will be appointed members of the College of whom no more than two will sit on Council. The chair of the Board of Trustees will initially be the President, although this is allowed to change in the future. This arrangement will allow a smaller group of Trustees to focus on the core business of running the College, keeping themselves up to date with the various regulations and skills that go into Charity Governance.

The College Council will become a professional advisory body, allowing its members to focus on professional matters and advise the Trustees appropriately where this plays into how College is run or where key financial decisions are made. All committees of the College except the Corporate Governance Committee and the Appointments Committee will report to Council. The various roles and responsibilities of the Trustees, Council Members, and College staff will be clearly laid out in a scheme of delegation.

Voting and elections
We are taking the opportunity to review senior College posts and in particular we are proposing that we broaden the College electorate to include all Fellows, Associate Fellows and Members (excluding Honorary Fellows, Associate Members and Affiliates), who shall be entitled to vote in the election of the President and other members of Council. We are making sure that in the future there is provision for all parts of our membership, including ACPs and other senior clinicians, to participate in College Elections, possibly through reintroduction of the Member by Election category.

We have of course consulted our legal advisors to ensure that any potential risks inherent in complying with the Charity Governance Code have been considered and mitigated as much as possible by the drafting of the ordinances and bylaws. We will remain a professional and inclusive membership organisation and the key functions that we undertake around education, specialist training, defining and promoting quality and high standards in emergency medicine, supporting research, and developing our international work will all continue. We will need to place our trust in our appointed Trustees and the College team, to ensure RCEM will be well run to meet its core objectives under its charter and charitable status as we enter the next stage of our development. These changes should equip us for the future.

Royal College of Emergency Medicine Code of Conduct

In parallel with the corporate governance review and the work to bring us into alignment with the recommendations of the Charity Governance Code we have also developed a Code of Conduct for our Members and Fellows. Most other medical Royal Colleges already have well established codes of conduct for their members and this is another strand of our work to improve our governance procedures as a mature organisation. The Code is intended to provide a clear set of expectations as to how Members, Fellows and Affiliates of the Royal College of Emergency Medicine (RCEM) conduct themselves in accordance with the stated RCEM core values of an Emergency Clinician. The principle aims of the Code are to uphold the professional reputation of the College and ensure that all of its Members and staff are treated with fairness and respect according to best practice regarding equality and diversity. The Code is intended to be used as an adjunct to guidance provided by the GMC and other Professional bodies and does not diminish an individual’s duty to act in accordance with their employing organisation’s requirements and their contract of employment.

Complaints about the College or allegations of misconduct regarding individual members are fortunately very rare. However it is important that if complaints are made that there is a fair process to allow them to be investigated without prejudice, and in accordance with a clearly defined framework. It is not the College’s role to investigate complaints from patients or other members of the public or to be involved in any investigations regarding alleged clinical competency issues which would come under the remit of the member’s regulatory body or employer. However, it may be the case that if a member is erased, or sanctions imposed by, their regulatory body that the circumstances leading to this may constitute a breach of the Code and thereby subject to investigation under the College’s Disciplinary Proceedings Rules. Other possible triggers for an investigation could include misconduct in exams, plagiarism of RCEM educational material or branding or allegations of behaviour constituting discrimination, bullying or harassment, intimidation or sexual harassment during the course of College activities or events. The Code compliments recent separately developed codes around Examinations and Events.

Legal input
The newly developed Disciplinary Proceedings Rules have been developed with input from our legal advisers and have been incorporated as new College Byelaws. They clearly set out the process that should be followed when deciding whether an investigation should be commenced and at each stage of the investigation process. The Rules also set out the process whereby a member may appeal the findings of the investigation. Various membership sanctions may be imposed if the investigation panel finds that the Code has been breached ranging from termination of College membership to a formal apology for the behaviour that lead to the complaint.

Whilst it may seem to some members that the Code of Conduct and Disciplinary Rules appear unnecessarily autocratic, learning gained from a small number of previous incidents has taught us that the best way to protect all of our members and staff, and to ensure fair and supportive management of any allegations of misconduct, is to have a transparent formal process that has been subject to legal scrutiny. By developing the Code of Conduct and the Disciplinary Proceedings Rules we hope to reassure you all that we now have the appropriate procedures in place to ensure that this is the case.

Ian Higginson Vice President
Carole Gavin, Vice President (Membership)
Gordon Miles, CEO

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