RCP invites members to comment on Leng review draft clinical protocol for physician assistants

Update: The Leng review has today (9 October) agreed to the RCP’s request to extend the 6-week consultation deadline to allow more time for fellows and members to consider the draft protocol and share their views, as well as for RCP Council to consider the college’s response. Fellows and members now should log in to the RCP website to read the draft protocol and share feedback by Monday 2 November.  

The draft protocol has been developed by the Leng review as part of the process for implementing its recommendations. It focuses on teamworking and the circumstances in which PAs may see undifferentiated patients, including the supervision and governance arrangements that should apply.

The document is an external draft for targeted stakeholder consultation and does not represent agreed national guidance or RCP policy. The Leng review implementation process is seeking organisational responses from stakeholders, rather than individual submissions. The RCP is therefore gathering feedback from across its fellowship and membership to help shape a single, coordinated response.

The RCP is undertaking extensive engagement on the draft protocol through its established representative structures, including its network of more than 30 medical specialties, RCP Council, career-grade committees, networks and regional advisers. Collectively, these groups include hundreds of elected and appointed representatives from across the membership and fellowship.

To support wider engagement and transparency, the RCP has also made the draft protocol available to all fellows and members through its website and is inviting their views to inform an organisational response. More details can be found behind the membership log-in.

RCP president Professor Mumtaz Patel said:

‘We recognise the strength of feeling on this issue and the importance of ensuring that the views of our fellows and members are reflected in the RCP’s response to this draft protocol, which is being discussed widely through the college’s representative structures. 

‘With permission from the Leng review, we are now also making it available on our website so that fellows and members can share their perspectives with us. All feedback received will be carefully considered before a final organisational response is agreed and signed off by RCP Council.’

Fellows and members can access the draft clinical protocol through the RCP website. Comments should be submitted by 5pm on Monday 02 November 2026 to allow the RCP time to review the feedback, coordinate its organisational response and complete the necessary governance and sign-off process. Details of how to share feedback are set out behind the log-in.

The RCP will review all feedback received and use it to shape a single organisational response to the consultation. The final response will be signed off by RCP Council.

The RCP does not own this draft protocol and has not been responsible for developing its content. Making it available to fellows and members should not be interpreted as RCP endorsement of the document or its recommendations. It remains a draft for consultation and does not represent agreed national guidance.

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