2020-12-31-accounts

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Annual report 2020

Supporting our members in a year like no other

Contents
About the RCP	1
Foreword from the RCP president	2
Chair’s report	4
CEO’s report	5
Report of trustees	6
1Improving care for patients	7
2Developing physicians throughout their careers	13
3Leading and supporting our members	19
4Shaping the future of health and healthcare	25
5Investing in our future, building on our heritage	31
Our ambitious plans to improve diversity and inclusion	37
RCP at The Spine	38
Our strategy for 2022–25	40
RCP boards, committees and lists	41
Financial policies	46
Structure, governance and management	50
Statement of trustees’ responsibilities	52
Treasurer’s annual report	55
Independent auditor’s report to the trustees of the RCP	58
Consolidated statement of fnancial activities	61
Consolidated and RCP balance sheets	62
Consolidated statement of cash fow	63
Notes to the fnancial statements	65

RCP annual report 2020

About the RCP

The Royal College of Physicians (RCP) is a professional membership body for physicians, with over 40,000 members and fellows around the globe working in hospitals and communities across 30 medical specialties. Physicians diagnose and treat illness, and promote good health. They care for millions of medical patients with a broad range of conditions, from asthma and diabetes to stroke and yellow fever.

Everything that we do at the RCP aims to improve patient care and reduce illness. Our work is patient centred and clinically led. We drive improvement in the diagnosis of disease, the care of individual patients and the health of the whole population, both in the UK and across the globe. We work to ensure that physicians are educated and trained to provide high-quality care. We also develop doctors to become leaders, providing advice and expertise to deliver service improvements across the NHS and more broadly.

to ensure that the charity’s purpose accords with the objects set out in its governing document (the charter). Uniquely for the time, through the charter the king established the RCP in perpetuity as a professional body in the name of the public benefit. He empowered it to set standards by regulating practice, to protect the public.

Our vision and mission

Our vision is the best possible health and healthcare for everyone. As the leading body for physicians in the UK and internationally, we work to achieve our vision by:

influencing the way that healthcare is designed and delivered
promoting good health and leading the prevention of ill health across communities

Today the RCP continues to focus its work to support high standards of medical training and patient care through activities within the meaning of charitable purpose as defined by the Charities Act 2011 that are carried out for the general public benefit. In particular, most of our activities fall within the purposes of the advancement of health or the saving of lives; the advancement of education; and the advancement of the arts, culture, heritage or science.

supporting physicians to fulfil their potential.

Our values

We are committed to taking care, learning, and being collaborative. These values drive the way we behave, how we interact with each other, and how we work together to achieve our vision and improve patient care.

Public benefit

Our work in these areas is made possible through the involvement of our fellows and members wherever they work, in the UK or overseas, and is summarised annually in this report.

The Royal College of Physicians (RCP) was established by royal charter in 1518. It is a registered charity, and the trustees are mindful of their duty

RCP annual report 2020

Foreword from the RCP president

Andrew Goddard, RCP president

‘A year like no other’ seems an understatement to describe 2020. Physicians across the world have been at the forefront of the response to the COVID-19 pandemic which, as I write this in the spring of 2021, continues to influence much of what we do.

I have always said the RCP is not its buildings or treasures but its people – the members, fellows and staff. When called upon in the past year all have stepped up and shown the RCP in its best light. We have seen the physician body collaborate and innovate, rapidly adapting both clinical ways of working as well as those related to research, education and training. This has been the case not just in the UK but across the globe and I have never been prouder to call myself a physician.

The pandemic has taken its toll on both the public and the profession. For the former, the health inequalities in our society have been brutally exposed and reinforced the importance of public health and underinvestment in health services over the past decades. We knew health inequalities were an issue before the pandemic and had started bringing together the Inequalities in Health Alliance before the first wave hit. This united front by health charities and other groups is one of our most important achievements last year.

The fragility of our own workforce has also been shown in all too much detail, both with respect to understaffing but also the effect of COVID-19 itself. In the first wave in 2020 a fifth of physicians contracted COVID-19 and sadly many died. That most of these physicians were from minority ethnic backgrounds was a wake-up call to us all. The loss caused by the death of colleagues and close friends will stay with us forever. For the RCP, the death of our registrar, Professor Donal O’Donoghue was the biggest personal tragedy we have seen in my 18 years working for the college.

The pandemic has resulted in very different ways of working for the RCP, some of which were needed and some most unwanted. The cancellation of face-to-face meetings was a big blow to our income and thus finances. The rapid development of alternatives including the RCP Player and virtual conferences has shown our adaptability and I must thank all our staff for continuing to work so hard throughout the year. We have dramatically increased our profile in 2020 and, in a time when everyone has an opinion, ours has been always seen as the trustworthy one.

RCP annual report 2020

It was undoubtedly the hardest year for us financially for many decades. We have had to make some difficult decisions and consider options unpalatable to some. We have, though, survived while other charities have not been so lucky. Our metaphorical belt will need to remain tight for the next couple of years.

Donal, if he were here, would want us to focus on the positive achievements of 2020, many of which bear his fingerprints. This report lays these out by the different themes of our strategy but the two of which he would be most proud are at the end of the report. Our work to improve the diversity of the RCP and its inclusion of people from all backgrounds achieved a major milestone this year. We must build on the Summerskill report in 2021 and beyond. Our vision of The Spine has also been realised, with the first exams taking place within its walls in May 2021. I hope Donal would be proud of the wall that will bear his name in that building.

Future generations of physicians will look back at 2020 and see it as a turning point for medicine in many ways. We have been challenged as never before but have shown what we can achieve. When the going gets tough, the RCP has shown it gets going.

RCP annual report 2020

Chair’s report

David Croisdale-Appleby, chair of Board of Trustees

The advent of a global pandemic presented the RCP with some major challenges in 2020. Securing the future of the RCP became the principal focus of the Board of Trustees, particularly in relation to the substantial reduction in our income due to the cessation of exams and severe curtailment of events and conferences.

However, much is expected of us by our fellows and members across the globe, our staff, and our audiences in the government, NHS, media and wider health sector – all of whom look to the RCP for informed views, clarity of communications, and solutions to problems. I think the RCP has delivered against those high expectations. It is a privilege to lead the trustees in overseeing this delivery and I wish to express my appreciation for the huge contribution they have made to the RCP in such challenging circumstances. The advances made by the RCP have been impressive, such as seeing RCP at The Spine in Liverpool through to successful completion, and making great progress in the vital area of driving forward our ambitious equality and diversity agenda.

In addition to ensuring the financial stability of the RCP through the pandemic, we are in a position to return to financial break-even in 2021/22 despite the continuing extreme pressures caused by COVID-19 and its effect on the economy. I and my fellow trustees share a great deal of optimism as we emerge from the shadow of the pandemic with the determination to continue to provide leadership to all those served by the RCP.

RCP annual report 2020

CEO’s report

Ian Bullock, chief executive

The year 2020 started with RCP at The Spine becoming real and construction progressing well, marking the culmination of a 5-year vision. This wonderful building, our new northern home, reflects our desire to increase engagement and relevance with a growing membership.

As the looming shadow of a global pandemic crept ever closer it was clear that we were about to enter perhaps the most challenging time in recent RCP history, with the Spanish flu in 1918 the closest historical comparison.

In mid-March 2020, the RCP transformed overnight into a digital organisation with our support services in IT and HR ensured a smooth transition and minimal disruption. Working at home became the norm and, despite the challenges, our staff responded innovatively and diligently. They worked flexibly alongside caring commitments, home schooling, changing circumstances, family illness and bereavement. Supporting staff wellbeing became key across the RCP, modelling our values of taking care, learning and being collaborative. For many, the experience has made them more resilient, while for others the pandemic remains a huge shadow in their lives.

It has been a very difficult year personally and professionally for most of us, though. The impact on RCP finances has been enormous, and the response from staff to minimise this has been remarkable. I would like to thank the staff, officers and volunteers of the RCP, who have enabled us to develop an even stronger influence on healthcare decision making and delivery, and to ensure our core charitable purpose was realised in 2020 – both of which are reflected in this annual report.

RCP annual report 2020

Report of trustees

The trustees of the RCP present their annual report for the year ended 31 December 2020. The report presents the RCP’s activities, significant achievements and successes in 2020 against plans derived from the 5-year strategy covering 2015–20 and is set out under the five key strategic themes:

Improving care for patients
Developing physicians throughout their careers
Leading and supporting our members
Shaping the future of health and healthcare
Investing in our future, building on our heritage

During 2020, we consulted widely with our stakeholders and plan to launch our new strategy at the end of 2021. This will guide our planned activities from 2022–25. There is more information about the development of our new strategy on page 40.

The Federation of the Royal Colleges of Physicians

The Federation of the Royal Colleges of Physicians is a collaboration between the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow, and the RCP. Together, the three colleges represent around 60,000 physicians worldwide.

The Federation develops and delivers services to support doctors at every stage of their careers, including:

continuing professional development (CPD)
examinations (Membership of the Royal Colleges of Physicians of the UK – MRCP(UK), specialty certificate examinations and international clinical examinations)
training (Joint Royal Colleges of Physicians Training Board – JRCPTB).

Highlights of Federation activities are included in this report.

RCP annual report 2020

1 Improving care for patients

We want patients to receive the best possible care. We work directly with physicians, clinical teams, hospitals and policymakers to design person-centred services, and involve patients and carers to help shape best practice.

RCP annual report 2020

Our objectives

In 2020, we planned to:

support physicians and multidisciplinary teams to lead quality and service improvement
set, measure and promote standards that improve care for patients
implement our vision of the future hospital and promote good practice in health service design
develop health services that promote patient safety, patient experience, staff wellbeing and service improvement.

Our key achievements

Supporting service improvement

Our flagship Chief Registrar Programme, now in its fifth year, continued to go from strength to strength in 2020. This programme is designed to develop doctors in training with the skills to lead and revolutionise the healthcare of the future. Due to the pandemic we delivered the programme modules virtually this year and increased the support provided by mentors and interaction with the RCP Patient and Carer (PCN). Since 2016, 68 trusts across the UK have supported the programme with 244 chief registrars. The programme attracted 61 participants in 2020/21, despite the impact of the pandemic, and a large proportion led improvements related to COVID-19 in their trusts. High levels of expressions of interest have again been received from NHS trusts for the 2021/22 cohort.

We continued to assess the quality of clinical services through our accreditation programmes for endoscopy, allergy, pulmonary rehabilitation, primary immunodeficiency and liver services. During 2020 and in response to the pandemic, we rapidly redesigned the approach to assessments to reduce the number of assessors on site, and introduced remote review and virtual interviews.

In 2020, over 30 new services registered with our accreditation programmes, and we also:

delivered 30 training events for clinical services and assessors to support them with participating in accreditation
awarded almost 400 certificates to endoscopy trainees to demonstrate competence and accredited over 25 endoscopists to become bowel cancer screeners
collaborated with specialist societies to publish the impact of the COVID-19 pandemic on allergy and immunology services
published the results of the 2019 Joint Advisory Group on GI Endoscopy census together with interactive dashboards for local services to benchmark against national results.

Setting standards

The National Guideline Centre continued to develop, consult on and publish guidelines in 2020. These included publication of guidelines on tinnitus, perioperative care, joint replacement, low back pain and acute coronary syndromes, and consultation on atrial fibrillation, chronic pain, and myalgic encephalomyelitis / chronic fatigue syndrome.

RCP annual report 2020

The RCP continues to be commissioned by NHSE and others to deliver four national clinical audit programmes: the Falls and Fragility Fractures Audit Programme, the National Asthma and COPD Audit Programme, the National Lung Cancer Audit Programme and the National Mesothelioma Audit. In 2020 we published 13 national reports, including reports on adults with COPD; people with asthma in Wales; inpatient falls; pulmonary rehabilitation; lung cancer and fracture liaison services. We also published the National Mesothelioma Audit report which raised the profile of this asbestos-related cancer and reported on care during 2016–18.

COVID-19 impacted hip fracture care in 2020 and the National Hip Fracture Database team were able to identify where rates of non-operative management were high and carried patient safety risks. With the support of funders, the deputy national strategic incident director for COVID-19, and national clinical director for trauma, we provided local units with data to support them to change practice.

We published a range of new guidance to improve care for patients, on topics including using NEWS2 to identify people at risk of deterioration, multiprofessional working on COVID-19 wards, patient safety advice when using PPE, and an updated acute care toolkit on older people living with frailty. We also worked in partnership with the Royal College of Nursing and other organisations to produce new guidance on modern ward rounds.

COVID-19 impacted hip fracture care in 2020 and the National Hip Fracture Database team were able to identify where rates of nonoperative management were high and carried patient safety risks.

RCP annual report 2020

Supporting quality assurance in endoscopy

Our work to develop the National Endoscopy Database (NED) was instrumental in supporting quality assurance in endoscopy. Over 400 services uploaded data to this central store of key procedural data in 2020 and we captured 1 million procedures, making it a unique and invaluable research platform.

Endoscopy quality is known to vary among individual endoscopists and between units. NED has enabled automatic reporting of nationally agreed KPIs which are vital for monitoring the safety and quality of services, and has reduced the burden on each endoscopy unit having to carry out performance audits.

The importance of NED was highlighted in NHS England’s report Diagnostics: recovery and renewal , which recommended mandating participation for the 20% of NHS trusts not already doing so.

NED is now a central source of service intelligence. It has provided an accurate overview of endoscopy workload and workforce, facilitated capacity and demand management and contributed to longer-term planning for endoscopy delivery both locally and nationally.

In 2020, data were used to perform the first national analysis of the impact of the pandemic on endoscopy which demonstrated a substantial and concerning reduction in cancer detection.

Our vision of the future hospital and health service design

Although the Future Hospital Programme drew to a close 3 years ago, we continued to support the 11 principles of patient care published in the groundbreaking Future Hospital Commission report.

Our PCN promoted the message that the future hospital principles must remain a clear and tangible ambition for all partners in healthcare. In 2020 the PCN developed a partnership strategy for 2021–24 which sets out a vision for how patients and carers can support committees, projects, boards and activities across the RCP to achieve co-production and the future hospital vision.

The PCN continued with its ambitious target to support the RCP in all discussions around public and patient involvement and determine where projects sit on the ‘ladder of involvement’.

Developing health services

To improve patient safety, we launched a patient-held steroid emergency card (supported by patient information), evidence-based guidance for professionals, and issued a national patient safety alert calling for organisational action. We provided tailored training for NHS organisations on structured judgement review to facilitate learning and service improvement in trusts.

The Falls and Fragility Fractures Audit Programme published tips to overcome common quality improvement (QI) barriers, and a video for hip fracture services on how to navigate run charts to support using audit data for improvement. We also published an updated guide for patients on the care to expect before and after a hip operation.

RCP annual report 2020

Our work in numbers

5 new NICE guidelines produced

Over 240 chief registrars recruited since the launch of this flagship programme

More than 30 new services registered with our accreditation programmes

The National Asthma and COPD Audit Programme launched a set of guidance documents to support pulmonary rehabilitation services working remotely with their patients to obtain consent to enable their continued participation in the audit as the pandemic reduced face-to-face rehabilitation.

We collaborated with the British Society of Gastroenterology to publish advice and guidance for endoscopy teams on planning their services during the COVID-19 pandemic, and on the use of PPE in endoscopy procedures, environment, service restoration and vaccination.

In digital health we worked collaboratively with key stakeholders including NICE, NHSX, NHS England and the MHRA. We facilitated an RCP partnership with the Liverpool Civic Data Trust, which aims to use insights from integrated health data to improve the health of people in deprived communities. In establishing a partnership with NHSX we now have representation on the NHSX Remote Care Board and NHSX Electronic Referral System Clinical Council. We convened a digital health group to support the Academy of Medical Royal Colleges’ response on advancing the digital health

agenda. We also increased understanding of digital health through a series of webinars, lectures and articles in Commentary magazine, and guest-edited an issue of Future Healthcare Journal focusing on the digital health workforce.

Through the Federation, we developed new quality criteria for medical registrars which we are aiming to implement in 2021.

In 2020 the PCN developed a partnership strategy for 2021–24 which sets out a vision for how patients and carers can support committees, projects, boards and activities across the RCP to achieve co-production and the future hospital vision.

RCP annual report 2020

Looking forward

In 2021, we plan to carry out the following activities:

further develop and expand our flagship Chief Registrar Programme for doctors in training
continue to deliver national clinical audit programmes in COPD and adult and children’s asthma care, falls and fragility fracture care, and lung cancer care
increase the numbers of endoscopy, allergy, immunology, liver and pulmonary rehabilitation services registering and gaining accreditation
promote and deliver guidance and resources for members to improve quality and safety of patient care
publish guidance on improving medicines safety, PPE and improving safety, the hospital discharge improvement
publish learning from structured judgement reviews into COVID-19 cases during 2020 and support physicians and their teams to review patient safety systems
work with NICE, NHS business support units and charities to develop evidence-based advice and guidance
revitalise the RCP Medical Care website, our online guide to service design
continue to influence the development and delivery of the digital health care agenda
work with our Patient and Carer Network to improve involvement in projects and enhance the impact of the patient voice in the RCP.

RCP annual report 2020

2 Developing physicians throughout their careers

Our education and training programmes support physicians to fulfil their potential. We develop doctors to deliver the best possible patient care and become excellent clinicians.

RCP annual report 2020

Our objectives

In 2020, we planned to:

shape the future of the medical workforce in the UK
promote high-quality medical education and clinical leadership across the world
promote lifelong learning for physicians, and accessible opportunities for development
support physicians throughout their careers
promote medicine as a career.

Our key achievements

Shaping the medical workforce

At the end of 2020, 57 trainees were participating in the pilot flexible portfolio training programme, combining their usual clinical training with 1 day per week dedicated to development in a complementary field such as clinical informatics, medical education, quality improvement or research. This joint initiative with Health Education England aims to address the shortfall of medical registrars in difficult to recruit to specialties and areas.

We launched pre- and post-CCT pathways for a Professional Diploma in Obstetric Medicine for doctors from any medical specialty. Clinicians following this credential curriculum undertake a full- or part-time fellowship attachment with an approved training centre.

The first cohort of our ‘Springboard to Leadership: supporting diversity’ programme launched in 2020. It supports the development of clinicians from diverse groups who may be underrepresented within healthcare leadership positions, and clinicians with a deep interest in supporting equality, diversity and inclusion within their organisation.

We commenced a study for Health Education England, examining the increasing phenomenon of trainees choosing ‘Foundation 3’ roles and other types of experience before

(or instead of) commencing a higher specialty training pathway. Understanding this is important because it may reshape medical careers and training pathways.

Our Patient and Carer Network continued to help shape the future of the physician associate (PA) role through the Faculty of Physician Associates Board and involvement in General Medical Council (GMC) patient roundtable events. The patient and carer perspective in this piece of work is vital as the PA role moves towards regulation by the GMC.

Through our work with the Federation of Royal Colleges of Physicians, the curricula for stage 1 and stage 2 internal medicine training were approved by the GMC and a four-nation group set up to oversee implementation. New curricula have been developed for the 29 higher medical specialties and the subspecialty of stroke medicine with a rolling programme of submission to the GMC for approval, and the principles for transition to the new curricula have been agreed.

Recognising the increasing number of nonmedical senior roles in clinical care for older people, we worked in partnership with the British Geriatrics Society to review the Diploma in Geriatric Medicine and open it to other professions. We expect to examine the first non-medical candidates during 2021.

RCP annual report 2020

The Federation of the Royal Colleges of Physicians published guidance on physician training recruitment, run by Health Education England, following the introduction of the new internal medicine curriculum.

High-quality education across the world

In-person international education was severely curtailed by pandemic travel restrictions, but we focused on redesigning a number of programmes as high-quality interactive learning in virtual classrooms. For example, we delivered a 5-day faculty development programme for the Swiss Institute of Medical Education. We also substantially increased our provision of online learning, available to clinicians everywhere.

We delivered a series of three joint seminars with partners at Sunway Medical Group in Malaysia and Cambridge University on the topics of geriatrics, vasculitis/lupus and oncology for physicians in the Asia Pacific region.

The Federation delivered the first-ever diet of the harmonised European Specialty Examination in Nephrology, Federation also delivered the first pathfinder and full diet of MRCP(UK) PACES examination in Pakistan and supported Annual Reviews of Competence Progression online for our partners in Iceland, India and Dubai. Following the signing of a memorandum of agreement in 2019, the Federation introduced specialty certificate exams (SCEs) in Singapore in acute medicine, dermatology and neurology.

The Federation introduced online exam delivery for MRCP(UK) Part 1 and Part 2 written exams, so that candidates in the UK and those overseas who needed the exam for training progression could sit online in 2020, and provided contingency exam dates for all written exams. Delivery of PACES was maintained with a modified format during the pandemic to allow trainee career progression.

The Federation also ensured that all SCEs were delivered despite COVID-19 with reduced support from UK examiners at our most experienced PACES centres, including in Hong

Kong and Singapore where the exams ran entirely with local examiner panels.

The number of clinicians using the Federation’s CPD diary increased to 21,000 consultants and 2,000 physician associates, 10,000 of whom accessed and used the CPD app in 2020.

Promoting lifelong learning

Our new platform for online learning launched successfully. RCP OnlineEd has much greater functionality and provides a better user experience. This led to over 8,000 users accessing our online courses in 2020, a 200% increase since 2019. New online courses included ‘Delegating under pressure’ and three bite-sized introductions to leadership.

Our RCP Medicine podcasts also transferred to a new platform in May. We launched 15 new episodes in 2020 and had over 36,000 downloads. We developed a special bundle of episodes focusing on COVID-19 to support doctors throughout the pandemic. These episodes alone had over 13,500 downloads.

In-person education was restricted by the pandemic, so we redesigned our longer courses, such as MSc degrees, the Chief Registrar Programme and Emerging Women Leaders Programme, for delivery in virtual classrooms. When infection rates were low in late summer, some inperson workshops took place in small groups with social distancing and other infection-control measures in place.

RCP OnlineEd, our new platform for online learning, has much greater functionality and provides a better user experience.

In partnership with Edge Hill University, we secured an expanded 5-year contract from Health Education North West to deliver two master’s modules to all of the region’s 600 trainees.

RCP annual report 2020

Adapting exams during the pandemic

On 17 March 2020 RCP Assessment Unit staff met to discuss the possible impact of COVID-19 on their upcoming exams. Little did they imagine that this would be the last time they would meet in person – for the rest of the year and beyond.

By 25 March all planned assessments had been cancelled until at least September and as the year progressed it became clear that COVID-19 was here to stay, and assessments could no longer be delivered as they had been pre-pandemic.

In response, the Assessment team worked hard and at pace, overcoming challenge after challenge to adapt the national exam for physician associates (both written and clinical) to be delivered in a COVID-safe way, including social distancing, PPE and many other vital adjustments. Thanks to these adaptations 655 new PAs entered the workforce in 2020 – an amazing achievement.

That same innovation and expertise was also called on to work with Federation to adapt MRCP(UK) PACES exams so that they too could continue to take place in COVID-safe conditions.

Due to the pandemic, all RCP exams ceased in March. Our major exams were redesigned to enable clinicians to take them at the appropriate career stages. Exams then restarted in September. This was particularly important for the Physician Associate National Examinations, which permit entry to the Managed Voluntary Register and to become part of the PA workforce.

We concluded delivery of the Medical Training and Fellowship Programme, a 5-year capacity-building programme to reduce the burden of cancer and neurological disorders in Kenya, Tanzania, Uganda and Rwanda. A total of 550 doctors were trained, 58 oncology trainers were upskilled to teach others and over 5,000 healthcare professionals are estimated to have benefited from the programme.

We launched an online equality and diversity training course that is used across royal colleges to train members in interviewing skills.

The Federation Framework for International Engagement was approved.

Supporting physicians throughout their careers

RCP Player launched in 2020 and swiftly became a go-to platform for webinars and virtual lectures with over 10,000 people tuning in to our digital events. Due to COVID-19, we transformed our Medicine 2020 annual conference planned for April into an extremely successful virtual event at the beginning of 2021.

Burnout, work-related stress and mental illness are increasingly recognised within the physician workforce. Early in the year we launched a new mental health and wellbeing resource to support doctors, who often find it difficult to seek help. This online resource aims to open up the conversation about mental health issues

RCP annual report 2020

Our work in numbers

Over 8,000 doctors accessed our online courses

More than 10,000 people tuned in to our digital events on RCP Player

655 physician associates entered the workforce following success in their exams

and their impact with a focus on recognising the triggers, wellbeing tools and where to seek support. As the pandemic took hold, this resource became even more relevant and we actively encouraged the physician workforce to remain aware of their wellbeing during extremely challenging times.

COVID-19 had a huge impact on trainees who have been unable to meet the required competencies before completing their core training. The Federation updated the Annual Review of Competence Progression form to reflect that the trainee was unable to meet specific requirements through no fault of their own.

We produced a new video resource to support the massive move to online consultations, which were unfamiliar to many. ‘Effective remote consultations’ was accessed almost 900 times in just the first few days it was available.

Trainees who completed core training were given 12 months free ePortfolio access to continue with recording their evidence and obtaining the required competencies/exam as a way of supporting them during the pandemic.

The Medical Training Initiative (MTI) scheme supports doctors from low- and middle-income countries to come to the UK for short-term (typically 2-year) training experience within the NHS. Despite the challenges of the pandemic, the RCP supported 300 MTI doctors within the NHS throughout the year while working to develop virtual interviews, induction and pastoral support.

In collaboration with Maudsley Learning, we produced an online course for clinical leaders to proactively support the mental wellbeing of their teams. It includes insights into how to manage uncertainty, particularly important in the context of the pandemic.

We transformed our Medicine 2020 annual conference planned for April into an extremely successful virtual event at the beginning of 2021.

RCP annual report 2020

The Federation introduced a fortnightly newsletter for both clinical and written exam candidates in the UK and internationally as well as a programme of live Twitter Q&A sessions, allowing candidates to have their questions and comments seen and answered by MRCP(UK) medical directors.

school places. This included a call for the government to undertake further detailed work and research to fully understand the appetite for medical school places and the perceptions of the entry process to medicine.

In October we promoted the role of physician associates during ‘PA week’ to raise awareness and visibility of the profession. It went virtual in 2020 and used social media to highlight facts and myths about PAs.

Promoting medicine as a career

We prepared Double or quits , our report detailing a blueprint for expanding medical

Looking forward

In 2021 we plan to:

continue to deliver most elements of our education and CPD portfolio online to support clinicians’ learning through the pandemic
continue to run clinical exams safely, while increasing the number of candidates and beginning to address the backlog caused by COVID-19
design and launch a new CPD programme to support new consultants
continue to expand our successful Medicine podcast series
develop new leadership modules with Birkbeck, University of London
support members representing the RCP on Advisory Appointment Committees with e-learning on equality, diversity and interview skills
facilitate clinical training in the UK for up to 300 international medical graduates though the Medical Training Initiative
work with the Federation to embed the internal medicine stage one curriculum into UK training programmes and implement stage two; continue to rewrite and introduce the 30 higher and sub-specialty curricula and cascade their delivery to trainees and trainers
monitor developments in relation to EU/UEMS-approved common training frameworks and tests following Brexit
work with the Federation to monitor GMC proposals for credentialing and alternative pathway proposals to the specialist register to assess their impact
work with the Federation to explore moving MRCP(UK) written exams online for the next 12 months in the UK, and for international online exams where appropriate; and introduce an additional diet in 2021.

RCP annual report 2020

3 Leading and supporting our members

We lead the profession by supporting and inspiring our members to meet the challenges of practising medicine today. Our members are our greatest asset – we listen to, support and learn from them.

RCP annual report 2020

Our objectives

In 2020, we aimed to:

lead the medical profession and champion medical professionalism
increase our reach and relevance to all our members
support our members in their daily practice
deliver an exceptional membership experience for all
increase our understanding of the context in which our members work in the UK and around the world.

Our key achievements

Leading the profession

In any given year, the RCP replies to hundreds of consultations from bodies such as NICE and NHS England. The first half of the year saw an exponential rise in the number of consultations and requests for review and endorsement of COVID-19 related materials and guidance.

Our invited review service went virtual in 2020 and continued to deliver high-quality recommendations to trusts and health boards dealing with difficult problems, leading to direct improvements in patient care.

Partnership working with specialist societies has been key throughout the COVID-19 pandemic and we have been able to play a significant leadership and coordination role around major issues. The Medical Specialties Board met frequently throughout the year and provided a vibrant and well-attended focus for this work.

Our specialist networks, members and the UK regions have proven to be invaluable in supporting physicians and PAs working with patients. This includes our committees for trainees and new consultants, SAS doctor network and regional network of advisers.

The RCP is a lead partner of the COVID-19 Therapeutics Advice and Support Group which

was established to provide advice and support in the management of the pandemic while national guidelines evolved.

We supported our partners the East, Central and Southern Africa College of Physicians (ECSACOP) in the delivery of their first postgraduate examinations, their virtual conference and through the provision of training for clinical supervisors across the region.

Increasing our reach and relevance

We honoured our duty of care to doctors on, or applying to, the Medical Training Initiative (MTI) scheme by supporting them through regularly changing regulations on visa extensions, international travel, quarantine requirements, delays to appointments and requirements to return to their home countries to support their COVID-19 response.

We hosted our fifth annual Excellence in Patient Care Awards. In 2020 it was more important than ever to celebrate the amazing work of physicians and their teams with so many achieving so much during, before and despite COVID-19. We received 94 applications and the winners came from a diverse range of projects and areas. The ceremony was converted to a virtual event and we used our social media platforms to announce the winners, resulting

RCP annual report 2020

in huge reach and engagement – the ‘opening ceremony’ animation received almost 50,000 impressions on Twitter alone.

We expanded the criteria for RCP fellowship in order to recognise the contribution of physicians in the first few years of their consultant career earlier than would traditionally have been the case.

We hosted a series of five regional international adviser meetings to strengthen regional and local networks around the world and to inform the development of our new global strategy. The ‘RCP Global stories’ series of webinars covered topics including palliative medicine in low- and middle- income countries, the COVID-19 response and the impact of the Beirut explosion on physicians in Lebanon.

We saw a significant increase in delegate numbers at virtual events that were previously face-to-face, including our conference for college and associate college tutors and New Consultants National Conference both with over 200 attendees, and our Turner-Warwick lectures with over 1,000 attendees watching one of the lecture webinars. These figures represent a significant increase in reach compared with attendance in 2019.

Fostering engagement with physicians across our regions, we held over 120 online meetings with regional representatives. Six regions ran webinars covering 18 topics across six specialties and achieving over 3,500 views.

In 2020 it was more important than ever to celebrate the amazing work of physicians and their teams with so many achieving so much during, before and despite COVID-19.

RCP annual report 2020

Our global strategy

The RCP’s ambitious new global strategy for 2021–24 is based on the RCP’s core values, vision, mission and principles. It sets out how we will achieve three strands: educating physicians to fulfil their potential, influencing healthcare design and delivery, and improving health and care by leading on the prevention of ill health globally.

The strategy was developed following wide stakeholder consultation and sets out our goals under the following key themes:

membership and fellowship engagement
the Medical Training Initiative and supporting the international workforce
education and training
conferences and continuing medical education events
federated activity including exams
projects mapped to RCP strategic aims, vision, mission, principles and charitable purpose.

Our global strategy will be achieved through close collaborative working across the RCP directorates, the Federation of the Royal Colleges of Physicians of the UK and partner organisations in the UK and internationally. Our associate global directors, wide network of international advisers and members, fellows and patient representatives will be key to shaping and supporting our plans.

We also held new consultants forums, pilot virtual poster competitions and virtual trust visits led by our regional offices.

Supporting our members

Throughout 2020 we increased activity to support and represent our members during what has no doubt been the most challenging period in their careers. From a COVID-19 hub on our website to campaigning for PPE, we addressed key challenges facing our members.

As the pandemic took hold in April we launched a new regular COVID-19 e-newsletter for members and sent 32 bulletins from our president to keep members informed and supported during the pandemic, increasing the frequency from monthly to weekly at key points in the year. These digital updates have proved highly popular and received much higher than average open rates (rising from 32% in 2019 to 41%) and compliments for ‘being a lifeline’.

Our Advisory Appointment Committees quality assured consultant job descriptions and provided an RCP representative for consultant appointment panels. Following a reduction in advertised consultant posts during the first wave of the pandemic, we supported around 400 appointments and reviewed over 750 job descriptions. We also kitemarked 74 job descriptions so potential applicants can see where the RCP has endorsed a post to indicate it has met national quality standards.

We established a new working party on pharmacogenomics in the NHS, revised and updated a working party report on eating and drinking difficulties and developed UK guidelines on the diagnosis of fibromyalgia syndrome. All will be published in 2021.

We began work to reinvigorate the RCP Medical Care website to create a vibrant, updated resource to engage clinicians in healthcare and digital transformation. We will deliver this in 2021 working closely with NHSX.

RCP annual report 2020

Our work in numbers

Our membership grew to 39,500

Over 3,500 physicians tuned in to our specialty webinars

Our Excellence in Patient Care Awards received almost 100 applications

In Federation, we successfully communicated the waiving of annual CPD requirements, extended the 2019/20 CPD diary deadline by a month and increased options for adding livestreamed/distance-learning activities. We also supported derogation of full MRCP(UK) for ST3 appointments and reviewed critical transition points in all 32 specialties to allow continued career progression for trainees. We negotiated with the GMC to allow physicians to triple accredit with intensive care medicine in some specialties, undertook further work on differential attainment and reasonable adjustment and improved CESR performance (GMC SLA).

Delivering an exceptional membership experience

interviews with members, officers, staff and volunteers. Valuing and promoting diversity underpins our vision for cultural transition, and our new Diversity and Inclusion Delivery Group is working on an action plan to ensure the 29 recommendations in the report are achieved.

The Faculty of Physician Associates (FPA) worked closely with Health Education England, Health Education in Wales and physician associate schools. Together with HEE we developed opportunities for graduates who could not take their national PA examinations due to COVID-19 to be given alternative employment in the NHS until they could progress to being qualified and registered PAs. ‘Physician Associates Week’ went virtual in 2020 and provided information and CPD content for our members in place of the usual conference.

At the end of 2020 we had over 39,500 members. This represents a 23% increase in membership over the strategic period 2015–20.

A record number of candidates were elected into RCP fellowship in 2020 despite the effect of the pandemic on the fellowship grading process.

We were proud to have steered to fruition and publication an independent review into diversity and inclusion at the RCP carried out by Ben Summerskill. The review encapsulated feedback from over 1,100 survey responses and

Partnership working with specialist societies has been key throughout the COVID-19 pandemic.

RCP annual report 2020

We published the results of the latest CCT progression survey, a collaboration with JRCPTB. This looks at the experience of people within 1 year of attaining their certificate of completion of training and has monitored changing outcomes since 2009.

Increasing our understanding

Our Medical Workforce Unit supports workforce planning by collecting and analysing a wide range of information on UK physicians. We published the annual census of consultants, higher specialty trainee physicians and physician associates conducted in partnership with the Scottish royal colleges of physicians and the Faculty of Physician Associates. The census data supports key healthcare bodies to identify trends, monitor specialty expansion rates, make recommendations, and plan for workforce development.

We also provided a survey service both within the RCP and to external medical bodies. This included running and reporting the findings from a series of COVID-19 surveys conducted across our membership throughout 2020.

Looking forward

Our plans for 2021 include:

supporting trusts to improve professionalism through our invited reviews
reviewing job descriptions for new consultant posts and sourcing RCP representatives for AACs
carrying out the consultant and higher specialty trainee census for 2021 and a survey on career progression
supporting physician associates by working with the GMC on regulation in 2022, with HEE to develop a career framework for progression, holding an annual conference, and undertaking the 2021 census
publishing new guidance on fibromyalgia syndrome and supporting people who have eating and drinking difficulties, and supporting the working party on pharmacogenomics in the NHS
running the 2021 Excellence in Patient Care Awards
supporting our college tutor and associate college tutor network
reviewing the RCP fellowship system
delivering webinars, virtual conferences and the Turner-Warwick lecture scheme to support and encourage trainees across our 18 regions
increasing our support for SAS doctors and delivering forums for new consultants
building on our global strategy to grow and diversify our international membership
supporting the development of the East, Central and Southern Africa College of Physicians and fundraising activities for Physicians in Africa
piloting a new programme of work to support women from low- and middleincome countries in career progression
engaging with fellows and members to improve the CPD diary.

RCP annual report 2020

4 Shaping the future of health and healthcare

Our 39,500 members and their patients are central to shaping the RCP’s ambitious vision for the best possible health and care for all. Throughout 2020 we continued to promote, advocate and campaign on the issues that we know matter most to them.

RCP annual report 2020

Our objectives

In 2020, we planned to:

use the expertise of physicians and the experience of patients to influence the future of healthcare, from parliaments to wards
improve the public’s health by championing evidence-based action to prevent ill health, nationally and internationally
foster innovation in health and promote research
ensure that patients’ and carers’ experiences shape everything that we do.

Our key achievements

Using expertise and experience to influence healthcare

From informing to influencing and engaging we increased the RCP’s profile dramatically during 2020. We focused on the issues impacting our members working at the heart of the response to COVID-19 and positioned the RCP as an authoritative voice.

Over 8,000 members and fellows responded to our series of seven surveys on the impact of COVID-19 on the workforce. Their responses helped us to gain direct insight into what was happening in hospitals and establish the issues we should be addressing on our members’ behalf. This led to high-profile successful campaigning to support doctors to do their jobs as safely as possible by highlighting issues around testing, accessing PPE and staff absence.

We convened an expert online update for doctors, with a high-profile panel including Professor Chris Whitty and other key medical leaders. And in July, health secretary Matt Hancock chose the RCP to host his keynote speech on the future of healthcare.

We enhanced our political relationships and felt our influence in government grow with around 50 UK parliamentary mentions, many related to COVID-19. They covered a range of issues such

as PPE – which was raised by the leader of the opposition Sir Keir Starmer MP among others – COVID-19 testing and how people were being discharged from hospital, as well as smoking cessation and air quality.

We also shone a light on the role of the international workforce – a long-term priority for us – quickly developing a ‘new deal’ for overseas staff. It has so far resulted in the exemption of NHS and social care staff from the international health surcharge.

Calls to our media team rose by 50% and we logged almost 13,000 pieces of coverage (compared with just over 11,000 in 2019). Highlights included five national newspaper front pages, and high-profile broadcast coverage such as BBC Breakfast and BBC News at 10. Survey feedback from our membership showed that 60% would describe the RCP’s national media profile as either high or very high, compared with just 23% before the pandemic.

Ensuring that patients shape everything that we do

Our Patient and Carer Network (PCN) is an integral part of the RCP and our shared goal is the provision of patient-centred care. In 2020, members of the PCN contributed their time to over 36 RCP committees, boards and

RCP annual report 2020

working groups, were involved in policy work on integration, health inequalities and research as well as quality improvement and digital health. Representatives contributed to new guidance on modern ward rounds, ensuring the patient perspective was fully embedded.

The PCN issued a statement in support of healthcare professionals during the COVID-19 pandemic and continued to be part of supportive messaging around workforce issues.

We ensured that the patient perspective is represented on working parties covering new guidance on fibromyalgia and pharmacogenomics in the NHS, both due to be published in 2021.

Improving public health

We continued to support important campaigns aligned with our public health work. These included a call convened by Crisis to protect people sleeping rough during the winter and a campaign on the Environment Bill with the UK Health Alliance on Climate Change.

Following our call for obesity to be recognised as a disease, we were proud to partner with over 100 organisations to sign a consensus statement calling for an end to the stigma surrounding obesity. Published in the journal Nature Medicine

We focused on the issues impacting our members working at the heart of the response to COVID-19 and positioned the RCP as an authoritative voice.

RCP annual report 2020

Tackling inequalities in health

In October we launched the Inequalities in Health Alliance with a letter to the prime minister pressing for urgent action to reduce health inequalities.

The COVID-19 pandemic has hit those already disadvantaged in our society hardest, exposing and exacerbating health inequalities. The moral case for tackling this is imperative. It is important to the public too – in a 2020 public opinion poll, 81% agreed that there should be a UK government strategy to reduce health inequality.

Our letter urged the prime minister to ask the government to do three things: develop a cross-government strategy to reduce health inequalities, commence the socio-economic duty (section 1 of the Equality Act 2010), and adopt a ‘child health in all policies’ approach.

We received substantial interest from organisations requesting to join the coalition demonstrating the overwhelming support for action. At the beginning of 2021 we were delighted that the IHA had grown to almost 160 members, including royal colleges, specialist societies, charities, think tanks, local authorities and NHS trusts. By building momentum we hope to achieve long-lasting change.

to mark the first-ever World Obesity Day, the statement called for legislation to prevent weight-based discrimination. We continued to raise awareness, develop educational opportunities and influence for more focus on this area.

Towards the end of 2020 we established the Inequalities in Health Alliance (IHA) of over 80 organisations to campaign for a cross-government strategy to reduce health inequalities.

Fostering innovation

We positioned the RCP website at the heart of our COVID-19 digital response, quickly curating bespoke areas to share key information and guidance. Website page views increased to nearly 4 million – up by over 30% on 2019 – and RCP Player, our new streaming platform, hosted a growing number of webinars and events welcoming over 10,000 participants.

We focused on developing engagement across all RCP social media channels, including the launch of a new Instagram account, helping us to reach a younger demographic. Our social media audience grew by 25% to well over 130,000, and engagements increased by 40%. Our ‘This Doctor Can’ Twitter campaign became a powerful vehicle to celebrate the diversity of the RCP community, promoting the stories of fellows and members from ethnic minority backgrounds throughout South Asian Heritage Month and Black History Month. Facebook Live Q&As saw our president reaching audiences in the thousands, particularly important in the early months of the pandemic.

Clinical Medicine and Future Healthcare Journal continued to grow their reputation as high-quality sources of clinical and thought leadership content. We developed our strategy to move more content online, with a focus on environmental and financial sustainability,

RCP annual report 2020

Our work in numbers

Over 8,000 members responded to our surveys on the impact of COVID-19

We were mentioned more than 13,000 times in the media

Articles in our journals were downloaded more than 3.3 million times

while article submissions rose by 250% and readership doubled. A COVID-19 subject collection proved extremely popular and, alongside a new journal club series on Twitter, further elevated our medical publishing profile. Our membership magazine Commentary saw particularly vibrant engagement with our trainee members and included more diverse voices.

We published the RCP’s research strategy and launched a new research and innovation hub, enhancing our profile in this area. The online resource is a one-stop shop for supporting physicians to become more involved in research

and develop their career. It fulfils one of the key aims in our research strategy, also published earlier this year.

RCP staff faced an unsettling time with the almost wholesale move to home working and loss of income impacting many areas. Our internal communications focused on ensuring staff felt supported through digital bulletins, videos and all staff briefings. A survey showed our staff felt valued and well supported, with 80% open rates for our weekly bulletin and good attendance at virtual staff events.

We positioned the RCP website at the heart of our COVID-19 digital response, quickly curating bespoke areas to share key information and guidance.

RCP annual report 2020

Looking forward

Our objectives for 2021 include:

reflecting our members’ priorities by urging UK governments to increase the medical workforce; influencing health and care legislation to improve integration, workforce planning and regulation; leading the Inequalities in Health Alliance; and working to increase the number of doctors involved in research
supporting the resetting of the NHS and development of new guidance
increasing the reach and impact of our media work with a new media strategy and growing our following on social media
working to replace the RCP website and incorporate greater use of video
promoting and cementing our presence in the north from RCP at The Spine
publishing to shape best practice in medicine and developing the RCP brand
reviewing the publishing model for our peer-reviewed journals and developing income-generating opportunities for our design, editorial and print services
exploring innovative internal communications platforms to connect with our staff in all sites
conserving, shaping and promoting our resources on the history of medicine and the RCP
developing a 2021 programme of exhibitions, displays and events
complying with archive and museum standards and accreditation to embody best practice.

RCP annual report 2020

5 Investing in our future, building on our heritage

The RCP is at the forefront of clinical innovation, yet we also share and learn from our medical heritage, which dates back over 500 years to 1518.

RCP annual report 2020

Our objectives

In 2020, we planned to:

deliver a financially sustainable future by making the most of our expertise and managing our finances well
run an excellent organisation that enables us to deliver our vision of better health and healthcare for everyone
be a responsible organisation that lives by the values which we champion in the health service
make our current knowledge and our long history work for the benefit of present and future generations.

Our key achievements

A financially sustainable future

Our 2020 financial result was a net operating deficit of £3.3 million. This was due to the significant impact of COVID-19, which reduced our income by over a quarter (£12.0 million). Costs were managed to mitigate this, including through use of the government furlough scheme for those staff unable to do their usual work. The 2020 deficit on unrestricted funds was £5.0 million, with free reserves falling to £12.4 million (equivalent to around 5 months of unrestricted expenditure).

The investment portfolio and defined benefit pension scheme both ended the year with high single-digit percentage value growth.

The core and shell of The Spine building in Liverpool, developed by Liverpool City Council, was completed in June 2020 and the RCP’s fit-out of our seven floors finalised on 13 April 2021. Up to December 2020, £13.5 million (including irrecoverable VAT) had been spent on the fit-out, with £1.75 million funded by fundraising, £4.3 million by previously liquidated investments, and £7.5 million by drawing down on our credit facility with Santander.

Although COVID-19 and the completion of The Spine in Liverpool have impacted adversely on our short-term financial position, those events also provide the RCP with an opportunity to

rebalance its activities in line with our new strategy for 2022–25. While we anticipate that our income levels will recover, our focus will be to ensure that we undertake our work and activities in an efficient and sustainable way, maximising the benefits of our facilities in London and Liverpool alongside our people and technology capabilities.

Our Fundraising team had another successful year and are well on the way towards the target of £3 million for The Spine, as well as £127k (raised via the Physicians for Africa appeal) for the East, Central and Southern Africa College of Physicians.

In 2018 the RCP committed to work towards reducing its gender pay gap within 5 years. In April 2020, our gender pay gap fell to a mean of 11.8% and median of 16.7% (2019: mean 14.8%, median 17.8%). The RCP follows an equal pay policy and within each grade band the gender pay differences are minimal. The overall gender pay gap is therefore due to the higher-than-average numbers of male staff at senior grades, and higher-than-average numbers of female staff at junior grades.

We completed the rollout of our new purchase order procurement system to the RCP’s departments and suppliers, resulting in further processing efficiencies and financial benefits.

RCP annual report 2020

Events team won the Conference 2020 Awards best conference venue under 450 theatre-style category, a significant national award.

The Procurement team carried out several significant tenders and had discussions with suppliers to mitigate COVID-19 impact and secure refunds.

We delivered further improvements identified by internal audits, including in fundraising and trust funds management.

We implemented a new RCP anti-fraud policy, along with a supporting fraud response plan. These set out responsibilities for the prevention of fraud, as well as the action to be taken if fraud is discovered or suspected.

Our Programme Management Office engaged in a variety of change projects, including coordinating the RCP at The Spine programme, and the implementation of new e-learning software.

A separate accounting database for Federation enabled improved and faster reporting, and greater clarity around financial flows. An independent audit of Federation was conducted by Shipleys LLP in the first quarter of 2021 which provided additional assurances to the three colleges (RCP, RCPE and RCPSG) that the joint venture is being run in line with the Memorandum of Agreement.

We held our annual general meeting (AGM), uncontested presidential election and central elections virtually. This allowed our members to continue to engage during the pandemic and key decisions to take place. The resultant environmental and other resource savings led to RCP Council agreeing that future elections will remain online only and key governance meetings will have hybrid physical/virtual attendance.

To meet the sudden demand for virtual events, we rapidly developed two online platforms – RCP Player and RCP Virtual – both have proved a great success.

An excellent organisation

We continued to increase on the number of staff based in Liverpool. By the end of 2020, 65 people were

based in our interim offices at the University of Liverpool, working across all five of our directorates. Throughout 2020, staff were supported to work remotely and we quickly adapted our services to continue to operate as far as possible during the pandemic.

A significant revision of the RCP’s bye-laws was approved at the AGM. Fundamental to the RCP’s governance, these link back to our 1518 royal charter. This was the first major revision in recent years and aimed to modernise the bye-laws where necessary, but also maintain core historic aspects. In particular, the role and responsibilities of the Board of Trustees was clarified.

Technology improvements in 2020 included implementing Microsoft Teams and Office 365, planning the move of our server infrastructure off site and the JISC universities network, achieving Cyber Essentials Plus accreditation, and continuing to develop new Federation IT systems to improve physicians’ exams, training and CPD experience.

Through the Federation, we ensured that examinations continued throughout the pandemic by adapting to virtual and hybrid boards and committees. Through the Federation, we delivered remotely proctored exams and PACES stations 2 and 4, and provided contingency exams to ensure career progression was not jeopardised.

To meet the sudden demand for virtual events, we rapidly developed two online platforms – RCP Player and RCP Virtual – both have proved a great success. Just before lockdown, our Meeting and

RCP annual report 2020

Heading towards zero carbon

We began divesting from fossil fuel companies over 5 years ago to manage our long-term financial risk and align with our strong advocacy on clean air. In 2020, we published our new Climate Policy which includes support for the Transition Pathway Initiative, an independent tool developed for investors to move away from any oil, gas or mining company that has not set emissions targets.

By March 2021 the percentage of fossil fuel companies within the RCP investment portfolio had fallen to 0.03% and by the end of 2021 it will be down to zero.

Andrew Goddard, RCP president, said:

‘Climate change will significantly impact public health in the UK and around the world and the RCP has an important role to play in highlighting the health impact. If our voice is to be effective, we must ensure that our public advocacy is consistent with our own investments. Our new Climate Policy reflects the pace of climate change and the urgent need for everything possible to be done to limit global temperature rises in line with the goals of the Paris Climate Agreement.’

A responsible organisation

Throughout the COVID-19 lockdowns, we ensured that the RCP values of taking care, learning and being collaborative were woven into our support for NHS physicians and our staff working remotely while home schooling their children or caring for family members. In August, with our on-site facilities managers CBRE, we put in place industry best practice COVID-19 safety measures and were awarded the COVID-safe ‘Good to Go’ quality mark. From September we cautiously reopened the London site to host exams and hybrid events.

During 2020, our fund managers started to implement the Board of Trustees’ decision in 2019 to decarbonise our investment portfolio over a 3-year period. Our staff pension schemes also introduced a more ethical ESG (environmental, social and governance) stance within their investment strategy.

We completed installation of LED lighting at our Regent’s Park offices, and maintained our Carbon Trust, ISO 14001 and ESOS-2 environmental and energy saving certifications. Energy usage at our sites fell by around 15% due to over 95% of our staff continuing to work from home through the lockdown.

The fit-out of our seven floors of The Spine in Liverpool (~71,000 sq ft) is BREEAM Excellent, and the building is classed as A++ ESOS-2 energy efficient. We are also applying for WELL Platinum Standard – an audited standard of ‘wellness’ for buildings, which will make it one of the healthiest work and events spaces in the UK.

The RCP farmland at Burmarsh in Kent, a gift to the College in William Harvey’s 1656 will, is being evaluated for its carbon offsetting and biodiversity potential as an organic market garden or beehives for ‘Harvey’s Honey’.

RCP annual report 2020

Our work in numbers

2 online platforms launched to meet the new demand for digital events

The number of staff based in Liverpool grew to 65

£1.75 million raised towards development of RCP at The Spine

Benefit present and future generations

The Spine building in Liverpool opened in May 2021 when the RCP formally commenced our occupancy of seven out of 14 floors, on a 25-year lease from the landlord Liverpool City Council. Because of national COVID-19 restrictions we anticipate that practical occupancy and activities will be limited initially, but will increase gradually up to September 2021.

Over the next 3–4 years the aim is to rebalance the workforce between Liverpool and London, with around 185 staff at each site, and to engage wholeheartedly with initiatives to improve health and address health inequalities in the north of England. The Spine forms a key part of Liverpool’s Knowledge Quarter and its state-of-the-art assessment centre and educational facilities will transform what we are able to offer our members in the north and enhance our provision nationally. This is a longterm investment and partnership with the city of Liverpool and the north. Some space has been set aside at The Spine for other medical colleges, faculties and societies to take serviced office or sublet space, to form a ‘medical campus’.

RCP Player became a key online platform for webinars and streamed content for our members during the pandemic.

RCP annual report 2020

As some staff moved to Liverpool and space opened up at our Regent’s Park office, we began to sublet the terrace houses in St Andrews Place. In 2020 we secured three new tenants – the Tropical Health and Education Trust, C3 Collaborating for Health and the British Society for Heart Failure.

Our archives and museum were closed to visitors due to COVID-19. We developed an innovative new virtual exhibition, RCP Unseen, to showcase some of the hidden treasures in our collection.

Looking forward

Our plans for 2021 include:

continuing with plans to repair the financial impact of the COVID-19 pandemic and return the RCP to a financially sustainable position
completing the fit-out and installation of The Spine, moving staff into the building, implementing the WELL Standard, and transition planning for the moving of roles from London to Liverpool in 2022–24
launching RCP Spaces at The Spine for conferences and events, exams and training, and office space
fundraising to reach the £3 million target for The Spine
finalising and publishing the RCP’s new strategy for 2022–25 (see p40)
successfully delivering our Medicine 2021 annual conference and a programme of virtual/hybrid educational conferences
building the professional conference organiser business Circulus
completing the migration of the RCP website and email addresses to www.rcp.ac.uk as well as migrating our IT server infrastructure to the JISC/ JANET UK universities network
developing the RCP Digital Strategy, including website improvements, an RCP app and online exam software
commissioning internal audits of cybersecurity and our international activities
enhancing our environmental credentials, including progressing the plan to achieve carbon neutrality by 2030, and developing the biodiversity/ carbon offsetting potential of the farmland at Burmarsh.

RCP annual report 2020

Our ambitious plans to improve diversity and inclusion

This year we welcomed the findings of an independent review of diversity and inclusion at the RCP. The report was compiled by consultant Ben Summerskill, previously chief executive of Stonewall and a commissioner at the Equality and Human Rights Commission.

The findings drew on one-to-one interviews with a range of members from different backgrounds and at different stages in their careers. Over 1,000 RCP members, staff and stakeholders also responded to an anonymous online survey.

to-read findings have propelled us to take action with a programme of work to ensure the recommendations are achieved. Andrew Goddard, RCP president, said it has: ‘united all in the RCP to committing to and doing something about the racism and disparities it highlighted’.

The report’s six sections look at the current make-up of the RCP, how diversity is measured and monitored, how we present ourselves and how some perceive us, how we recruit and retain staff and volunteers, and at our ways of working. There are 29 wideranging recommendations, covering areas such as advertising, recruitment, representation, staff networks and systems and training.

We are now developing a communications inclusion policy and reviewing our physical spaces to ensure they embody our commitment to inclusion and engagement. Data is key and work has begun to ensure systems and engagement strategies with members and staff are improved to record, reflect and encourage greater diversity. With the expertise of our project teams and stakeholders to guide us, we are committed to delivering on the 29 recommendations in the report. This is just the start of our ambitious plans to improve diversity and inclusion across the organisation to ensure all our people – fellows, members, staff and volunteers – are enabled to contribute fully to the RCP’s work.

The report’s publication in July was very timely, coinciding with the renewed urgency given to improving diversity by Black Lives Matter protests, and at a time when the disproportionate impact of COVID-19 upon some communities has been keenly felt in the health sector. Its candid and sometimes difficult-

RCP annual report 2020

RCP at The Spine

In 2021, we open an exciting new purpose-built office in partnership with Liverpool City Council – RCP at The Spine. For the first time in our 500-year history, the RCP will be working from two main homes, transforming our reach and facilities for members in the north.

Despite the COVID-19 pandemic, impressive progress has been made on the fit-out of The Spine, our new home in Liverpool’s Knowledge Quarter, as part of a wider new development known as Paddington Village.

The RCP has funded the Cat-B fit-out of the seven floors we are taking space on, and employed Overbury as the principal contractor, along with Recursive, MTI and Pure AV as contractors for the IT and AV facilities. We have been supported by generous donations from several organisations, for which we are very grateful.

The onset of the pandemic posed considerable and unexpected challenges. However, these were overcome thanks to close collaboration with Liverpool City Council, Morgan Sindall (the construction contractors), CBRE (our professional advisers), and our own contractors. As a result, work started on site in June 2020 (rather than March), taking full account of all industry standards and regulations to ensure safe working in these unique circumstances. By the end of 2020 it was possible to see the plans and architect’s impressions becoming reality, contributing to what is a striking

and important building. The Spine will enable the RCP to provide its services such as examinations, educational courses and meetings, lectures, and wider events in an environment that has extensive biophilic features and meets the Platinum WELL Standard, supported by state-of-the-art facilities. These include a Harvard-style theatre, and a virtual video wall enabling remote as well as physical participation and interaction with delegates.

In 2020 the new Clatterbridge Cancer Centre opened close to The Spine, and their headquarters will be based in the building, as our neighbours. Along with the proximity of the Royal Liverpool Hospital, the universities, and other health and academic institutions, the RCP will be at the heart of a vibrant scientific community. We have also strengthened our links with the city and city region authorities, such as by Liverpool City Council’s acceptance of our invitation to join the Inequalities in Health Alliance. We opened our new facilities in May 2021, and despite the continuing uncertainties and challenges of the pandemic, we look forward to engagement with the city and developing the RCP’s activities.

RCP annual report 2020

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Our strategy for 2022–25

During 2020, the RCP’s work was reprioritised due to the global pandemic. We focused on providing support for our members at the forefront of the response to COVID-19, rapidly adapting many of our services and developing new ways of working.

Given these challenges, we decided to postpone finalising and publication of our new strategy, originally planned to cover 2021– 24. During 2021 we continued to be guided by our strategy for 2015–20.

We discussed what we had learned from the survey feedback, made some changes to our proposals and set out our three key priorities. In late 2020, our vision and revised priorities were supported by the Board of Trustees.

Our vision for 2022–25 will continue to be ‘the best possible health and healthcare for everyone’. As the leading body for physicians in the UK and internationally, we will set ourselves the mission of achieving our vision by:

Our new 4-year strategy covering 2022–25 has gone through a process of consultation. We decided to keep our vision, but to develop a new mission statement and priorities. In early 2020 we asked our members and staff, as well as key organisations and people we work with, what they thought.

educating physicians and supporting them to fulfil their potential

They broadly supported our proposals, with three-quarters of our members agreeing we should have fewer priorities than the five in our current strategy. When asked ‘if we could do only one thing, what should it be?’, the majority of our members said it should be support for doctors, education or influencing.

influencing the way that healthcare is designed and delivered
improving health and care and the prevention of ill health.

The Board of Trustees, RCP officers and staff are now working together to develop the objectives under each of these three key priority areas. This work will complete our strategy and provide a roadmap to guide our work over the next 4 years.

RCP annual report 2020

RCP boards, committees and lists

The officers, trustees and councillors listed below served during 2020. Current lists can be found via www.rcplondon.ac.uk/about-us/who-weare/our-governance

Officers and senior roles of the RCP

Professor Rudolf Bilous Dr David Cohen (demitted July 2020) Dr Manish Gautam (appointed August 2020) Dr Rasha Mukhtar Dr Catherine Sargent (appointed August 2020) Dr Robert Wright (demitted July 2020)

Visitor

Her Majesty the Queen

President

Dr Andrew Goddard

Vice president for education and training (senior censor)

Vice president for Wales

Dr Emma Vaux (demitted July 2020) Professor Áine Burns (appointed August 2020)

Dr Olwen Williams OBE

Vice president – global

Professor Ali Jawad (demitted August 2020) Dr Mumtaz Patel (appointed September 2020)

Clinical vice president Dr Sarah Clarke

Academic vice president Professor Cheng-Hock Toh

Linacre fellow

Dr Ananthakrishnan Raghuram (demitted July 2020) Dr Joanna Szram (appointed August 2020)

Treasurer

Professor Chuka Nwokolo

Registrar

Harveian librarian

Professor Donal O’Donoghue OBE*

Professor Simon Bowman (demitted August 2020) Dr Louella Vaughan (appointed September 2020)

Censors

Dr Jyoti Baharani Dr Celia Bielawski

Following Professor Donal O’Donoghue’s tragic death from COVID-19 in January 2021, Dr Peter Belfield took over as interim registrar until May 2021 when Dr Cathryn Edwards was appointed.

RCP annual report 2020

Deputy treasurer Professor Simon Bowman

Medical director of publishing Professor Anton Emmanuel

Editor-in-chief, Clinical

Medicine and Commentary Professor Anton Emmanuel

Editor, Future Healthcare Journal Dr Kevin Fox

Clinical director for quality improvement and patient safety Dr John Dean

Medical director, of CME and CPD

Dr Emma Vaux (until 31 July 2020) Professor Áine Burns (from 1 August 2020)

Senior examiner of the London College (PACES) Dr Abdul-Majeed Salmasi

RCP chief examiner Dr Emma Vaux (from September 2020)

Director, Medical Workforce Unit Dr Nigel Trudgill

Deputy directors, Medical Workforce Unit Dr Sarah Logan and Dr Rifca Le Dieu (job-share)

Clinical lead for engagement – The Spine Dr Louise Bate

Patient involvement officer Dr Helen Gentles

Director, invited service reviews Dr Peter Belfield

Deputy medical director, invited service reviews Dr Adam De Belder

Deputy medical director, invited service reviews Dr Jonathan Bennett

Deputy registrars Dr Alastair Gilmore Dr Sonia Panchal

Clinical director for audit and accreditation Dr Jane Youde

Clinical director for digital health Dr Wajid Hussain

Garden fellow Dr Henry Oakeley

Representative on the Advisory Committee of the Chelsea Physic Garden Professor Michael de Swiet

Chief executive Dr Ian Bullock

Officers of the Federation of Royal Colleges of Physicians of the UK

Executive medical director Dr Gerrard Phillips

Medical director, training and development Dr Mike Jones

Medical director, assessment Dr Kenneth Dagg

International medical director, training and development Professor David Black

Associate medical director, CPD Dr Adrian Jennings

Associate medical director, written examinations Professor Albert Ferro

Associate medical director, clinical examinations Dr Stuart Hood

Deputy medical director, JRCPTB Dr Alastair Miller

Board of Trustees

Ex-officio members

Dr Andrew Goddard, president Professor Donal O’Donoghue, registrar (until January 2021) Dr Peter Belfield, interim registrar (January – June 2021) Dr Cathryn Edwards, registrar (appointed May 2021) Professor Chuka Nwokolo, treasurer Dr Sarah Clarke, clinical vice president Professor Cheng-Hock Toh, academic vice president (demitted July 2021) Professor Ramesh Arasaradnam, academic vice president (appointed August 2021) Dr Emma Vaux, vice president for education and training and senior censor (demitted July 2020) Professor Áine Burns, vice

president for education and training and senior censor (appointed August 2020)

International medical director, assessment Dr Donald Farquhar

RCP annual report 2020

Members nominated from Council

Professor Namita Kumar Dr Iain Lawrie Dr John Dean Dr Jo Szram (appointed April 2021)

Lay members Professor David CroisdaleAppleby OBE Professor Charles Baden-Fuller Sarah Barzycki Andrew Chandler Graham Meek

Members of Council

Dr Andrew Goddard Professor Aine Burns Dr Sarah Clarke Professor Cheng-Hock Toh Professor Chuka Nwokolo Professor Donal O’Donoghue OBE Dr Olwen Williams OBE Dr Tun Aung (appointed August 2020) Dr Angshu Bhowmik (appointed August 2020) Professor Susan Carr (demitted July 2020) Dr Kaushik Chaudhuri Dr Parijat De Professor Rob George Professor Namita Kumar (demitted July 2020) Dr Ruth Law Dr Philippa Medcalf MBE (demitted July 2020) Professor Tom Solomon Dr Joanna Szram Dr Mark Temple (appointed August 2020) Dr Jenny Vaughan Dr Robert Wright (appointed August 2020) Professor Áine Burns (demitted July 2020) Dr John Dean

Dr Iain Lawrie (appointed March 2020) Dr Celia Bielawski Professor Rudolf Bilous Dr Margaret Stark Dr Anne de Bono Professor Tim Higenbottam Professor Maggie Rae Dr Alison Pittard Ms Kate Straughton Dr Tun Aung

(demitted July 2020) Dr Mick Kumwenda (appointed September 2020) Dr David Price

(demitted July 2020) Dr Kanwaljit Sandhu Dr Ruth Murphy (demitted July 2020) Dr Tanya Bleiker (appointed July 2020) Dr Sanjeev Patel (appointed April 2020) Dr Elizabeth Price (demitted April 2020) Dr Cathryn Edwards (demitted June 2020) Dr Alastair McKinlay (appointed June 2020) Dr Jennifer Burns (appointed December 2020) Professor Tahir Masud

(demitted December 2020) Professor Jonathan Bennett Dr Susan Crossland Professor David Burn Dr Robert Gregory Dr Katherine Henderson Dr Katie Honney (appointed August 2020) Dr Madhu Varma (demitted July 2020) Dr Ajay Verma Professor Simon Ray Dr Michael Fitzpatrick Dr Matthew Roycroft Dr Rachel Jones Dr Waleed Arshad Dr Helen Gentles Mr Eddie Kinsella (appointed April 2020)

Finance and Resources Board

Professor Charles Baden-Fuller Professor Chuka Nwokolo,

treasurer Dr Andrew Goddard, president Professor Simon Bowman, Harveian librarian and deputy treasurer Professor Donal O’Donoghue, registrar Roger Speddy Dr Kaushik Chaudhuri Professor Rob George Dr Mark Temple Dr Wajid Hussain

Audit and Risk Committee

Andrew Chandler Graham Meek Ray Sadler Tim Golbourn Roger Speddy Dr Angshu Bhowmik

Investment Advisory Panel

Professor Chuka Nwokolo Professor Simon Bowman Consuelo Brooke James Hordern Adam Matthews Professor Ganesh Subramanian Peter Allen Martin Been

Remuneration Committee

Professor Chuka Nwokolo Professor Simon Bowman Andrew Chandler Graham Meek Professor Anthony B Ward Nigel Turner

RCP annual report 2020

Awards, prizes and lectures

Christmas lecture Professor Sir Michael Marmot

FitzPatrick lecture Professor Ali Jawad

Graham Bull prize and Goulstonian lecture Dr Rickie Patani

Harveian orator Professor Sir Peter Ratcliffe

Linacre lecture Dr Adam Croft

Teale essay prize for trainees Dr Sina Ghadiri

President’s Medal Dr Henry Oakeley Anne McSweeney

Excellence in Patient Care Awards

Digital award Flash Glucose Collaboration (ABCD, DTN-UK, NHS England)

Innovation award

Kettering General Hospital NHS Foundation Trust

International award

Team CAPD (continuous ambulatory peritoneal dialysis), Anuradhapura Teaching Hospital, Sri Lanka

Medical education and training award The Prescribing Safety Assessment (PSA) partnership

Person-centred care award Moving Medicine, Faculty of Sport and Exercise Medicine

Quality improvement award FORWARD, Guy’s and St Thomas’ NHS Foundation Trust

The Lancet research award Newcastle University, South Tyneside and Sunderland NHS Foundation Trust and the Northern Region Endoscopy Group

Welfare and wellbeing award ‘Professionals together’ team, HEE West Midlands

Contribution to the profession award Dr Amit Arora, consultant physician and geriatrician

Fellowships and bursaries

Rosetrees Trust – RCP joint fellowships

Dr Ray Tan Dr Jennifer Piggott

Whitney-Wood Scholarship Dr Stephen Sammut

Elections and admissions

New fellows

1,939 elected under bye-law 39 (a, c and d) 6 elected under bye-law 39 (b) 1 elected under bye-law 39 (e) 22 elected under bye-law 39 (f) 85 elected under bye-law 39 (g) 7 elected under bye-law 43

New honorary fellows Consuelo Brooke Professor Hugo BarreraSaldaña Andrew Chandler Simon Ellen James Hordern Professor Francesca Levi-Schaffer Sir Simon Stevens

Major donors for 2020

Celgene Daiichi Sankyo Dr Barry Anthony Enoch Dr Robert Hardwick Garfield Weston Foundation GSK Jerwood Foundation Lord Leverhulme’s Charitable Trust Modiano Charitable Trust Mrs Dorothy Whitney-Wood Norgine Novartis Novo Nordisk Pfizer Rosetrees Trust Tay Charitable Trust The Thompson Educational Trust The Williams Charitable Trust The Wolfson Foundation

Principal advisers

Solicitors

Fieldfisher LLP Riverbank House 2 Swan Lane London EC4R 3TT

DAC Beachcroft LLC Administration Centre Portwall Place Portwall Lane Bristol BS1 9HS

RCP annual report 2020

Bankers

C Hoare and Company 37 Fleet Street London EC4P 4DQ

Lloyds plc National Clubs and Charities Centre Sedgemoor House Dean Gate Avenue Blackbrook Business Park Taunton TA1 2UF

Santander UK plc Education Specialist Sectors Group 4 St Paul’s Square Liverpool L3 9SJ

Auditor

Crowe Clark U.K. LLP 55 Ludgate Hill London EC4M 7JW

Investment managers

Cazenove Capital Management 12 Moorgate London EC2R 6DA

Ruffer LLP 80 Victoria Street London SW1E 5JL

Morgan Stanley Private Wealth Management 25 Cabot Square Canary Wharf London E14 4QA

CCLA Investment Management Senator House 85 Queen Victoria Street London EC4V 4ET

Principal address

11 St Andrews Place Regent’s Park London NW1 4LE

Chief executive Dr Ian Bullock

Supported by key management personnel

Executive director, Membership Support and Global Engagement Matthew Foster

Executive director, Care Quality Improvement Rhona Buckingham

Executive director, Education Professor Della Freeth

Executive director, Corporate Services Justin Smith

Director, Communications, Policy and Research Claire Burroughs

Commissioning director for RCP at The Spine Clive Constable

Chief operating officer – Federation Yasmin Becker

RCP annual report 2020

Financial policies

This section should be read in conjunction with the financial statements on pages 61 to 88. An overview of the financial results is given in the treasurer’s report on page 55.

Fundraising

The RCP is grateful for the exceptional level of support that we have received during the course of 2020 from generous donors, including members and fellows, charitable trusts and foundations, and corporate partners.

Philanthropic support and corporate sponsorship are fundamental to the work of the RCP and help us to fulfil our wider charitable aim of improving healthcare. The funds that we raise go directly to supporting research; education and training; clinical improvement; patient safety; and the maintenance and development of our facilities. This report allows us to show how our charitable funds are distributed and spent. It demonstrates the benefits and impact that fundraising has on supporting physicians and improving standards of patient care.

Principal fundraising activities and performance

Giving Health is the RCP’s ongoing fundraising appeal to secure philanthropic donations to fund key areas of our work. Giving Health aims to raise funds for four vital projects that demonstrate our shared commitment to the medical profession:

Physicians for Africa – a partnership with the East, Central and Southern Africa College of Physicians to provide financial and in-kind support for a region desperately short of well-trained doctors
The Physicians’ Fund – the award of grants to trainees and new consultants pursuing innovation in medicine and helping to create a research-active health service
RCP at The Spine – a state-of-the-art facility in Liverpool for the education and examination of physicians, which will pioneer advances in medical education and support RCP members
Heritage – maintaining our Grade I listed buildings in London, including caring for our historic collections and providing welcoming spaces for meeting and collaboration.

COVID-19 required us to adapt our original fundraising strategy, which was focused on face-to-face meetings with major donors, a series of high level events, and international fundraising visits. We focused instead on a greater number of approaches to mid-level donors, smaller trusts/foundations, and more resilient corporate partners.

Fundraising income in 2020 (including gifts to unrestricted funds and to restricted income and endowment funds) increased to £2,238k (2019: £594k).

Our annual membership appeal was focused on COVID-19 and raised a total of £133k. This funded grants to help the NHS manage the response and longer-term consequences of the pandemic.

Nearly 300 donors to our Giving Health campaign have now been recognised through the Linacre Wall at the main entrance to our London home. Plans are being advanced to erect a counterpart wall in Liverpool at RCP at The Spine, and to establish a new legacy society of donors.

The RCP’s fundraising programme is carried out by a small team including specialists in trust/foundation, corporate, and major donor fundraising. The director of development reports to the CEO and works closely with the Board of Trustees. We aim to keep our fundraising costs below the average for the sector and in 2020 these costs were 13.5% of monies raised.

Fundraising controls and regulation

We recognise that our fundraising success is dependent on maintaining the trust of our donors and the public. We have a number of controls in place to ensure that our fundraising remains ethical, transparent, respects vulnerable people and is compliant with current regulation. Our campaigns are run by an in-house team and we do not engage the services of commercial partners to raise funds on our behalf.

Our Board of Trustees plays an active role in our fundraising activities, reviews fundraising plans, and ensures that fundraising activity operates in line with regulatory requirements and relevant best practice.

We have an ethical fundraising policy and carry out due diligence to ensure that we do not receive any donations that conflict with our values. All of our fundraisers receive compulsory training in this area and are members of the Chartered Institute of Fundraising, the professional membership body for UK fundraising.

The RCP is registered with the Fundraising Regulator (ref 128235) and has adopted the Code of Fundraising Practice. No complaints were received in relation to our fundraising activities during 2020 (2019: nil).

Investments

Powers and governance

The RCP’s bye-laws give the trustees powers to appoint fund managers to manage its investments.

The Investment Advisory Panel (IAP) is responsible for monitoring the performance of the investment portfolios and of the fund managers. The IAP meets with the fund managers quarterly to review their reports and progress. The IAP is chaired by the treasurer, and its membership includes fellows, independent external advisers, the executive director of Corporate Services and the director of Finance. The panel reports to the Finance and Resources Board.

Management

The majority of investments are managed by Cazenove Capital (part of Schroders plc) who have discretionary powers of investment within agreed restrictions as agreed in the Statement of Investment Principles.

The managers’ mandate is to invest, on a total returns basis, in a globally diversified portfolio of cash, equity, fixed income, convertible bonds, hedge fund securities, property funds and commodities’ funds. A relatively small investment remains with the former (pre-2011) investment managers Morgan Stanley, in the form of hedge funds that are slowly being run down, liquidated and transferred to Cazenove. Three specific trust funds invested with fund manager CCLA were transferred to Cazenove in early 2020. One other trust fund (The Cotton Trust) remains invested (as per its terms) with RBC / Royal Trust Corporation of Canada.

During 2020, the management of the investment portfolio has been reviewed by the finance and resources board, and the trustees, and our approach has been clarified with the investment managers.

The RCP’s objective is to invest its investment assets to manage returns, with a low to moderate level of risk, with targeted returns of CPI + 3% through a diversified asset portfolio. Within this framework a number of objectives have been agreed to help guide the Finance and Resources Board in their strategic management of the RCP’s investments.

Ethical and Climate Change Investment Policy

The RCP has operated an Ethical Investment Policy in line with guidance issued by the Church of England Investment Fund. We continue to hold minimal tolerances on the proportion of indirect funds held linked to production or supply of tobacco, armaments, pornography, gambling and sale or production of alcohol.

Climate change will significantly impact public health both in the UK and around the world. All that can be done should be done to limit global temperature rises in line with the goals of the Paris Agreement on climate change. If we are to avoid the extreme impacts of climate change on both people and the environment this means a world where we limit temperature rises to 1.5 degrees above pre-industrial levels.

As a medical college the Royal College of Physicians (RCP) has a particular role to play in highlighting the health impact of climate change.

In December 2019, the Board of Trustees approved a new Climate Change Investment Policy developed by the IAP. One of its main goals is set out below:

‘Disinvesting by 2023 from fossil fuel companies not demonstrably in line with the goals of the Paris Agreement: By 2023 and after engagement by our fund managers with those remaining oil and gas and mining companies in which we still retain a holding we will ask our fund managers to undertake a final assessment, using the insights of the Transition Pathway Initiative (TPI), to identify which oil and gas and mining companies are demonstrably on a path in line with the goals of the Paris Agreement. Any company that is not on such a path will be disinvested from.

Reporting by our fund managers: The RCP instructs its fund managers to report on a quarterly basis on their delivery against this policy and to evidence the seriousness by which they are engaging with companies and how they are using their voting and shareholder rights to do so.

Reporting on progress: The RCP will report annually on progress in implementing this policy.’

By December 2020 our fund managers reported that indirect investment in fossil fuels had decreased to less than 1% of the value of the portfolio and that total divestment was likely to occur earlier than expected, possibly in 2021.

Total returns policy

The RCP received a total return order from the Charity Commission, dated 6 February 2012, which enables the trustees to decide which part of the unapplied total return from the investment of the charity’s permanent endowments should be held on trust for application for the purposes of the charity.

The policy applied in determining the initial amounts of the trusts for investments and any unapplied total return was identifying an appropriate and suitable date at which the investments (which were all invested with and managed by external fund managers) were at their lowest. This date was determined (through reference to the general stock market conditions over the period) as 30 September 1988.

The value of the investments at this date was ‘frozen’ and classified as frozen permanent capital and the remainder of the investments was classified as unapplied total return.

The amount of the unapplied total return allocated to income was the actual costs of grants, fellowships and other costs such as medals, prizes and honoraria that were awarded in the financial year, as stipulated by and within the remit of the various funds.

Policy on reserves

To deliver its business plan, the RCP has agreed a budgeting and reserves policy that enables it to make appropriate strategic allocations of funds, while also securing a sound financial base for future requirements. Services are provided with a clear understanding of whether they should be subsidised, cost neutral or delivered at a surplus. Through this policy, the RCP seeks to develop new sources of income to mitigate the risk of overreliance on major income streams. Investment decisions on the resources necessary, both to deliver new activities and to sustain continuing commitments, are based on the RCP’s overall strategic needs.

The trustees make allocations between the main activities, based on the current environment and the changing requirements of the RCP’s key activities. The Finance and Resources Board recommends an overall financial framework for the preparation of annual budgets to the trustees, taking into account the need to maintain an appropriate level of reserves.

Reserves provide an important base from which the RCP can deliver against its charitable objectives, recognizing that some areas of income and expenditure can be variable and uncertain. The budgets and future plans are put in place to overcome any uncertainty over income or unexpected calls on the charity’s funds. At 31 December 2020 total reserves of RCP were £45.0 million. The RCP holds a number of permanently endowed and restricted funds which result from bequests or donations for particular purposes, details of which are set out in notes 22 and 23 to the financial statements. At 31 December 2020 total restricted funds were £3.7 million and endowment funds were £11.4 million.

The RCP also holds reserves in the form of designated funds that are earmarked for particular purposes by the trustees. At 31 December 2020 the balance on the designated funds was £17.5m. The main designated fund is the intangible and fixed assets fund, represented by tangible and intangible fixed assets less associated loan finance outstanding in respect of The Spine fit-out, which are not readily converted into cash. The leasehold replacement fund had been identified in prior years as one source of funds for the fit-out of RCP at The Spine in Liverpool, the fund and associated cash deposits has been released to the general fund in 2020 in line with this spend.

The general reserves of the RCP, excluding designated funds, are represented by a mixture of external investments and net assets that include cash reserves. The minimum target free reserves level is in the range of 3–6 months of unrestricted expenditure and is set based on: the risk to income and expenditure fluctuations, unexpected needs for funds, and the need to provide working capital for the operation.

The general reserves of the RCP as at 31 December 2020 were £16.7 million (2019 free reserves restated: £17.9 million). At 31 December 2020 the defined benefit pension scheme deficit was £4.2 million (2019: £4.2 million). Free reserves net of pension scheme deficit represent 7.3 months of the unrestricted operational expenditure, which is beyond the target free reserves level of between 3 and 6 months (£7.2m-£14.4m). While the financial impact of COVID-19 is likely to put pressure on the level of free reserves going forward, the target level is still appropriate.

Trading subsidiary

The principal activity of the company is to organise, provide facilities for and hold conferences, seminars, and courses of instruction, demonstrations, lectures, exhibitions, private dinners and functions. Net deficit for the RCP’s wholly owned trading subsidiary, The RCP Regent’s Park Limited, for the year ended 31 December 2020 was £106k. The company is looking to recover its trading position through the provision of more virtual and hybrid events, as well as harnessing opportunities from new facilities at the Spine building. The trading results and balance sheet of the subsidiary extracted from its audited accounts are set out in note 25 to the financial statements.

Going concern

The financial statements are prepared on a going concern basis. The Board of Trustees has considered the adoption of a going concern basis in the preparation of these financial statements. A projection of the RCP’s financial position to December 2022 has been undertaken including:

a review of budgets and forecasts
consideration of the key risks and uncertainties in the context of the RCP’s operations, including COVID-19
the mitigating actions the RCP can deploy for liquidity, together with the impact on reserves.

The COVID-19 pandemic has had a significant, immediate impact on the RCP’s operations. The government guidelines introduced in March 2020 resulted in two of the four main income streams for the RCP being impacted: examinations, and conference and event activity. Membership support and income is key and the RCP continues to ensure the delivery of value of being a member. The most significant financial impact has been in relation to the cancellation of face-to-face events and conferences, impacting RCP activity directly as well in the wholly owned trading subsidiary, Regents Park Ltd.

For the period to December 2022 the Board of Trustees has considered the impact of a series of scenarios and the actions required to mitigate the impact of the pandemic, including income generation, cost-saving measures and (in 2020 and 2021) utilising the support offered by the UK government through its Coronavirus Job Retention Scheme. Working capital requirements are met through income received from business activities and the RCP has the ability to drawdown against funds held within the investment portfolio if required. At December 2020 the RCP has adequate levels of cash and reserves and that is expected to remain the case through 2022 with operating income and expenditure expected to return to surplus in 2022.

Having regard to the above, the Board of Trustees believes it appropriate to adopt the going concern basis of accounting in preparing the financial statements.

Structure, governance and management

The RCP is a registered charity (no. 210508), incorporated by royal charter dated 23 September 1518, affirmed by an act of parliament in 1523. The charter of 1518 was amended by a supplemental royal charter dated 11 March 1999. The governing instruments of the RCP are the royal charters, and the bye-laws as amended from time to time. The RCP is also registered at Companies House as a company incorporated by royal charter (no. RC000899).

Board of Trustees

The Board of Trustees is the RCP’s governing body and meets five times a year – four main quarterly meetings plus a November budget review meeting. It is responsible for:

ensuring the RCP operates within its charitable objectives, and its standing orders in terms of matters reserved for the Board and those delegated to the CEO

providing strategic direction
agreeing the RCP annual operations plan and monitoring the progress of performance against that plan
ensuring the effective management and custody of all RCP assets.

The RCP is committed to ensuring best practice governance and the Board of Trustees embeds the Charity Governance Code to ensure the organisation’s effectiveness:

Organisational purpose – the Board of Trustees is clear about the RCP’s purpose, vision and mission as described in this report, and the public benefit this serves in supporting the evolution of the healthcare agenda. During 2020, trustees considered how the 2015–20 RCP strategy had fulfilled its purpose and in early 2021 we consulted widely with our stakeholders and plan to launch our new strategy at the end of 2021. This will guide our planned activities from 2022–25.
Leadership – in addition to setting strategy, the Board of Trustees seeks to provide leadership for the RCP and ensure delivery of the charity’s aims and values by the involvement of trustees (officers and lay trustees) alongside the executive team in key committees. The review of the bye-laws during 2019 enabled development of tighter governance processes and provided greater clarity around the respective roles of the Board of Trustees and Council. This work was ratified at the annual general meeting in September 2020.
Integrity – trustees are expected to follow The 7 principles of public life drawn up by the Committee on Standards in Public Life. During 2020 the RCP embedded its Code of Conduct and organisational values within all areas of its business. A raising concerns policy was written to support and encourage a responsive culture where people can speak up when things go wrong and the organisation can continue to learn and improve. In November 2020, an anti-fraud policy was published supported by existing RCP policies including hospitality and gifts (anti-bribery). A statement relating to the Modern Slavery Act is on the RCP website.
Decision-making, risk and control – in order to ensure strong oversight of the organisation by the Board of Trustees, the RCP commissioned two internal audits in Q1 2020, with one audit postponed to Q1 2021. The RCP embraced an improved risk identification and reporting processes and provided training to teams throughout the organisation to improve the understanding of risk and risk reporting.
Board effectiveness – the members of the Board reflect the complexity of the organisation. As part of the ongoing modernisation of governance and effectiveness of trustees a lay chair was appointed in June 2019.
Diversity – the Board currently has a diverse membership, and this will be kept under review. In 2020 the RCP published an independent review of equality, diversity and inclusivity across all areas of activity with recommendations to the trustees.
Openness and accountability – the RCP has many touchpoints with a wide variety of stakeholders. As part of the bye-law review consideration was given to aligning a Council meeting with the annual general meeting to improve attendance and enable a question-and-answer session with trustees as part of the meeting. Due to the pandemic, the AGM in 2020 was held virtually but it was agreed that future AGMs would follow a hybrid model to increase attendance and provide opportunity to engage with the trustees.

The Board of Trustees has the authority to delegate any of its powers to the RCP’s boards and committees. Ultimately, all decisions apart from changes to the bye-laws and regulations are either taken by or on behalf of the Board of Trustees, and reported at the annual general meeting.

The Board of Trustees comprises:

senior officers of the RCP ( ex officio – six)
members nominated from Council (four)
lay members appointed by the Board of Trustees (five).

Trustees are inducted in the operations of the RCP as well as their statutory obligations as a charity trustee when they are appointed. The training requirement for trustees is kept under regular review. An online governance hub makes material more accessible to trustees and an online declaration of personal interests and good standing of trustees supports good governance processes.

RCP Council

Council meets six times a year. Its function is to develop RCP policy in relation to professional and clinical matters, and to give authority to:

RCP statements and publications
conduct and results of the MRCP(UK) examination
elections to the fellowship and membership as well as of RCP officers.

There is one board with specific responsibility to the Council:

Medical Specialties Board.

RCP officers

The senior officers of the RCP (president, vice presidents, treasurer and registrar) are all trustees of the charity. Their involvement in all of the main boards and committees of the RCP ensures that due consideration is given to the RCP’s charter and bye-laws on every occasion.

Annual general meeting

The annual presidential election is held on the first Monday after Palm Sunday by act of parliament. In 2020, the AGM was decoupled from the presidential election to take place later in the year.

Fellows

Fellowship is the highest level of membership of the RCP and comes with many benefits and responsibilities. Fellows have distinguished themselves in the practice of medicine, medical science or medical literature. At the time of election, the fellow is normally a member of the RCP of at least 4 years standing, in a substantive consultant post for a minimum of 3 years, and making a significant contribution in one or more of these areas of practice. Fellows are nominated for election by Council and have the right to stand for office, to vote for officers and to attend and vote at the AGM.

Boards

There are four boards with specific responsibility to the Board of Trustees. They are:

Council
Finance and Resources Board (also the Board responsible for strategic theme 5)
Audit and Risk Committee
Remuneration Committee.

Four further boards report on the operational work of the RCP under the strategy themes and report through the operational plan to the Board of Trustees:

Care Quality and Improvement Board
Education Board
Membership Support and Global Engagement Board
Communications, Policy and Research Board.

Finance and Resources Board

In 2020 the Finance and Resources Board met four times. It has responsibility for:

agreeing and monitoring the application and use of resources
monitoring the business planning process and delegating decisions on new activities to senior management within agreed financial limits.

The Board is chaired by the treasurer, and its membership includes the president and registrar (both ex officio ), two elected members of Council, two other fellows and up to five members from outside the RCP.

There are two committees with specific responsibility to the Finance and Resources Board. They are:

Funding Awards Committee (formerly Trust Funds Management Committee)
Investment Advisory Panel.

Audit and Risk Committee

Formed at the end of 2016, this committee is responsible for internal controls, risk management and audit, leading to assurances on the veracity of the financial and management statements. During the year the committee commissioned one internal audit by haysmacintyre, as part of a continuing series which seeks to examine and improve various financial and operational practices of the RCP.

Remuneration Committee

This committee has been established to provide independent review and recommendations to the Board on the RCP’s remuneration policy, pay awards, senior staff performance reviews, and pay and related matters.

Statement of trustees’ responsibilities

The trustees are responsible for preparing the annual report and the financial statements in accordance with applicable law and regulations.

Charity law requires the trustees to prepare financial statements for each financial year in accordance with International Financial Reporting Standards (FRS102) and applicable law.

Under charity law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charity and the group and of the group’s net incoming or outgoing resources for that period. In preparing these financial statements, the trustees are required to:

select suitable accounting policies and then apply them consistently
observe the presentation principles in the Charities’ Statement of Recommended Practice (SORP)
make judgements and estimates that are reasonable and prudent
state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements
prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity and the group will continue to operate.

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charity’s and the group’s transactions and disclose with reasonable accuracy at any time the financial position of the charity and the group and enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the royal charters and byelaws. They are also responsible for safeguarding the assets of the charity and the group, and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The trustees of the charity are aware of their duty under section 17 of the Charities Act 2011 to have due regard to public benefit guidance published by the Charity Commission for England and Wales.

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charity’s website. Legislation in the UK governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Management

Responsibility for the day-to-day operations of the RCP is delegated to the chief executive, who is accountable to the Board of Trustees. The management and staff of the RCP are structured to carry forward the work and achieve the objectives of the RCP, and to provide support services. Each department of the RCP is also overseen at a governance level by a designated officer.

Key management personnel are considered to be those personnel who have the authority and responsibility for planning, directing and controlling the activities of the RCP. Key management personnel are remunerated within the RCP’s general staff policy for pay and reward that is competitive within the charity sector, proportionate to the complexity of each role, and responsible in line with our charitable objectives.

A large number of volunteers are involved with the RCP’s work, in the UK and abroad. The vast majority are doctors who are RCP members who support RCP activities, such as by being examiners, regional advisers, or representatives on consultant appointment committees. There are many more examples, and the RCP also has a Patient and Carer Network which allows members of the public to become involved. Medical staff give their own time, but also rely on NHS guidance about the ability to use NHS time for the greater benefit of the NHS.

Modern slavery statement

Pursuant to section 54(1) of the Modern Slavery Act 2015, the RCP has published a slavery and human trafficking statement for the financial year ending 31 December 2020. This is available to view on our website at: www.rcplondon.ac.uk/modern-slavery-and-human-trafficking-statement.

Risk management

The trustees have overall responsibility for risk management in the RCP. Agreed processes are in place by which the trustees review, identify and assess major risks and agree with management the controls that already are, or will be, put in place to manage those risks. These details form part of the risk register, which trustees regularly review in full. The controls put in place provide a reasonable but not absolute assurance that risks have been adequately mitigated.

Risk issues in the day-to-day operation of the RCP are delegated to management to monitor and implement appropriate control measures. Any new areas of risk identified are reported to the Audit and Risk Committee, including how they have been managed. The Audit and Risk Committee reports any areas of concern to the trustees, with recommendations for corrective action.

The principal categories of risk that the RCP monitored and sought to mitigate in 2020 and into 2021 are:

Area of risk	Risk	Mitigating factors	Mitigating factors
COVID-19	Shortfall in revenue due to cancellation of		Use of government furlough scheme.
	exams, conferences and events as a result		Implementing a range of cost
	of lockdowns.		improvements, including job vacancies not
			being replaced, reductions in workforce
	Potential impact on member enagegment,		and savings in non-payroll costs.
	operational delivery and staff welfare due		Establishment of RCP19 group looking at
	to remote working.		staff and estates issues.
			Weekly communications huddle to
			address immediate policy and
			communications requirements as a result
			of the pandemic.
			Investment in IT support.
			Staff surveys.
			Flexible working arrangements.
Governance	Complex range of activities and		Revision to bye-laws and clarification of
	organisational structure.		the role and responsibilities of the Board
			of Trustees.
			Adequate internal controls and policies in
			place.
			Appointment of internal auditors in 2017
			to help focus on high-risk areas.
			Development of the RCP strategy for
			2022–25.

Governance	Ongoing services structure provided		Revised memorandum of agreement
	through the Federation with the Scottish		(MoA) was agreed and signed in Dec 2018.
	physician colleges.		Independent audit of the Federation
			undertaken in 2021.
			Detailed operational plans have been
			developed.

Operational	Ageing and inflexible (grade I) estates		A capable property and facilities team,
plans	infrastructure in London, and the new		supported by advisers CBRE.
	expansion plans in Liverpool.

Area of risk	Risk	Mitigating factors	Mitigating factors

Operational	Strategic project puts excessive pressure on		Good project/programme management.
plans – RCP at	the reserves, causes management stretch		Focus on financial management/planning,
The Spine	and key personnel to leave. Fails to deliver		supported funding proposals.
	on opportunity.		Regular staff communication.

Financial risks	A deficit in the closed defined benefit		A new agreed deficit repayment of
	pension scheme, for which we have agreed		£685k pa until Dec 2023.
	a repayment over 7 years.		A strong Defined Benefit Trustee Board.
	Ability to generate income/fundraise and		Increased focus of cash management and
	grow/diversify the revenue base and our		planning.
	ability to control costs, causing cash		Established team assisting the RCP to raise
	management strain.		funds for strategic purposes.
			RCP at The Spine income diversification.
	Loss making trading activities.		Move to virtual events with lower costs in
			both the charity and trading company to
			mitigate loss of income as a result of
			COVID-19.

Environmental	Government policy on the NHS and impact		Continued influence on the engagement
or external	on medical professionalism and standards,		plans with our members and government
factors	while remaining aligned to the views of our		on NHS policy.
	members.

External auditor

Crowe U.K. LLP has indicated its willingness to be reappointed as statutory auditor.

Approved by the Board

The annual report has been approved by the Board of Trustees on 31 August 2021 and signed on its behalf by:

Professor David Croisdale-Appleby Chair of trustees

Professor Chuka Nwokolo Treasurer

Treasurer’s annual report

I am pleased to present my report for the year ending 31 December 2020.

During this, our 502nd year, the RCP has faced challenges unprecedented in our history as a result of COVID-19. Like many businesses and other charities, the RCP has had to find ways to mitigate the effects of the pandemic on its finances. In 2020 unrestricted income dropped by 33%, with expenditure falling by 22% in line with decreased activity across the RCP, resulting in a total operating deficit of (£3,284k), around three times greater than the deficit in 2019.

Despite the market volatility experienced by world financial markets leading to a reduction in equity values in the first half of the year, the RCP’s risk-based investment mix and a subsequent rallying of markets in the latter stages of the year resulted in an overall gain on investments of £1,460k. However, this was partly offset by an increase in the (closed) defined benefit pension fund actuarial deficit of (£602k), resulting in a overall net deficit funds movement of (£2,426k) (2019: £671k surplus).

	----------------------------- 2020 (£000) --------------------------- 2019 (£000) Unrestricted Restricted Endowment Total Total 23,738 7,085 200 31,023 42,732 28,778 5,415 114 34,307 43,899 (5,040) 1,670 86 (3,284) (1,167) 1,064 15 381 1,460 3,712 (602) 0 0 (602) (1,874) 1,353 (1,331) (22) 0 0 (3,225) 354 445 (2,426) 671
Total income
Total expenditure
Net operating result
Net (losses)/gains on investment assets
Other net gains/(losses)
Transfers
Net movement in funds for the year

Income and expenditure

The RCP’s consolidated total income in 2020 was £31.0 million (2019: £42.7 million), representing a substantial drop in income compared with 2019. The COVID-19 crisis and subsequent lockdowns had a severe impact in 2020 on a number of important RCP activities – exams and assessment, conferences and events, face-to-face education and training workshops, regional events and quality improvement collaboratives. The RCP benefited from the government Coronavirus Job Retention Scheme throughout the year, with just over £1.1 million claimed during the period, representing 4% of total income.

While unrestricted income took a significant hit throughout the period, restricted income recorded a 3% increase due in large part to donations received specifically for RCP at The Spine (£1.1 million compared with £0.1 million in 2019) and two significant legacy donations received in the same period. This offset the reduced clinical standards, national guidelines and education restricted work.

2020 saw membership numbers ending the year at 39,500, a growth of 7%. The newer physician associate category of membership continues to grow rapidly.

With decreased activity across the RCP, expenditure has fallen further to £34.3 million (2019: £43.9 million). College officers and staff have grappled with the twin objectives of maintaining the key activities of the RCP and keeping expenditure down. The executive team have been working hard to mitigate the financial position, including deferring investments in the London estate and IT systems development, and cutting non-essential costs, while preserving our core capabilities, key NHS services and support for members tackling the pandemic.

Construction and fit-out of The Spine was completed in May 2021. As part of Liverpool’s Knowledge Quarter, The Spine will be a centre of excellence and innovation to engage members, fellows and partner organisations in the north and enhance RCP activities. It will be certified to the Platinum WELL Standard, which will make it one of the healthiest buildings in the UK. Although RCP at The Spine will not be fully open until September, we have already begun to host exams in our purpose-built assessment facilities, with physician associate exams held from 6 May 2021.

Our fundraising team is now well established and is working well towards its objective of contributing £3 million towards the funding of The Spine, with over £1 million raised in 2020. The success of the Linacre Wall personalised brick project in RCP at Regent’s Park has led to plans for a similar fundraising project for RCP at The Spine. The COVID-19 Appeal has been successful in raising funds to support research into aspects of the pandemic.

Investments

As at 31 December 2020 our investments, including cash deposits, stood at £32.9 million. During the year the leasehold fund, £4.3 million, was liquidated in order to support the fit-out of RCP at The Spine. In the same period £12.5 million was liquidated from main funds to support ongoing working capital as a result of the pandemic and significant shortfall in income.

The objectives of our investment strategy are to achieve long-term growth at 3% ahead of CPI inflation, at an acceptable level of risk, applying a total return startegy. Our investments are now mainly held by fund managers Cazenove, with small holdings still with Morgan Stanley and Canada Trust Corp. The investment skills of Cazenove, together with our knowledgeable Investment Advisory Panel enable us, on average, to achieve target performance with downside protection. We are continuing to evolve our ethical investment stance, which is aligned to the RCP’s charitable objectives to improve health and prevent health harms. The process of removing any residual fossil fuel assets in the RCP’s portfolio is almost complete.

Pensions

As at the end of 2020, the deficit of the defined benefit pension scheme, which has been closed to new members since 2002 and to further accrual from 2008, decreased slightly from (£4.243) million to (£4.239) million on an FRS 102 basis. Despite an increase in scheme liabilities over the year due to a change in financial assumptions the funding position has remained broadly the same due to assets performing well over the period. A liability driven investment (LDI) strategy is in place with the inflation and interest rate risk in the scheme decreased substantially. The effect of this protection has been apparent in 2020.

The RCP continues to run a Group Personal Pension Plan (GPPP) scheme for new staff joiners and maintains the RCP single employer trust-based defined contribution pension scheme which was closed to new entrants from the start of 2018 but continues to run for existing staff members.

Balance sheet and reserves

Despite the significant challenges faced in 2020, at the end of the year the RCP held net assets of £45.0 million of which £32.9 million is the market value of our investment portfolio and £11.0 million in cash. Endowment and restricted funds comprise £15.1 million, therefore unrestricted funds comprise £30.0 million, of which free reserves (net of the designated funds but gross of the long-term defined benefit pension deficit) have fallen slightly to £16.7 million from £17.9 million in 2019. Heritage assets (rare books, manuscripts, paintings, silverware), originally gifts to the college over the past 5 centuries, are not valued at all in the financial balance sheet, but have an insurance value of ~£41 million.

Future financial plans

The trustees and I remain vigilant in seeking to protect the RCP and support its members and to use the resources available to fulfil the RCP’s objectives and promote its work as efficiently as possible. Our reserves policy is to maintain the level of general reserves at between 3 and 6 months of unrestricted operational expenditure.

While the RCP’s balance sheet position remains strong, the COVID-19 crisis has had a severe impact on core activities in 2020 and this has followed the RCP into 2021. The focus will be on keeping expenditure down while continuing to carry out key activities.

With thanks

As ever, I am extremely grateful for the help and support that I have received in my role, from so many who have given generously of their time to help carry the work of the RCP forward.

I owe a particular debt of gratitude to our independent pro-bono external advisers, who give unfailingly of their time and expertise to advise and support the infrastructure and financial activities of the RCP. I should also particularly like to thank: all the staff of the RCP Finance Department for their unfailing help and advice; the members of the Finance and Resources Board for their assistance in overseeing and monitoring the RCP’s finances, developments of our IT facilities, and our estates strategy; the members of the Investment Advisory Panel for their work in monitoring the implementation of our investment strategy and the performance of the investment managers; and the Audit and Risk Committee for their assistance in reviewing and providing assurances on the RCP’s governance and controls.

Professor Chuka Nwokolo Treasurer 31 August 2021

Independent auditor’s report to the trustees of the Royal College of Physicians

Opinion

We have audited the financial statements of the Royal College of Physicians for the year ended 31 December 2020 which comprise the consolidated statement of financial activities, the parent and consolidated balance sheets, the consolidated cash flow statements and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102, the Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

give a true and fair view of the state of the group’s and of the parent charity’s affairs as at 31 December 2020 and of the group’s incoming resources and application of resources, for the year then ended;
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
have been prepared in accordance with the requirements of the Charities Act 2011.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustee’s use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company’s ability to continue as a going concern for a period of at least 12 months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The trustees are responsible for the other information contained within the annual report. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters in relation to which the Charities Act 2011 requires us to report to you if, in our opinion:

the information given in the financial statements is inconsistent in any material respect with the trustees’ report; or
sufficient accounting records have not been kept by the parent charity; or
the financial statements are not in agreement with the accounting records and returns; or
we have not received all the information and explanations we require for our audit.

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 52, the trustees are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group’s and the parent charity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charity or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditor under section 151 of the Charities Act 2011 and report in accordance with the Act and relevant regulations made or having effect thereunder.

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Details of the extent to which the audit was considered capable of detecting irregularities, including fraud and non-compliance with laws and regulations are set out below.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

We obtained an understanding of the legal and regulatory frameworks within which the charitable group operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Charities Act 2011 together with compliance with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charity for fraud. The laws and regulations we considered in this context were General Data Protection Regulation (GDPR), employment legislations and taxation legislations.

Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the trustees and other management and inspection of regulatory and legal correspondence, if any.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the timing of recognition of income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management and the trustees about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission, review of internal audit reports conducted in the period and reading minutes of meetings of those charged with governance.

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non-compliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.

Use of our report

This report is made solely to the charity’s trustees, as a body, in accordance with section 154 of the Charities Act 2011. Our audit work has been undertaken so that we might state to the charity’s trustees those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charity and the charity’s trustees as a body, for our audit work, for this report, or for the opinions we have formed.

Crowe U.K. LLP

Statutory auditor London

3rd September 2021

Crowe UK LLP is eligible for appointment as auditor of the charity by virtue of its eligibility for appointment as auditor of a company under section 1212 of the Companies Act 2006.

Consolidated statement of financial activities for the year ended 31 December 2020

	Notes Unrestricted funds	Restricted funds	Endowment funds	Total funds
				31 Dec 20 31 Dec 19
	£000	£000	£000	£000 £000
Income from:
Fundraising	2 307	1,931	-	2,238 594
Charitable activities
Care quality improvement	3 2,501	4,876	-	7,377 8,530
Education and Federation	4 9,819	159	-	9,978 17,982
Membership support and global engagement	5 7,818	2	-	7,820 8,096
Communications, policy and research*	6 42	88	-	130 130
Heritage and investing in our future	7 71	-	-	71 73
Meetings and events (medical)	573	-	-	573 4,269
Activities to generate funds
Investment income	8 448	18	200	666 1,085
Meetings and events (non-medical) – trading	25 928	-	-	928 1,772
Coronavirus Job Retention Scheme	1,083	11	-	1,094
Other income	148	-	-	148 201
Total income	23,738	7,085	200	31,023 42,732
Expenditure on:
Raising funds
Fundraising costs	346	-	-	346 253
Investment management fees	113	4	48	165 159
Meetings and events (non-medical)	25 1,033	-	-	1,033 1,713
	1,492	4	48	1,544 2,125
Charitable activities
Care quality improvement	9 4,181	4,686	-	8,867 10,605
Education and Federation	10 9,244	487	-	9,731 14,138
Membership support and global engagement	11 3,602	157	-	3,759 4,668
Communications, policy and research	12 3,211	75	-	3,286 4,016
Heritage and investing in our future	13 2,698	3	-	2,701 2,265
Meetings and events (medical)	4,350	-	-	4,350 6,016
Trusts and fellowships	-	3	66	69 66
Total expenditure	14/15 28,778	5,415	114	34,307 43,899
Net operating (loss)/gain	(5,040)	1,670	86	(3,284) (1,167)
Net gains/(losses) on investment assets	1,064	15	381	1,460 3,712
Net income/(expenditure)	(3,976)	1,685	467	(1,824) 2,545
Transfers between funds	21/22 1,353	(1,331)	(22)	- -
Actuarial (losses)/gains on defined benefitpension scheme	26 (602)	-	-	(602) (1,874)
Net movement in funds for the year	(3,225)	354	445	(2,426) 671
Funds brought forward at 1 Jan 2020 21/22/23 33,141		3,356	10,975	47,472 46,801
Funds carried forward at 31 December 2020	29,916	3,710	11,420	45,046 47,472

*formerly Strategy, communications and policy

Consolidated and RCP balance sheets as at 31 December 2020

			2020	2019
		Group	RCP	Group RCP
	Notes	£000	£000	£000 £000
Fixed assets
	Intangible assets 16a	1,417	1,417	2,018 2,018
	Tangible fixed assets 16b	23,324	23,324	12,762 12,762
	Investments 17	32,932	32,932	48,194 48,194
		57,673	57,673	62,974 62,974
Current assets
	Stocks	114	114	178 178
	Debtors 18	6,102	6,287	4,247 4,061
	Investment accounts	309	303	309 303
	Cash	10,981	10,845	1,465 1,385
		17,506	17,549	6,199 5,927
Creditors
Amounts falling due within 1year
Creditors and accrued expenses 19		(10,308)	(10,245)	(11,170) (10,898)
Examination and other income received in 19 advance		(7,226)	(7,226)	(6,288) (6,288 )
Provisions 19b		(127)	(127)
		(17,661)	(17,598)	(17,458) (17,186)
Amounts falling due after 1year 19		(8,233)	(8,233)	- -

Net current liabilities		(155)	(49)	(11,259) (11,259)

Net assets excluding pension liability		49,285	49,391	51,715 51,715

Defined benefitpension scheme liability 26		(4,239)	(4,239)	(4,243) (4,243)

Net assets including pension liability 24		45,046	45,152	47,472 47,472
Represented by
Unrestricted funds:
Designated funds	21
	Leasehold Replacement Fund	-	-	4,357 4,357
	Fixed and Intangible Assets Fund	17,241	17,241	14,780 14,780
	Legacies Development Fund	147	147	147 147
	Carequalityimprovement	105	105	179 179
		17,493	17,493	19,463 19,463

General charitable fund		16,662	16,768	17,948 17,921
	Less: Pension scheme liabilities 26	(4,239)	(4,239)	(4,243) (4,243)
		12,423	12,529	13,678 13,678

Total unrestricted		29,916	30,022	33,998 33,141
Restricted	22	3,710	3,710	3,187 3,356
Endowment	23	11,420	11,420	9,616 10,975
		45,046	45,152	47,472 47,472

The results of the parent charity for the year ended 31 December 2020 was a £2,426k deficit (2019: £671k gain).

Approved for and on behalf of the RCP (Charity Registration No. 210508) on 31 August 2021 and authorised for issue.

President: Andrew Goddard

Treasurer: Chuka Nwokolo

Consolidated statement of cash flow for the year ended 31 December 2020

		2020 £000 2019 £000
Cash flow from operating activities
Net cashprovided by / (used in)operatingactivities	A	(3,327) 2,396
Dividends,interest and rents from investments		666 1,085
Purchase ofproperty, plant and equipment		(11,669) (2,247)
Purchase of intangible assets		(296) (475)
Proceeds from sale of investments		19,775 4,838
Purchase of investments		(3,053) (5,419)
Donation of cash to discontinued operation		- (804)
Net cashprovided by (used in) investing activities		5,423 (3,022)
Proceeds from borrowings*		7,500 -
Borrowings interest andprincipal repayments*		(58) -
Finance leasepayments**		(22) -
Net cashprovided by (used in) financing activities		7,420 -
Change in cash and cash equivalents in the reporting period		9,516 (626)
Cash and cash equivalents at the beginning of the reporting period	B	1,774 2,400
Cash and cash equivalents at the end of the reporting period	B	11,290 1,774

*During 2020 the organisation utilised £7.5m of a £10m revolving credit facility with Santander to fund the RCP at The Spine development.

**During 2020 the organisation entered into a finance lease for new IT infrastructure.

Notes to consolidated statement of cash flow for the year ended 31 December 2020

	2020 £000	2019 £000
A. Reconciliation of net income/(expenditure) to net cash flow from operating activities
Net movement in funds for the reporting period (as per the statement of financial activities)	(1,823)	2,545
Adjustments for:
Depreciation charges	1,472	1,471
Amortisation charges	897	901
Loss/(gains)on investments	(1,460)	(3,712)
Loss on discontinued operation	-	767
Increase/(decrease)inprovisions	127	-
Dividends,interest and rents from investments	(666)	(1,085)
(Gain)on valuation of defined benefitpension scheme	(606)	(609)
(Increase)/decrease in stocks	64	(19)
(Increase)/decrease in debtors	(1,855)	(249)
Increase/(decrease)in creditors	523	2,386
Net cashprovided by/(used in) operating activities	(3,327)	2,396

B. Analysis of cash and cash equivalents
Cash in hand	10,981	1,465
Notice deposits and investment accounts (less than 30 days)	309	309
Total cash and cash equivalents	11,290	1,774

Analysis of changes in net debt

								Interest
				At 1 Jan	Cash	New finance	Acquired	and non-	At 31 Dec
				2020	flow	leases	debt	utilisation	2020
								charges
				£000	£000	£000	£000	£000	£000
Cash and	cash	equivalents
Cash in hand				1,465	9,516	-	-	-	10,981
Notice deposits and investment accounts(less than 30 days)				309	-	-	-	-	309
Total cash and cash equivalents				1,774	9,516	-	-	-	11,290

Borrowings
Loan to finance			fixed assets –
falling due after more than one				-	58	-	(7,500)	(58)	(7,500)
year
Finance lease obligations				-	22	(364)	-	(9)	(351)
Total borrowings				-	80	(364)	(7,500)	(67)	(7,851)
Total net	debt			1,774	9,596	(364)	(7,500)	(67)	3,439

Notes to the financial statements for the year ended 31 December 2020

1 Accounting policies

Charity information

The Royal College of Physicians (RCP) was established by royal charter in 1518. It is a registered with the Charity Commission for England and Wales and is a Royal Charter company registered with Company House. The charity registration number is 210508 and the company registration number is RC000899. RCP is a Public Benefit Entity and its registered office is 11 St Andrews Place, London NW1 4LE.

Basis of preparation

The consolidated financial statements comprise the financial statements of RCP, and its subsidiary undertaking, The RCP Regent’s Park Limited, on a line-by-line basis and adjusted for the elimination of inter-group transactions and balances.

The financial statements have been prepared in accordance with the Statement of Recommended Practice: Accounting and Reporting by Charities (2015) preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Charities Act 2011.

The financial statements have been prepared to give a ‘true and fair’ view and have departed from the Charities (Accounts and Reports) Regulations 2008 only to the extent required to provide a ‘true and fair view’. This departure has involved following Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) issued on 16 July 2014 rather than the Accounting and Reporting by Charities: Statement of Recommended Practice effective from 1 April 2005 which has since been withdrawn.

RCP constitutes a public benefit entity as defined by FRS 102.

The financial statements are drawn up on the historical accounting basis, except that investments held as fixed assets are carried at market value.

Going concern

a review of budgets and forecasts
consideration of the key risks and uncertainties in the context of the RCP’s operations, including COVID-19
the mitigating actions the RCP can deploy for liquidity, together with the impact on reserves.

examinations, and conference and event activity. Membership support and income is key and the RCP continues to ensure the delivery of value of being a member. The most significant financial impact has been in relation to the cancellation of face-to-face events and conferences, impacting RCP activity directly as well in the wholly owned trading subsidiary, Regents Park Ltd.

Having regard to the above, the Board of Trustees believes it appropriate to adopt the going concern basis of accounting in preparing the financial statements.

Income

Subscriptions income, admission fees, grants and donations are accounted for once there is entitlement, probability of receipt and can be reliably measured. Legacies are accounted for when there is adequate probability over entitlement, amount and receipt. For residual legacies, entitlement is deemed to be the earlier of settled estate accounts and notification of a pending payment or actual payment being received. Investment income is recognised when due except for dividends which are accounted for on receipt. Income is deferred only when conditions have to be fulfilled before the RCP becomes entitled to it or where the donor has specified that the income is to be expended in the future period. In the case of membership subscriptions and examination admissions any receipt in respect of future years is shown as deferred income. Government grants are recognised as income when any specific conditions are met.

Expenditure

All expenditure is accounted for under the accruals concept and stated gross of irrecoverable VAT. All costs are allocated to the charitable cost centres on an actual basis, with the exception of administration costs which are allocated on the following basis:

central management and human resources: number of staff in the cost centres
finance: proportion of transactions processed
buildings and office services: square footage of office space occupied
IT services: number of users of the RCP network.

Salaries are allocated according to the nature of work performed by each member of staff.

Governance costs comprise the costs incurred, which are directly attributable to the management of the charity’s assets, organisational procedures and the necessary legal procedures for compliance with statutory requirements.

Rentals for leased assets held under the terms of operating leases are charged directly to the statement of financial activities (SOFA) over the term of the lease.

Tangible and intangible fixed assets

No 11 St Andrews Place, a leasehold property held under a 99-year lease expiring in 2060 and Nos 1–10 St Andrews Place, leasehold properties held under a lease that expires in 2084, are being depreciated over 49 years from the commencement of the respective leases. The cost of additions to existing structures has been depreciated, concurrently, over the remaining life of the leases. Equipment, intangible assets, furniture and fixtures are capitalised when the cost of the project exceeds £15,000 and has a useful life spread over a number of financial years. These capital costs are depreciated and intangible assets amortised by equal instalments over their anticipated useful lives, at rates between 5% and 25%. Depreciation and amortisation is allocated to the departments within the RCP on the basis of area occupied. No depreciation or amortisation is charged on assets in the course of construction. At each reporting date the RCP assesses if there is any indication of impairment of its estate and other fixed assets.

Costs that have been capitalised for RCP North phase 1 are being depreciated over the life of the lease, currently 3 years.

Collections

In addition to the capitalised fixed assets held for the RCP’s own use, the RCP also has a number of assets of historical interest. These comprise learned publications and a unique collection of busts and portraits, together with other objects, whose intrinsic value is also bound up with the RCP’s history. The trustees consider that the significant administrative expenses incurred in deriving a reliable cost for the capitalisation of these items would exceed the usefulness of such information to the user of the financial statements.

Finance leases

Finance leases are recognised where the risks and rewards of ownership of the leased asset are held by the lessee (The RCP). These are recongised as a right-to-use fixed assets with a corresponding lease liability comprised of the present value of the minimum lease payments, derived by discounting them at the interest rate implicit in the lease. Right-to-use assets are depreciated over the lease period or asset life, where the asset is retained at the end of lease and has an asset life longer that the lease term.

Investments

Investments are stated in the balance sheet at the mid-market value at the balance sheet date. Realised gains or losses are calculated by reference to disposal proceeds and either opening market value or cost if acquired during the year.

Stock

Stock is valued at the lower of cost and net realisable value.

Cash and cash equivalents

Cash and cash equivalents includes cash at bank and in hand, cash held for reinvestment and short-term deposits.

Pensions

The RCP has three pension schemes, one providing defined benefits based on final salary, the other two providing benefits based on defined contributions invested with Standard Life. The pension costs for the defined contribution scheme are charged to the statement of financial activities as they become payable in accordance with FRS 102. The pension costs relating to the defined benefit scheme are assessed in accordance with the advice of an independent qualified actuary.

The defined benefit pension scheme current service costs and the net of the scheme interest cost and the expected return on the scheme assets for the year are charged to the statement of financial activities within superannuation costs. Actuarial gains and losses are recognised within other recognised gains and losses.

The defined benefit pension scheme assets are measured at fair value at the balance sheet date. Scheme liabilities are measured on an actuarial basis at the balance sheet date using the projected unit method and discounted at a rate equivalent to the current rate of return on a high-quality corporate bond of equivalent term to the scheme liabilities. The resulting defined benefit asset or liability is presented separately after other net assets on the face of the balance sheet.

Taxation

The RCP is eligible for the tax exemptions available for charitable activities.

Unrestricted funds

These funds are received and applied to achieve the general objectives of the RCP.

Designated funds

Designated funds are unrestricted funds set aside by the trustees for specific future purposes or projects. The movements on these funds are analysed in note 21.

Restricted funds

Restricted funds are subject to specific conditions laid down by the donors as to how they may be used. Note 22 gives details of these funds.

Endowment funds

Endowment funds relate to bequests and gifts to the RCP, the terms of which stipulate that the capital may not be spent, and the income is to be utilised to meet the costs of awards, lectures and other RCP expenditure. Movements in these funds are shown in note 23.

Total return accounting

The trustees of the RCP applied to the Charity Commission in January 2012 for authorisation to enable the permanent endowments within the RCP trust funds to be invested on a total return basis as this would facilitate a better return on investments, without prejudicing the investment management policy.

Upon receiving the requisite order from the Charity Commission on 6 February 2012 the RCP trust fund committee approved the base date for the commencement of the total return investment policy to be 30 September 1988. The permanent endowments in note 23 of the financial statements have been recalculated as at the above date.

Critical accounting judgements and key sources of estimation uncertainty

The key sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements are described in the accounting policies and are summarised below:

Pension liabilities – the charity recognises its liability to its defined benefit pension scheme which involves a number of estimations as disclosed in note 26.

Financial instruments

Financial assets and financial liabilities are recognised when the RCP becomes a party to the contractual provisions of the instrument. Additionally all financial assets and liabilities are classified according to the substance of the contractual arrangements entered into. Financial assets and liabilities are initially measured at transaction price (including transaction costs) and are subsequently re-measured where applicable at amortised cost. Financial assets held at amortised cost comprise cash at bank and in hand, short-term investments together with accrued interest and other debtors. Financial liabilities held at amortised costs comprise other creditors and accruals.

Operating leases

Rental income from operating leases is recognised on a straight-line basis over the term of the relevant lease. Initial direct costs incurred in negotiating and arranging an operating lease are added to the carrying amount of the leased asset and recognised on a straight-line basis over the lease term.

Notes to the financial statements continued

Incoming resources

		Unrestricted	Restricted/	2020	2019
			endowment
		£000	£000	£000	£000
2	Fundraising
	Donations	155	264	419	443
	Legacies	152	518	670	61
	Libraryand museum	-	3	3	2
	RCP North	-	1,051	1,051	57
	RCP CQID	-	15	15	-
	Physicians’ fund	-	80	80	31
		307	1,931	2,238	594

3	Carequality improvement
	National Guideline Centre	71	2,761	2,832	3,222
	Core and Audit and Accreditation	2,190	2,115	4,305	5,063
	Invited Service Reviews	240	-	240	245
		2,501	4,876	7,377	8,530

4	Education and Federation
	Education and conferences	1,659	159	1,818	4,206
	Continuing professional development	15	-	15	215
	MRCP(UK)examinations	6,413	-	6,413	11,809
	Physicians TrainingBoard	1,732	-	1,732	1,626
		9,819	159	9,978	17,982

5	Membership support andglobal engagement
	Membership	7,609	-	7,609	7,194
	UK regional offices	124	-	124	557
	International	79	2	81	333
	Medical Workforce Unit	6	-	6	12
		7,818	2	7,820	8,096

6	Communications, policy and research
	Publications	30	-	30	47
	External communications	12	88	100	83
		42	88	130	130

7	Heritage and investing in our future
	Libraryand museum services	71	-	71	73
		71	-	71	73

8	Investment income
	Dividends	180	83	263	239
	Interest on investments	268	135	403	846
		448	218	666	1,085

Notes to the financial statements continued

Resources expended

		Unrestricted Restricted/ Endowment	2020	2019
		£000 £000	£000	£000
9	Carequality improvement
	National Guideline Centre	292 2,640	2,932	3,659
	Core and Audit and Accreditation	3,472 2,046	5,518	6,591
	Invited Service Reviews	417 -	417	355
		4,181 4,686	8,867	10,605

10	Education and Federation
	Education and conferences	4,206 487	4,693	6,317
	Continuing professional development	118 -	118	175
	MRCP(UK)examinations	4,084 -	4,084	5,473
	Physicians TrainingBoard	836 -	836	1,406
	Faculty of Medical Leadership and Management	- -	-	767
		9,244 487	9,731	14,138

11	Membership support andglobal engagement
	Membership	1,803 -	1,803	2,108
	UK regional offices	1,000 -	1,000	1,364
	International	496 157	653	848
	Medical Workforce Unit	303 -	303	348
		3,602 157	3,759	4,668

12	Communications, policy and research
	Professional affairs	468 -	468	644
	Committees	402 -	402	423
	Publications	864 -	864	1,184
	External communications	1,477 75	1,552	1,765
		3,211 75	3,286	4,016

13	Heritage and investing in our future
	Libraryand museum services	1,428 3	1,431	1,568
	RCP North	1,270 -	1,270	697
		2,698 3	2,701	2,265

Notes to the financial statements continued

Expenditure on	Direct costs	Staff costs	Other support costs	Total 2020	Total 2019
	£000	£000	£000	£000	£000
Raising funds
Fundraisingandpublicitycosts	16	257	73	346	253
Investment management fees	165	-	-	165	159
Meetings and events(non-medical)	464	-	569	1,033	1,713
Charitable expenditure
Carequalityimprovement	1,701	5,249	1,917	8,867	10,605
Education and Federation	2,586	5,645	1,500	9,731	14,138
Membership support and global engagement	524	2,045	1,190	3,759	4,668
Communications, policyand research	534	2,285	467	3,286	4,016
Heritage and investingin our future	170	1,248	1,283	2,701	2,265
Meetings and events(medical)	658	1,480	2,212	4,350	6,016
Trusts and fellowships	63	-	6	69	66
Total for 2020	6,881	18,209	9,217	34,307	43,899

Total for 2019	12,019	17,827	14,053	43,899

				2020	2019
The analysis of other support costs is as follows:				£000	£000
Administrative overheads				1,060	1,481
Information technologycosts				3,215	3,406
Buildingoverheads				2,202	2,372
Travel,meetings,subscriptions andjournals				178	705
Governance costs*				127	62
Other costs, including staff costs of central services				2,435	6,027
				9,217	14,053

*Governance costs include fees payable to the auditors from audit fees of £45.6k (2019: £41.5k) and non-audit services of £3k (2019: £2k).

Notes to the financial statements continued

15	Employees and trustees	2020	2019
	The total costs of salaries and wages were as follows:	£000	£000
	Salaries and wages	15,227	14,949
	Social securitycosts	1,575	1,544
	Pension Costs	1,407	1,334
		18,209	17,827

		2020	2019
	The average number of employees in theyear was:	413	414
	The number of employees whose emoluments exceeded £60,000 were:
	£60,001–£70,000	14	12
	£70,001–£80,000	9	5
	£80,001–£90,000	3	3
	£90,001–£100,000	5	6
	£100,001–£110,000	1	1
	£110,001–£120,000	1	-
	£120,001–£130,000	-	-
	£130,001–£140,000	-	-
	£140,001–£150,000	1	1

		2020	2019
15a	Keymanagementpersonnel	£000	£000
	Total employee benefits paid to key management personnel (Including pension contributions)	1,161	1,156

		2020	2019
15b	Terminationpayments
	No ofpayments	13	11
	Value ofpayments(£000)	103	90

15c	Payments to trustees	2020	2019
	No of payments made to trustees, this includes payments to officers supporting their defined roles as senior officers as well as their trustee roles. No other remuneration was paid to trustees from the RCP in the current orpreceding years.	7	15
	Value ofpayments(£000)	8	48

Trustees are not remunerated and this is a reimbursement of costs.

Twenty-eight (2019: 25) of the above employees are members of the defined contribution pension scheme, six are members of the GPPP scheme (2019: 3) and three are also members of the defined benefit pension scheme (2019: 3), which is now closed. Contributions paid into the defined contribution pension scheme for the employees for the year was £1,415k (2019: £1,334k).

£59k of termination payments remained outstanding at year-end to be paid in 2021.

Notes to the financial statements continued

16a Intangible IT assets (Group and RCP)	Intangible IT assets	Intangible IT assets under	Total
	in use	construction	2020
	£000	£000	£000
Cost at 1 January 2020*	4,527	229	4,756
Additions	58	238	296
Transfers/adjustments	104	(104)	-
Cost at 31 December 2020	4,689	363	5,052
Accumulated amortisation at 1 January 2020	(2,738)	-	(2,738)
Amortisation for theyear	(897)	-	(897)
Accumulated amortisation at 31 December 2020	(3,635)	-	(3,635)
Net book value at 31 December 2020	1,054	363	1,417
Net book value at 31 December 2019	1,789	229	2,018

16b Tangible assets (Group and RCP)	Leasehold	Furniture	IT & AV	Assets under	Total
	properties	and fixtures	tangible assets	construction	2020
	£000	£000	£000	£000	£000
Cost at 1 January 2020	22,734	1,239	2,186	1,086	27,245
Additions	146	22	606	11,259	12,033
Transfers/adjustments	-	-	33	(33)	-
Cost at 31 December 2020	22,880	1,261	2,825	12,312	39,278
Accumulated depreciation at *1 January 2020(restated) **	(12,506)	(499)	(1,477)	-	(14,482)
Depreciation for theyear	(1,036)	(111)	(325)	-	(1,472)
Accumulated depreciation at 31 December 2020	(13,542)	(610)	(1,802)	-	(15,954)
Net book value at 31 December 2020	9,338	651	1,023	12,312	23,324
Net book value at 31 December 2019	10,228	483	965	1,086	12,762

*Restatement relates to re-classification error from 2019 between furniture and fixtures and IT&AV tangible assets

The majority of the costs of tangible assets under construction relates to development fees and costs associated with RCP at The Spine.

|17 Investments (Group and RCP)
|------Unrestricted-------||||Total| |---|---|---|---| |Designated for leasehold
General|Restricted|Endowment|2020
2019| |£000
£000|£000|£000|£000
£000| |Market value at 1 January 2020
4,357
32,356|1,874|9,607|48,194
43,901| |Additions at cost
1,710
68|-|1,275|3,053
5,419| |Disposals
(6,014)
(12,602)|(1)|(1,158)|(19,775)
(4,838)| |Loss/gains
19
1,045|15|381|1,460
3,712| |Total investments at 31 December 2020
72
20,867|1,888|10,105|32,932
48,194| |Historical cost as at 31 December 2020|||34,597| |The above investments are held as follows:|||2020
2019| ||||£000
£000| |Equities|||18,462
23,455| |Bonds|||2,914
2,567| |Multi-asset funds|||3,064
4,333| |Alternatives|||4,722
6,249| |Cash|||3,770
11,590|

Notes to the financial statements continued

Debtors (Group and RCP)			2019
	Group	RCP	Group	RCP
	£000	£000	£000	£000
Current
Trade debtors	1,179	1,089	1,570	1,465
Other debtors	998	998	731	648
Prepayments	524	524	995	996
Accrued income	3,401	3,401	951	952
	6,102	6,012	4,247	4,061
Non-Current
Loans due from subsidiary	-	275	-	-
	6,102	6,287	4,247	4,061

19	Creditors and accrued expenses (Group and RCP) 2020 2019
	Group RCP Group RCP
	£000 £000 £000 £000
	Current
	Trade creditors 912 871 4,737 4,158
	Other creditors 3,089 2,859 2,866 2,799
	Tax and social securitycreditors 421 421 413 413
	Accruals 5,809 5,803 3,154 3,140
	Amount due to subsidiaryundertaking - 214 - 388
	Obligations under finance lease 77 77 - -
	10,308 10,245 11,170 10,898

	Examination and other income received in advance (Group and RCP) Balance b/f 1 Jan 20 Released to SOFA Received in year Balance c/f 31 Dec 20
	£000 £000 £000 £000

	Examination income 4,700 4,700 4,523 4,523
	Other income 1,588 1,558 2,673 2,703
	6,288 6,258 7,196 7,226

	Non-Current
	Group RCP Group RCP
	£000 £000 £000 £000
	Bank loan 7,500 7,500 - -
	Accruals 459 459 - -
	Obligations under finance lease 274 274 - -
	8,233 8,233 - -

Notes to the financial statements continued

19b Provisions for liabilities (Group)	Other £000	2020 total	2019 total
Provisions at 1 January	-	-	-
Additionalprovisions made in theyear	127	127	-
Provisions released fromprioryears	-	-	-
Provision for liabilities at 31 December	127	127	-

20 Financial assets and liabilities	2020	2019
	£000	£000
Financial assets held at fair value	32,932	48,194
Gains/(losses)on assets held at fair value	1,460	3,712

Notes to the financial statements continued

21 Unrestricted funds
	Balance					Balance
	as at	Income	Expenditure	Gains/losses	Transfers	as at
	01/01/2020					31/12/2020
	£000	£000	£000	£000	£000	£000
Unrestrictedgeneral	13,678	23,738	(28,778)	443	3,342	12,423

Unrestricted designated
Leasehold Replacement Fund	4,357	-	-	19	(4,376)	-
Fixed and Intangible Assets Fund	14,780	-	-	-	2,461	17,241
Legacies Development Fund	147	-	-	-		147
Care quality improvement	179	-	-	-	(74)	105
	33,141	23,738	(28,778)	462	1,353	29,916

Leasehold replacement fund – identified in prior years as one source of funds for the fit-out of the RCP at The Spine in Liverpool. The fund has been released to the general fund in 2020.

Fixed and intangible assets fund – this represents the amounts set aside from the general fund to fund the net book value of the RCP’s fixed and intangible assets, net of associated loan in respect of the Spine fit-out.

Legacies development fund – the fund will be utilised for appropriate and relevant projects for such purposes that the major donors can be recognised and remembered.

Care quality improvement – funds remaining on completed projects have been designated with the aim of expanding the work carried out by this department. It is expected that these funds will be used within the next year.

Notes to the financial statements continued

22 Restricted funds	Balance at	Income	Expenses	Gains	Transfers	Balance at
	01/01/2020					31/12/2020
	£000	£000	£000	£000	£000	£000

Carequalityimprovement	620	2,122	(1,971)	-	23	794
National Guideline Centre	-	2,761	(2,640)	-	(2)	119
Education	962	163	(425)	-	-	700
Membership support and global engagement	178	2	(20)	-	4	164
Drabu MTI Programme	37	10	(6)	-	2	43
Physicians for Africa	24	127	(131)	-	-	20
Eric Watts donation	100	-	(33)	-	-	67
RCP North	100	1,051	-	-	(1,151)	-
Physicians’ Fund	120	80	-	-	-	200
Dorothy Whitney Wood – Physicians’ Fund	-	518	-	-	-	518
FundraisingRCP CQID	-	15	(15)	-	-	-
COVID-19 appeal	-	127	(89)	-	-	38
External communications	75	88	(75)	-	-	88
Dr Everley-Jones legacy	320	5	(2)	6	(227)	102
Harold Thomas Barten Trust	106	2	(1)	2	-	109
Frank Peacock Bequest	65	1	-	1	-	67
Catherine Mills Bequest	70	2	-	1	-	73
Queenie Louisa Higgins Bequest	47	-	-	1	-	48
Thomas Cotton Trust	73	-	-	-	-	73
The London Fever Hospital Fund	15	1	-	-	3	19
The Saltwell Will Trust Research Branch	124	-	-	-	14	138
Will Edmunds Clinical Research Trusts	24	-	-	-	3	27
17 other funds balances below £40,000	296	10	(7)	4	-	303
Total	3,356	7,085	(5,415)	15	(1,331)	3,710

Funds with closing balances over £100k are as follows:

The grants for Care quality improvement, Education, and Membership support and global engagement are received in respect for specific projects.

The Physicians’ Fund awards grants to trainees and new consultants pursuing innovation in medicine. The grants enable recipients to take up to 12 months out of clinical practice to undertake research in a UK institution and are funded by donors to the RCP.

The Dorothy Whitney Wood Physicians’ relates to a legacy received in 2020 to establish the “Whitney-Wood Scholarship” to be awarded for the purposes of research in the field of medicine preferably concerned with the understanding and management of cancer.

The Dr Everley-Jones legacy was received from the estate of Dr Everley-Jones, to be used in the field of communication in medicine in its broadest sense, encompassing all aspects of information technology.

The Harold Thomas Barten Trust is to be used for the purpose of scientific study of the human brain and mental disorder.

Notes to the financial statements continued

23 Endowment funds Unapplied total return 01/01/2020 Income Gains Conversion to income Transfers	Unapplied total return ‘Frozen’ permanent capital Total endowment
	31/12/2020 31/12/2020 31/12/2020
£000 £000 £000 £000 £000	£000 £000 £000
Bradshaw Trust 203 7 6 (31) -	185 143 328
Eden Fellowship in Paediatrics 1,102 26 23 (6) -	1,145 142 1,287
John Rosser Scholarship 29 1 1 - -	31 42 73
Joseph Senior White Trust 101 4 5 (1) -	109 161 270
Lewis Thomas Gibbon Jenkins-Briton Ferry 1,297 50 47 (31) -	1,363 1,250 2,613
ORL Wilson Bequest 105 3 3 (1) -	110 44 154
James Maxwell Grant Prophit Bequest 433 19 18 (5) -	465 539 1,004
Sadleir Trust 357 10 8 (2) -	373 91 464
Samuel Leonard Simpson Fellowship 613 17 17 (4) -	643 280 923
T K Stubbins bequest 40 3 3 (17) -	29 104 133
Watson Smith Trust 522 20 18 (5) -	555 470 1,025
William WitheringPrize 134 4 3 (1) -	140 38 178
Dr J D Ramsay Scholarship 46 1 1 - -	48 30 78
Graham Bull Prize 51 - 1 - -	52 25 77
Sir Michael Perrin Lecture 76 1 2 - -	79 12 91
LadyTeale Lecture 95 3 3 (1) -	100 44 144
John Glyn 95 4 3 (1) -	101 80 181
Dame Sheila Kift Bequest 34 1 1 - -	36 38 74
13 other funds with balances below £40,000 161 4 5 (2) -	168 109 277
Subtotal 5,494 178 168 (108) -	5,732 3,642 9,374

Funds not included in total	Balance at	Income	Gains	Conversion	Transfers	‘Frozen’	Balance at
return	01/01/2020			to income		permanent	31/12/2020
						capital
	£000	£000	£000	£000	£000	£000	£000
Thomas Cotton Fund	180	-	6	-	-	-	186
The London Fever Hospital Research Fund	168	3	8	(1)	(3)	-	175
Saltwell Will Trust Research Branch	924	14	155	(3)	(14)	-	1,076
Will Edmunds Clinical Research Fund	447	3	41	(1)	(3)	-	487
Drabu Fund	120	2	3	(1)	(2)	-	122
Subtotal	1,839	22	213	(6)	(22)	-	2,046
Total endowment	7,333	200	381	(114)	(22)	3,642	11,420

The Drabu Fund endowment was received from the Drabu family in year, to be used for the placement of trainees from India (State of Jammu and Kashmir) and Pakistan to work in the UK for 2 years within palliative care to enhance their skills and learning.

Notes to the financial statements continued

Funds with closing balances over £300k are as follows:

The Bradshaw Trust was founded by a bequest from Mrs Sally Hall Bradshaw by her will of 1875, in memory of her husband Dr William Wood Bradshaw MRCP FRCS (1800–66): £1,000 to endow an annual lecture on a subject connected with medicine or surgery. The lecturer is appointed by the president: the honorarium is £20.
The Eden Fellowship in Paediatrics was established in 1947 from the estate of Dr Thomas Watts Eden, to establish and maintain travelling fellowships for the study of childhood in health and disease.
The Lewis Thomas Gibbon Jenkins of Briton Ferry Memorial Trust was received by the RCP in November 1998 from the executors of Mrs Nancy Crawshaw’s will. The capital is to remain intact for a minimum of 21 years after her death. The income is to be applied for the promotion of medical research connected with a physical disorder prevalent in Wales.
The James Maxwell Grant Prophit Trust was received in November 1998. The endowment is an addition to the Prophit Bequest and as with the original bequest the fund is to be devoted to the promotion and furthering of research work concerning the nature, causes, prevention, treatment and cure of tuberculosis.
The Samuel Leonard Simpson Fellowship was founded in 1984 by a gift of shares/stocks from Mrs HM Simpson in memory of her husband Dr Samuel Leonard Simpson FRCP (1900–83) for a travelling scholarship in endocrinology.
The Watson Smith Trust was a bequest from Dr Sydney Watson Smith FRCP in memory of his wife and himself, to endow an annual lecture and medical research fellowship.
The Sadleir Trust was established by a bequest from Lady Sadleir, wife of Sir Edwin Sadleir Bt and widow of Dr William Croone (1633–84), fellow of the RCP, to provide for the two annual lectures Dr Croone had planned, but for which he had made no endowment: one to be read before the Royal College of Physicians by a fellow of the college, with a sermon to be preached at St Mary-le-Bow; the other on the nature and laws of muscular motion to be delivered before the Royal Society.
The Cotton Trust was founded by a bequest from Dr Thomas Forrest Cotton FRCP (1884–1965), in memory of Sir William Osler Bt FRCP FRS (1849–1919). The legacy, received in 1968, is invested and managed by the trustees of The Royal Trust Corporation of Canada/The Royal Trust Company, and the income is paid to RCP.
The London Fever Hospital Research Fund was established in 1947 for the trustees in the encouragement of or reward for advances in the prevention, treatment and housing of infectious diseases.
Saltwell Will Trust Research Branch was established for the income generated to be used to aid research work in connection with and the cure and prevention of cancer, rheumatism, malaria and morbid conditions of the prostate gland.
Will Edmunds Clinical Research Fund was established in 1925 to award a fellowship in clinical research in hospitals in the Metropolitan area of London. The research must concern diseases usually treated at a general hospital, excluding tropical and rare diseases.

Notes to the financial statements continued

24 Analysis	of group net assets after pension scheme liability	of group net assets after pension scheme liability	of group net assets after pension scheme liability
							Total
		Intangible				Net liabilities
		and tangible	Loan		Investments	inc. pension	2020	2019
		assets				liability
		£000			£000	£000	£000	£000
Unrestricted:
Designated	Leasehold Replacement Fund			-	-	-	-	4,357
	Fixed Assets Fund	24,741	(7,500)		-	-	17,241	14,780
	Legacies Development Fund	-		-	-	147	147	147
	Care quality improvement	-		-	-	105	105	179
		24,741	(7,500)		-	252	17,493	19,463
General funds		-		-	20,939	(8,516)	12,423	13,678
		24,741	(7,500)		20,939	(8,264)	29,916	33,141
Restricted		-		-	1,888	1,822	3,710	3,356
Endowment		-		-	10,105	1,315	11,420	10,975
		24,741	(7,500)		32,932	(5,127)	45,046	47,472

Notes to the financial statements continued

25 Trading subsidiary – The RCP Regent’s Park Limited

	The trading results and balance sheet of the RCP subsidiary company as extracted from its audited accounts are set out below.	The trading results and balance sheet of the RCP subsidiary company as extracted from its audited accounts are set out below.	The trading results and balance sheet of the RCP subsidiary company as extracted from its audited accounts are set out below.
			2020 2019
	Profit and loss account		£000 £000
	Turnover		928 1,772
	Cost of sales		(476) (807)
	Grossprofit		452 965
	Administrative expenses		(558) (906)
	Operating profit		(106) 59
	Gift aid to Royal College of Physicians		- (59)
	Retainedprofit for the financialyear		(106) -

Included within operating costs is £530k (2019: £819k), which represents a reimbursement in respect of costs incurred by the RCP.

incurred bythe RCP.

	2020	2019
Balance sheet	£000	£000
Debtors	90	187
Debtor – due from RCP	214	388
Balance at bank	142	87
Current and total assets	446	662
Creditors due within 1year:	(277)	(661)
Creditors due more than 1year:	(275)
Total creditors	(552)	(661)
Net assets	(106)	1

Capital and reserves
Accumulated deficit	(106)	-
Called upshare capital	£1	£1
Shareholders’ funds	(106)	£1

The RCP’s wholly owned trading subsidiary, The RCP Regent’s Park Limited, was incorporated on 17 September 2001, company registration 04288664.

The operating loss for the year ended 31 December 2020 was £(106k) (2019 profit: £59k).

Notes to the financial statements continued

26 Pension schemes

Total pension costs charged for the year were £79k (2019: £76k) for the defined benefit pension scheme and employer pension contributions of £1,407k (2019: £1,334k) for the defined contribution pension scheme.

There are two defined contribution schemes. One scheme closed to new members in 2018 – employer contribution rates for this defined contribution scheme are determined by the members’ age bands with incremental rates for older members. The new scheme opened for new membership has a flat employer contribution rate of 7%.

The defined benefit pension scheme is closed to new members and closed to future accrual. There is no further salary linkage. For the purposes of FRS 102 the valuation of the defined benefit scheme has been calculated under FRS 102 as at 31 December 2020 by a qualified actuary.

The valuation, details of which are given below, shows £20.29 million of assets and £24.53 million of liabilities. The deficit of £4.24 million remained broadly the same as 2019. Although there was an increase in scheme liabilities over the year due to a change in financial assumptions this was off-set by assets performing well over the period.

The scheme’s assets and liabilities as at 31 December 2020, analysis of pension costs and details of the valuation were as follows:

Principal assumptions	2020	2019	2018	2017	2016
	% per	% per	% per	% per	% per
	annum	annum	annum	annum	annum
Discount rate	1.30	2.00	2.9	2.5	2.7
Aggregate long-term expected rate of return on	1.30	2.00	2.9	2.5	2.7
assets
Rate of increase of salaries	n/a	n/a	n/a	n/a	n/a
RPI inflation assumption forpensions inpayment	2.75	3.00	3.25	3.2	3.6
CPI inflation assumption for deferredpensions	2.15	2.00	2.25	2.2	2.6
Pension increases	2.75	2.95	3.15	3.1	3.4
Pension commencement lump sum taken at retirement	18.75% of benefit value	18.75% of benefit value	18.75% of benefit value	18.75% of benefit value	18.75% of benefit value

Mortality tables: 90% of S2PMA tables for males and 80% of S2PFA tables for females using CMI 2018 projections with a 1.25% long-term rate of improvement based on year of birth.

The assets valued below are in the form of monies invested with Standard Life, Newton Investment Management and Legal and General Investment Management, together with the trustees’ bank account. The assets in the scheme and the expected rate of return were:

Assets breakdown	2020	2019
	%	%
Real return and absolute return funds	-	-
Diversified Growth Fund	-	28.3
UK Government index-linkedgilts	-	-
Corporate bonds	-	-
Multi asset credit	34.44	25.7
UK corporate bonds	14.12	14.4
Liabilitydriven investments	27.33	22.8
Equities	14.91	-
Cash	9.20	8.8
Total market value of assets	100	100

Notes to the financial statements continued

The pension scheme has not invested in any of Royal College of Physicians’ own financial instruments, nor in properties or other assets used by the Royal College of Physicians. The assets are all quoted in an active market.

Movement in deficit during the year				2020		2019
				£000		£000
Pension scheme liabilityat the beginningof theyear				(4,243)		(2,978)
Actuarial losses andgains onpresent value of obligations				(2,315)		(2,470)
Experiencegains and losses on defined benefit obligations				-		-
Gains/(losses)on return of scheme assets				1,713		596
Employer contributions				685		685
Net interest on the net defined benefit liability				(79)		(76)
				(4,239)		(4,243)

Reconciliation of the opening and closing balances of scheme liabilities				2020		2019
				£000		£000
Present value of scheme liabilities at beginningof	theyear			22,482		19,966
Interest cost				443		571
Actuarial(loss)/gain on scheme liabilityassumption changes				2,315		2,470
Benefitspaid				(714)		(525)
Present value of scheme liabilities at the end of theyear				24,526		22,482

Reconciliation of the opening and closing balances of the fair value of assets				2020		2019
				£000		£000
Fair value of scheme assets at beginningof theyear				18,239		16,988
Interest income				364		495
Return on scheme assets				1,713		596
Employer contributions				685		685
Benefitspaid				(714)		(525)
Fair value of scheme assets at the end of theyear				20,287		18,239

Reconciliation of the present value of scheme liabilities and fair
value of assets to the asset and liability recognised in the				2020		2019
balance sheet
				£000		£000

Fair value of scheme assets				20,287		18,239
Value of liabilities(defined benefit obligation)				(24,526)		(22,482)
Funded status				(4,239)		(4,243)
Recognisedpension scheme liability				(4,239)		(4,243)

Analysis of pension scheme assets and liabilities
for the current andprevious five financialperiods	2020	2019	2018	2017	2016	2015
	£000	£000	£000	£000	£000	£000
Present value of scheme liability	(24,526)	(22,482)	(19,966)	(22,604)	(22,962)	(18,925)
Fair value of scheme assets	20,287	18,239	16,988	16,690	15,683	13,870
Deficit	(4,239)	(4,243)	(2,978)	(5,914)	(7,279)	(5,055)

At the date of the last triennial statutory actuarial assessment as at 1 January 2018, the market value of the scheme was £19.3 million and the actuarial value of those assets represented 83% of the value of the benefits which had accrued at that date, allowing for future pension increases.

Notes to the financial statements continued

Lease obligations	2020	2019
	£000	£000
Operatingleases on land and buildings,byexpirydate:
Under 1year	123	182
1 to 5years	58	71
5yearsplus	27,571	22
Total future minimum operating lease commitments	27,752	275

Operatingleases on office equipment and computers,byexpirydate:
Under 1year	20	2
1 to 5years	11	2
5yearsplus	-	-
Total future minimum operating lease commitments	31	4

Finance leases on IT equipment byexpirydate:
Under 1year	91	-
1 to 5years	294	-
5yearsplus	-	-
Total future minimum finance lease commitments	385	-

In August 2019 the RCP signed an agreement for lease for 69,890 square feet over seven floors of ‘The Spine’ with Liverpool City Council for 25 years. The rental for the total period is £27.5 million. The lease came into effect at the end of June 2020.

The new finance lease in year, relates to a 5 year agreement entered into for IT infrastructure.

28 Related party transactions

The Royal College of Physicians, a charity registered (charity number 210508) in England and Wales, is the ultimate controlling parent of its subsidiary undertaking, The RCP Regent’s Park Limited, which is consolidated on a line-by-line basis in these group accounts. During the year the Royal College of Physicians received £530k income from The RCP Regent’s Park Limited. At 31 December 2020 The RCP Regent’s Park Limited owed the RCP £275k in relation to an inter-company loan and the RCP owed the trading company £214k in respect of inter-company transactions. Mr Justin Smith is the executive director of Corporate Services for the RCP, during the year transactions worth £3k (2019: £16k) were incurred with Maya Blue Limited, as supplier to the RCP, of which the directors are Mr Justin Smith and Mrs Elizabeth Mullings-Smith, the spouse of Mr Justin Smith. There were no other related party transactions in the period.

Notes to the financial statements continued

29 Comparative notes from the prior year

a Consolidated statement of financial activities for the year ended 31 December 2019

	Notes	Unrestricted funds	Restricted funds	Endowment funds	Total	funds
					31 Dec 19	31 Dec 18 restated
		£000	£000	£000	£000	£000
Income from:
Fundraising	2	125	349	120	594	258
Charitable activities
Care quality improvement	3	3,201	5,329	-	8,530	9,143
Education and Federation	4	16,948	1,034	-	17,982	18,009
Membership support and global engagement	5	8,061	35	-	8,096	8,436
Communications, policy and research*	6	47	83	-	130	175
Heritage and investing in our future	7	73	-	-	73	73
Meetings and events (medical)		4,269	-	-	4,269	4,115
Activities to generate funds
Investment income	8	708	28	349	1,085	1,033
Meetings and events (non-medical) – trading	25	1,772	-	-	1,772	1,831
Other income		197	4	-	201	108
Total income		35,401	6,862	469	42,732	43,181
Expenditure on:
Raising funds
Fundraising costs		253	-	-	253	230
Investment management fees		123	3	33	159	135
Meetings and events (non-medical)	25	1,713	-	-	1,713	1,569
		2,089	3	33	2,125	1,934
Charitable activities
Care quality improvement	9	5,237	5,368	-	10,605	11,356
Education and Federation	10	13,003	1,135	-	14,138	15,262
Membership support and global engagement	11	4,472	196	-	4,668	4,577
Communications, policy and research	12	3,953	63	-	4,016	4,096
Heritage and investing in our future	13	2,265	-	-	2,265	2,718
Meetings and events (medical)		6,016	-	-	6,016	5,265
Trusts and fellowships		-	5	61	66	115
Total expenditure	14/15	37,035	6,770	94	43,899	45,323
Net operating (loss)/gain		(1,634)	92	375	(1,167)	(2,142)
Net gains/(losses) on investment assets		2,617	73	1,022	3,712	(3,007)
Net income/(expenditure)		983	165	1,397	2,545	(5,149)
Transfers between funds	21/22	34	4	(38)	-	-
Actuarial (losses)/gains on defined benefit pension scheme	26	(1,874)	-	-	(1,874)	2,105
Net movement in funds for the year		(857)	169	1,359	671	(3,044)
Funds brought forward at 1/1/19	21/22/23	33,998	3,187	9,616	46,801	49,845
Funds carried forward at 31 December 2019		33,141	3,356	10,975	47,472	46,801

*formerly Strategy, communications and policy

Notes to the financial statements continued

b Restricted funds 2019

Restricted funds	Balance at	Income	Expenses	Gains	Transfers	Balance at
	01/01/2019					31/12/2019
	£000	£000	£000	£000	£000	£000

Carequalityimprovement*	693	2,274	(2,311)	-	(36)	620
National Guideline Centre	-	3,055	(3,057)	-	2	-
Education	296	1,034	(368)	-	-	962
Faculty of Medical Leadership and Management	767	-	(767)	-	-	-
Membership support and global engagement***	187	35	(44)	-	-	178
Drabu MTI Programme	-	65	(28)			37
Physicians for Africa***	87	61	(124)			24
Eric Watts donation	-	100	-	-	-	100
RCP North**	43	57	-	-	-	100
Physicians’ Fund**	89	31	-	-	-	120
External communications	55	83	(63)	-	-	75
Dr Everley-Jones legacy	281	11	(1)	29	-	320
Harold Thomas Barten Trust	93	4	-	9	-	106
Frank Peacock Bequest	57	2	-	6	-	65
Catherine Mills Bequest	62	2	-	6	-	70
Queenie Louisa Higgins Bequest	41	2	-	4	-	47
Thomas Cotton Trust	68	-	-	-	5	73
The London Fever Hospital Fund	12	-	-	-	3	15
The Saltwell Will Trust Research Branch	100	-	-	-	24	124
Will Edmunds Clinical Research Trusts	18	-	-	-	6	24
17 other funds balances below £40,000	238	46	(7)	19	-	296
Total	3,187	6,862	(6,770)	73	4	3,356

formerly Clinical Standards *formerly Fundraising

***formerly included in Membership support and global engagement

Notes to the financial statements continued

c Endowment funds 2019

Endowment funds Unapplied total return 01/01/2019 Income Gains Conversion to income Transfers	Unapplied total return ‘Frozen’ permanent capital Total endowment
	31/12/2019 31/12/2019 31/12/2019
£000 £000 £000 £000 £000	£000 £000 £000
Bradshaw Trust 164 11 34 (6) -	203 143 346
Eden Fellowship in Paediatrics 960 41 110 (9) -	1,102 142 1,244
John Rosser Scholarship 20 3 6 - -	29 42 71
Joseph Senior White Trust 69 10 23 (1) -	101 161 262
Lewis Thomas Gibbon Jenkins-Briton Ferry 999 86 224 (12) -	1,297 1,250 2,547
ORL Wilson Bequest 88 5 13 (1) -	105 44 149
James Maxwell Grant Prophit Bequest 316 32 88 (3) -	433 539 972
Sadleir Trust 305 15 39 (2) -	357 91 448
Samuel Leonard Simpson Fellowship 513 30 79 (9) -	613 280 893
T K Stubbins bequest 33 5 15 (13) -	40 104 144
Watson Smith Trust 404 34 88 (4) -	522 470 992
William WitheringPrize 114 6 15 (1) -	134 38 172
Dr J D Ramsay Scholarship 37 3 7 (1) -	46 30 76
Graham Bull Prize 42 3 7 (1) -	51 25 76
Sir Michael Perrin Lecture 64 4 8 0 -	76 12 88
LadyTeale Lecture 79 5 12 (1) -	95 44 139
John Glyn 77 6 16 (4) -	95 80 175
Dame Sheila Kift Bequest 26 2 6 - -	34 38 72
17 other funds with balances below £40,000 152 10 25 (26) -	161 109 270
Subtotal 4,462 311 815 (94) -	5,494 3,642 9,136

Funds not included in total	Balance at	Income	Gains	Conversion	Transfers	‘Frozen’	Balance at
return	01/01/2019			to income		permanent	31/12/2019
						capital
	£000	£000	£000	£000	£000	£000	£000
Thomas Cotton Fund	140	5	40	-	(5)	-	180
The London Fever Hospital Research Fund	148	3	20	-	(3)	-	168
Saltwell Will Trust Research Branch	806	24	118	-	(24)	-	924
Will Edmunds Clinical Research Fund	418	6	29	-	(6)	-	447
Drabu Fund	-	120	-	-	-	-	120
Subtotal	1,512	158	207	-	(38)	-	1,839
Total endowment	5,974	469	1,022	(94)	(38)	3,642	10,975

Notes to the financial statements continued

d Analysis of group net assets after pension scheme liability 2019

Analysis of group net assets after pension scheme liability	Analysis of group net assets after pension scheme liability
	Total
Intangible and tangible assets Investments Net current assets inc. pension liability 2019 2018
	£000 £000 £000 £000 £000
Unrestricted:
Designated Leasehold Replacement Fund - 4,357 - 4,357 4,283
Fixed Assets Fund 14,780 - - 14,780 14,485
Legacies Development Fund - - 147 147 145
Care quality improvement - - 179 179 115
	14,780 4,357 326 19,463 19,028
General funds - 32,356 (18,678) 13,678 14,970
	14,780 36,713 (18,352) 33,141 33,988
Restricted	- 1,874 1,482 3,356 3,187
Endowment - 9,607 1,368 10,975 9,616
	14,780 48,194 (15,502) 47,472 46,801

30 Capital commitments

The Royal College of Physicians had a capital commitment of £3,284k as at 31 December 2020 (2019: £430k), the majority of which relates to the development of The Spine building.

11 St Andrews Place Regent’s Park London NW1 4LE

The Spine 2 Paddington Village Liverpool L7 3FA

www.rcp.ac.uk

Annual report 2020

Contents

About the RCP

Our vision and mission

Our values

Public benefit

Foreword from the RCP president

Andrew Goddard, RCP president

Chair’s report

David Croisdale-Appleby, chair of Board of Trustees

CEO’s report

Ian Bullock, chief executive

Report of trustees

The Federation of the Royal Colleges of Physicians

1

Improving care for patients

Our objectives

Our key achievements

Supporting service improvement

Setting standards

Supporting quality assurance in endoscopy

Our vision of the future hospital and health service design

Developing health services

Our work in numbers

Looking forward

2

Developing physicians throughout their careers

Our objectives

Our key achievements

Shaping the medical workforce

High-quality education across the world

Promoting lifelong learning

Adapting exams during the pandemic

Supporting physicians throughout their careers

Our work in numbers

Promoting medicine as a career

Looking forward

3

Leading and supporting our members

Our objectives

Our key achievements

Leading the profession

Increasing our reach and relevance

Our global strategy

Supporting our members

Our work in numbers

Delivering an exceptional membership experience

Increasing our understanding

Looking forward

4

Shaping the future of health and healthcare

Our objectives

Our key achievements

Using expertise and experience to influence healthcare

Ensuring that patients shape everything that we do

Improving public health

Tackling inequalities in health

Fostering innovation

Our work in numbers

Looking forward

5

Investing in our future, building on our heritage

Our objectives

Our key achievements

A financially sustainable future

An excellent organisation

Heading towards zero carbon

Andrew Goddard, RCP president, said:

A responsible organisation

Our work in numbers

Benefit present and future generations

Looking forward

Our ambitious plans to improve diversity and inclusion

RCP at The Spine

Our strategy for 2022–25

RCP boards, committees and lists

Officers and senior roles of the RCP

Visitor

President