A year in review

500 years of Annual review 2018 1 500 years of medicine The Royal College of

The Royal College of Physicians (RCP) is a professional membership body for physicians, with over 36,000 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 also work to ensure that physicians are educated and trained to provide high-quality care. 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 > 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.

2 Annual review 2018 Contents

Foreword 4 Introduction 5 Our history 6 Celebrating 500 years 8 2018 – our year at a glance 14 Highlights of our work 15 Improving clinical care 16 Our membership 18 Education and training 20 Guiding and influencing 22 International work 24 A strong organisation 25 RCP beyond 500 26 Giving Health 27

3 500 years of medicine Foreword

Andrew Goddard, RCP president 2018 was not a quiet year for the RCP, being both a celebration of the past 500 years and heralding the future of our college in the next 500. Our annual conference, celebratory dinners in London and Liverpool, garden party and various television appearances all showed the RCP at its best. In addition, there were three standout memories for me – the visit of Her Majesty the Queen in February, the first-ever membership and fellowship ceremony in Wales, and the amazing support for our RCP500 charter wherever it was taken (including by me on a bicycle). Her Majesty’s visit was a marvellous occasion with trainees, consultants, fellows, and staff there to welcome her. She had something to say to everyone and seemed genuinely delighted to be here. She unveiled our RCP500 charter, a commitment by members and fellows to provide high- quality healthcare for our patients, support each other, and to champion education and research. The 500-year celebrations allowed us to forge new links with friends throughout the world and more locally in Liverpool and surrounding regions. The Spine, our new building in that city, has started to take physical form as the concrete is poured. In less than 2 years it will be part of our fabric, a visible commitment to high-quality training and education nationally, and to improving clinical and academic links outside of London. As well as celebrating 500 years of the RCP, this review also includes a snapshot of the huge amount of activity that has gone on in the past year. The RCP has an increasingly high profile and is being listened to by many in government and the wider NHS. We have much to say.

4 Annual review 2018 Introduction

Founded in 1518 by royal charter from King Henry VIII, the Royal College of Physicians of London is the oldest medical college in England. 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. The year 2018 was a significant landmark for the RCP. From our early beginnings regulating the practice of medicine, to the creation of a modern charter, we marked 500 years of supporting doctors to improve care for patients. We celebrated our 500th anniversary by holding a number of high-profile events for our members and fellows throughout the year. We drew particular attention to the history and heritage of the RCP but also celebrated our vital work in the context of modern healthcare standards and its impact on public benefit through the advancement of health, education, and heritage and science. This booklet includes an overview of those events as well as highlights of our main activities in 2018. Thank you

We’d like to thank our members and fellows for their support, involvement and being part of the RCP. Our members are our greatest asset – we listen to, support, and learn with and from them. They inspire the staff and officers to aspire to excellence. We’d like to thank all those involved in our working parties, committees and research panels, our Patient and Carer Network, conferences and clinical reports. Your expertise and participation are invaluable. We have been supporting and guiding physicians for 500 years. Together with our membership, we want to continue to play a pivotal role in raising standards and shaping in the future.

5 500 years of medicine Our history

1518 1524 1546 1555 Henry VIII founds the College ’s home on The College is awarded First recorded minutes of Comitia, of Physicians to regulate the Knightrider Street becomes a grant of arms an official committee which practice of medicine the first College premises continues to meet today

1666 1697 1768 1825 The Great Fire of London The RCP opens its first Medical Transactions, The RCP moves to destroys the Amen public dispensary the first RCP journal, its fourth home in Corner premises is launched Pall Mall East

1948 1962 1964 1989 Launch of The RCP highlights the The RCP opens its Dame Margaret Turner-Warwick the NHS dangers of smoking in a fifth home near is appointed as the RCP’s first groundbreaking report The Regent’s Park female president

6 A year in review

1565 1614 1618 1628 The College is given the right to the The College moves to its second The first pharmacopoeia, William Harvey bodies of four hanged criminals a home at Amen Corner, near an official list of , publishes his theory year for anatomy lessons St Paul’s Cathedral is published by the College of blood circulation

1858 1869 1909–25 1940 The Medical Act The RCP publishes the The RCP welcomes its The RCP building creates the General Nomenclature of diseases first women members, on Pall Mall East is Medical Council licentiates and fellows damaged by bombs

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7 500 years of medicine Celebrating 500 years

2018 was a very special year for the RCP, marking the college’s 500th anniversary, which was established by a royal charter granted by King Henry VIII. Our celebrations took the form of a variety of exciting events that aimed to raise the RCP’s profile, engage with our membership, celebrate our history, and look forward to our future. This approach was in contrast with previous centenaries – events in 1918 made it impractical to celebrate, although the anniversary was marked by fellows on the Western Front.

RCP500 celebrations Special activities In February, we opened our celebrations with a rare visit from We held a series of special activities throughout 2018, Her Majesty the Queen, who was warmly welcomed to the including: RCP in London by a large gathering of members, fellows and > awarding quincentennial lectureships to medical staff. Her Majesty spent time meeting a range of doctors from trainees, to showcase clinical research trainees to consultant physicians, as well as RCP staff and members of our Patient and Carer Network. > running a historical reflections conference and a 500 years lecture series On 23 September, our actual anniversary, members and fellows enjoyed a guided walking tour of London, taking in the sites > publishing an illustrated history of the RCP and the final of the RCP’s homes throughout history. This was followed by volumes in our 500 reflections on the RCP series a special dinner to recognise and celebrate the contributions > holding an RCP500 Garden Party and open day made by a wide range of people, from trainees to trustees, who make the RCP the brilliant organisation it is today. > organising four public lectures in Liverpool. We also closed the year with a spectacular event, holding a Our membership admission ceremonies were enhanced gala dinner in the magnificent St George’s Hall in Liverpool in to reflect the celebration and raise awareness of our November, with 400 attendees comprising our membership work, including the first new fellows admission ceremony and representatives of the local academic and business to be held in the USA, marking our collaboration and community. All of these events were designed to celebrate our relationship with the American College of Physicians. incredible history as well as look forward to the future.

8 Annual review 2018

9 500 years of medicine

Innovation in Medicine 2018 Our annual conference took place at ExCeL London in June and was our biggest yet, attended by over 900 physicians and healthcare professionals. The conference marked our 500th anniversary, delivering an extensive programme of lectures and discussions that not only reflected on the tremendous progress made in medicine across all 30 medical specialties, but also looked forward to the future. It covered diverse topics including obesity, digital health, quality improvement and healthcare sustainability. Jeremy Hunt, then secretary of state for health and social care, delivered the keynote speech congratulating the RCP on ‘500 remarkable years’. We received fantastic feedback on the conference, with over 90% of respondents rating it as good or excellent.

10 Annual review 2018

Lord Mayor’s Show To commemorate the fact that we were based in the City of London until 1825, we took part in the popular and widely viewed Lord Mayor’s Show in November for the first time in the RCP’s history. The show is one of London’s most prestigious occasions, dating back to 1215 and involving some 6,500 participants and a variety of floats and bands. Our procession space told the story of physicians and medical innovations through the ages, showcasing our influence on the practice of medicine for the thousands of people lining the route and watching on television at home.

11 500 years of medicine

Two excellent exhibitions We held two major exhibitions in our 500th year. ‘Ceaseless motion: William Harvey’s experiments in circulation’ explored the work of the RCP’s most famous fellow. We were delighted to give Her Majesty the Queen a guided tour during her visit to the RCP in February. Our second exhibition, ‘This vexed question: 500 years of women in medicine’ focused on women in medicine, from early women healers and herbalists to the admittance of the first female licentiate of the RCP in 1909. It highlighted a long history of tension between formal, regulated medical practice and women healers.

12 Annual review 2018

A modern charter The actual date of our royal charter, 23 September, also marked the end of the RCP500 Charter Cycle. Our new president, Professor Andrew Goddard, completed his 2,018 mile cycle ride around England, Wales and Northern Ireland to raise money for the RCP’s development work, including Physicians for Africa. The president visited 48 hospitals and 2,100 physicians signed the RCP500 charter during its journey. Fellows and members around the country and beyond were invited to sign the RCP500 charter. This was not a legal document in the manner of the 1518 royal charter, but a modern set of promises made by the signatories in the spirit of the original, pledging best practice and professional commitment to modern patient care. It was drawn up and agreed by the RCP Council, and Her Majesty the Queen unveiled a copy during her visit in February, with a portrait of King Henry VIII looking on.

13 500 years of medicine 2018 – our year at a glance

57 4,000 7,000 chief registrars 7 doctors received face- recruited – the future people visited new NICE clinical leaders of to-face training from our exhibitions guidelines the NHS our educationalists produced

10,000 19,000 36,000 43,000 delegates came to physicians use members of the people follow our regional events the CPD diary RCP in 2018 us on Twitter

226,000 £400,000 1,000,000 1,800,000 downloads of the updated raised through rolling yearly downloads visits to the National Early Warning our Giving Health of articles from RCP website Score, NEWS2 fundraising appeal Clinical Medicine

14 Annual review 2018 Highlights of our work

We are proud to present highlights of some of our key activities and achievements in 2018.

Throughout the year we worked to deliver the goals set out in our 5-year strategy covering 2015–20. The strategy focuses on five key areas:

> 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

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 Royal College of Physicians of London. Together, the colleges represent more than 50,000 physicians worldwide and deliver: > continuing professional development (CPD) > examinations > training

15 500 years of medicine Improving clinical care

We deliver ambitious programmes of work to support healthcare improvement, working alongside frontline doctors and their teams, and patients and their carers to ensure our work is relevant to healthcare practice.

National Guideline Centre The RCP has been working with the National Institute for Health and Care Excellence (NICE) to support evidence-based guideline development since 2001 and has developed over 70 guidelines in the past 10 years. New clinical guidelines published in 2018 covered renal replacement , chronic heart failure, rheumatoid arthritis, hearing loss, Lyme disease, venous thromboembolism, and acute medical emergencies.

NEWS2 NEWS2, the updated National Early Warning Score published by the RCP, has been identified by NHS England as the standard approach required across all acute and ambulance trusts for the care of deteriorating patients. The score is being adopted across the world – NEWS2 was downloaded over 226,000 times in 2018.

16 Annual review 2018

Audit and accreditation Improving inpatient care Our audit programmes strive to raise standards for clinical Our 3-year National Mortality Case Record Review Programme services to develop excellent care. Over 120,000 records about (NMCRR) aims to improve the quality and safety of inpatient chronic obstructive pulmonary disease (COPD) patients have care and share best practice by reviewing deaths in hospital. now been included in the National COPD Audit, which is We held our first NMCRR annual conference, which attracted believed to be the largest COPD dataset worldwide. Over half a more than 130 delegates and excellent feedback. Since its million records are now entered into the National Hip Fracture launch in November 2016, the Structured Judgement Review Database making it the largest hip fracture audit in the world. (SJR) has been implemented as the method of reviewing The National Lung Cancer Audit reported on nearly 40,000 and learning from deaths in more than 100 acute NHS patients diagnosed with lung cancer in 2016 – the highest trusts across England. We also published our first NMCRR number so far. These were all achieved thanks to clinicians in annual report, which includes case studies from acute trusts hospital teams nationwide sharing data with our audit teams evidencing the improvements in patient care and safety that to enable local improvement. can be realised as a result of conducting SJRs. Patient panels were recruited for two of our audit programmes to represent the views of patients and make suggestions for improvements. Our resources for patients on secondary hip Quality improvement fracture and lung cancer were highly commended. The RCP is at the forefront of quality improvement (QI) in the Our accreditation services help clinical teams work NHS. Our QI programme works with clinical teams to actively collaboratively towards common goals to improve the quality, and continuously improve services by equipping healthcare safety and outcomes of healthcare, the patient experience professionals with the skills and methods required. We grew and service delivery. In 2018, 551 endoscopy services, 36 liver our QI faculty of experts to develop and support quality services and 25 services were part of an accreditation improvement NHS-wide, taking our total to 57 experts. We scheme, as well as 91% of immunodeficiency services and also held QI collaboratives on a range of topics, including 71% of pulmonary rehabilitation services across the UK. smoking cessation and inflammatory bowel disease.

17 500 years of medicine Our membership

With 500 years of history and over 36,000 members and fellows in the UK and internationally, the RCP is uniquely placed to support and represent physicians throughout their medical career. Our membership benefits support and enhance the professional life of a doctor.

Join the best We know that members and fellows join the RCP for different reasons. A major research project in 2018 gave us significant insight and enabled us to tailor our member communications to focus on things we know will interest them. This led to our new membership campaign: ‘Join the best’ celebrates RCP membership and encourages involvement in our vibrant professional community. The campaign features real members talking about the benefits of being part of the RCP and what they value most. We are delighted that it helped us to reach the fantastic milestone of 36,000 members at the end of 2018.

Regional events More than 10,000 delegates came to our highly regarded regional events held across the country, including regional updates in medicine. We received first-rate feedback – one delegate in Cardiff said, ‘Excellent event – great update in general medicine important to me – I work in palliative medicine but it has made me feel more knowledgeable about general medicine and confident in my care for patients’.

18 Annual review 2018

Supporting careers in medicine Patient care awards Medicine Jobs, the RCP’s new online jobs board, was launched We held the third Excellence in Patient Care awards to celebrate in 2018. Advertising a wide variety of hospital vacancies, the the work that physicians do to improve patient-centred care, board is designed to enhance RCP membership. We also increasing the number of applications to the awards. Eight launched a new kitemarking service offering NHS recruiters an award winners each received an award plaque and £1,000 in ‘RCP approved’ stamp before jobs are advertised. This helps prize money. physicians applying for consultant positions to know that the job meets required standards and has been independently quality assured. Serial publications The RCP Advisory Appointment Committees (AAC) Unit delivers Members and fellows continued to receive our much-valued a job description approval and quality assurance process and journals and membership magazine in 2018. Downloads of AAC panel representative service for the NHS. In 2018, AAC articles in Clinical Medicine topped 100,000 for the first time college representatives helped to appoint more than 500 NHS in October, bringing our rolling yearly downloads to well over consultants. 1 million. Future Healthcare Journal featured an editorial on We supported the Student and Foundation Doctor Network sustainability in June by London Mayor Sadiq Khan. High- to develop new resources for those starting their career in quality issues of Commentary, our membership magazine, medicine and provided an opportunity to help shape our policy, continued to stimulate debate and cover a wide variety services and activities. We also offered free membership to of topical content, including an interview with Sir Terence medical students and reduced subscription fees for doctors in Stephenson, the chair of the GMC, in the wake of the Bawa- specialty training. And we continued to expand and support the Garba case. Faculty of Associates, including delivering the national PA examination.

19 500 years of medicine Education and training

Our education and training programmes support CPD physicians to fulfil their potential. We develop doctors to deliver the best possible patient care and become The CPD diary scheme, shared by the three physician excellent clinicians. colleges, is now used by over 19,000 consultant physicians. To complement the diary, in 2018 we launched a new Federation Physicians’ CPD app which syncs with the CPD diary and lists several thousand approved activities. We also supported the Exams and education adoption of the Federation CPD diary scheme for physician associates. The new RCP Assessment Unit was established at the RCP in Liverpool to deliver excellence in written and clinical assessments. The unit is responsible for examinations for physician associates, MRCP(UK) PACES and the two RCP Leadership professional diplomas in geriatric medicine and tropical Our new development programme, ‘Emerging women medicine and hygiene. It is developing close links with clinical leaders’, targeted female consultant physicians and SAS partners in the region’s hospitals and local RCP members and doctors to help address the underrepresentation of women fellows. in medical leadership roles. A generous donation from the We continued to offer an extensive programme of educational Lord Leonard and Lady Estelle Wolfson Foundation supported workshops and events both internationally and in the UK. In scholarships for a pioneer cohort of 13 women selected from a 2018, over 4,000 delegates attended 160 education courses. strong field. The programme runs to summer 2019. The Federation of the Royal Colleges of Physicians published Our chief registrar scheme continues to be a very successful the State of physicianly training report to provide an evidence- leadership development programme for senior trainees. In based benchmark. Through our work with the Federation we 2018 we recruited a strong third cohort of 57 chief registrars implemented stage 1 of the new training from a wide variety of specialties to our scheme. curriculum and began development work on all specialty curricula. We also launched the general internal medicine and acute internal medicine quality criteria designed to enhance the educational experience of trainees and ultimately improve patient safety and experience.

20 Annual review 2018

New resources We worked with a team of over 75 leading clinicians and academics to develop the third edition of Medical Masterclass, which launched in September. Considered the most comprehensive MRCP(UK) revision package available, the set of 12 books has over 2,500 pages of relevant information and up-to-date content and is available from Amazon. We launched a new report to help healthcare teams make the most of daily learning opportunities in the workplace. Never too busy to learn has the potential to greatly improve the frequency, value and effectiveness of opportunistic learning across the team, with consequent benefits for the quality of patient care. The RCP led an Academy of Medical Royal Colleges grant- funded project on patient feedback. The report Improving patient feedback for doctors calls for an invigoration of the purpose of patient feedback and a more sophisticated, technology-supported approach to making use of it for doctors’ professional development, appraisal and revalidation.

21 500 years of medicine Guiding and influencing

The expertise and insight of physicians and patients helps to shape our vision for the future of health and healthcare.

Increasing our profile We worked with the media to maximise the profile of the RCP’s work in 2018 and enjoyed major coverage on high-profile issues such as safe staffing limits and the call for more places, new guidance on caring for dying patients, audit and quality improvement, public health, preparing for winter, the impact of Brexit and new models for outpatient services. We enjoyed a growing presence and engagement on social media and our website. Our followers on Twitter grew to 43,000 and the total number of visits to our website was nearly 1,800,000. Visitors downloaded almost 600,000 PDFs of our reports, audits and policy documents. We developed the RCP’s messages and partnerships on public health in the UK and EU, including on air pollution, tobacco, alcohol, obesity and sustainability. We received plaudits on a number of subjects from key stakeholders, including NHS England’s medical director, the secretary of state for health and the shadow health team. Other successes included developing a position and growing profile on the use of artificial intelligence in healthcare, and increasing political engagement at party conference roundtables. We also highlighted that people from black and minority ethnic backgrounds were less likely to be shortlisted or appointed to consultant roles. Published in a Guardian newspaper exclusive, we were praised for our candour and commitment to change.

22 Annual review 2018

Campaigning success Key reports The sites for 1,500 new medical school places were announced Two key reports published in 2018 sought to encourage in 2018. This was a major policy win for the RCP, which lobbied innovation in practice. Outpatients: the future argued that the heavily for the expansion. traditional model of outpatient care is no longer fit for purpose and provided proven examples of alternative, sustainable We campaigned for the introduction of statutory regulation models. Advancing medical professionalism aimed to help for physician associates and were delighted when this was doctors improve their professionalism in practical ways, focusing announced in October 2018. on seven key aspects of practice. With workforce an RCP priority and staff shortages an ongoing In addition, the RCP’s Guidance on safe medical staffing working membership concern, we successfully campaigned for the party report aims to help those planning and organising core removal of the government cap on tier 2 visas for overseas hospital medical services to determine how many doctors and health professionals. The move means there will be no with what capabilities are needed to provide safe, timely and restriction on the numbers that can be employed through tier 2 effective care for patients with medical problems. visas, giving the ability to recruit more international doctors and nurses to provide outstanding patient care when required.

Our Future Health Our Future Health was a year-long project in 2018 to coincide with our 500th anniversary. It addressed some of the difficult dilemmas facing doctors and the NHS now and in the future. Over the course of the year we hosted podcasts, articles and blogs, webinars, videos and reports. The project brought together a range of voices to discuss prevention, artificial intelligence, quality versus quantity of life and health inequalities. Outputs included the thought-provoking report Talking about dying, about holding conversations with patients much earlier after the diagnosis of a progressive or terminal condition.

23 500 years of medicine International work

Our international office was rebranded RCP Global to reflect its remit to relate to the whole world. Its core aims are to build resources and expertise to improve healthcare worldwide.

The RCP has members in 116 countries, who make up 20% of our membership. In 2018, we focused on a range of activities, including the Medical Training Initiative (MTI), joint conferences, teaching, local colleges and innovative projects. We supported training for over 300 international medical graduates in the NHS at any one time during the year through the MTI, a scheme that provides junior doctors from all over the world with the opportunity to work and train in the UK. All will return to their home countries to support global health improvements. Written MRCP(UK) examinations are available in 34 locations around the world and PACES in 19. We expanded our teaching internationally to new regions in South Asia and the Middle East. We taught 47 days of international training in 2018. We trained over 200 doctors in East Africa, providing them with specialist training in detecting and treating cancer and neurological conditions. The ambitious Medical Training and Fellowship (METAF) Programme is a partnership with the British Council and sponsored by the East African Development Bank (EADB). We supported the newly founded East, Central and Southern Africa College of Physicians, whose first trainees started their programmes in September 2018. Equality of opportunity is a top priority for the RCP. We hosted our second annual Global Health Horizons conference in October. Focusing on ‘Learning from the past, looking to the future’, the conference discussed some of the biggest global health challenges and opportunities.

24 Annual review 2018 A strong organisation

We want to ensure we are running a responsible organisation that invests in our future while preserving our history.

Our presence in Liverpool is growing with 34 staff based at our interim office in the University of Liverpool building. We are delivering an array of activities for members in the north, including examinations, workshops and training events. Liverpool is also the home of our QI programme, which is developing innovative new approaches to support healthcare systems. We have now agreed the final design for the new RCP building (The Spine) with Liverpool City Council. Scheduled to open in 2020, The Spine will become a major centre for the RCP and our members and fellows in the north. We were delighted to agree a new enhanced memorandum of agreement (MoA) with the Scottish colleges, effective from the beginning of 2019. The MoA sets out how the three colleges will continue to collaborate on key education, training and assessment activities through the Federation of the Royal Colleges of Physicians. We launched a new Code of Conduct for our members and fellows, which provides a clear set of expectations as to how members, fellows and other healthcare professionals conduct themselves when working for or representing the RCP. The code will be used among the fellowship proposal criteria and at new member and fellow ceremonies. Linked to this, we also agreed new core values for RCP staff in 2018 – taking care, learning and being collaborative. Sustainability is high on our agenda. We were delighted to achieve the prestigious Carbon Trust Standard accreditation in 2018 to add to our ISO14001 environmental certification. Once built, The Spine will be one of the most sustainable buildings in the UK.

25 500 years of medicine RCP beyond 500

Medical excellence, education and training have been a core part of the RCP since our foundation in 1518. As society and healthcare have changed, the RCP has grown and adapted. Now we look forward to the next 500 years.

We will continue to play a major role in spreading good practice, developing physicians to provide clinical excellence and improving care for patients. We will build on our membership, aiming to reach our goal of 40,000 members and fellows by the end of 2020. Our member benefits will continue to enhance and support the professional lives of doctors both in the UK and internationally. We will continue to grow our influence, engaging government and campaigning for change where it is needed. Our new RCP building in Liverpool’s Knowledge Quarter will champion our work on improving care, health inequalities, education and technology. We look forward to continuing to support the dedication and professionalism of physicians and healthcare colleagues today, and in the future.

26 Annual review 2018 Giving Health

Giving Health is the RCP’s fundraising appeal to raise philanthropic donations to fund key areas of work in the UK and overseas.

The appeal aims to raise funds for four vital projects: > Physicians for Africa – a partnership with leading physicians in east, central and southern Africa to create a new training college in a region desperately short of well-trained doctors > The Physicians’ Fund – the award of grants to trainees and new consultants seeking to pursue innovation in medicine > The Spine – the construction of a state-of-the-art facility in Liverpool for the education and examination of physicians, which will also pioneer advances in > Heritage – the improvement of facilities for fellows and members in London, including renovation of our exhibition space and new, welcoming spaces for meeting and collaboration. We would like to thank the generous donors, members and fellows, charitable trusts and foundations, and companies who supported this work in 2018. The appeal has been a huge success, raising £400,000 to date. The names of those who have donated £1,518 or more are featured on the Linacre Wall, which has pride of place in our Regent’s Park home. If you would like to donate to the appeal and have your name – or that of a loved one or esteemed colleague – permanently inscribed on the wall, please contact [email protected]. Donors will know that they are making an enduring impact on the physicians, patients and medical profession of the future.

27 500 years of medicine

500 years of medicine Annual review 2018

In London: Royal College of Physicians 11 St Andrews Place Regent’s Park London NW1 4LE

In Liverpool: Royal College of Physicians William Henry Duncan Building 6 West Derby Street Liverpool L7 8TX

www.rcplondon.ac.uk Registered charity no 210508

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