The College will urgently define and set the scope of work for Physician Assistants in mental health services.

Multidisciplinary teamwork can blur the boundaries between medically qualified staff and colleagues from Nursing, Psychology and other disciplines. However, there will always be aspects of our work that can only be safely carried out by doctors. The College is the guardian of professional standards of knowledge and competencies in Psychiatry, and we cannot betray the trust that our patients and their families place in us to maintain those standards when they come to us for assessment and treatment. The NHS Ten Year Plan represents a huge threat to this and our College’s current reluctance to define the scope and role of PAs risks a precedent for more fundamental substitution. I am clear that any substitution of the competencies of psychiatrists is not a safe or acceptable response to budgetary or workforce challenges, and we must urgently define viable and rewarding roles for PAs who work in our services, as other colleges have already done.

The College will support every consultant to make their posts sustainable, safe and satisfying.

Too many consultants leave unsustainable jobs or (perhaps worse) remain in posts that impact significantly on their health and happiness. There’s a sense of helplessness among colleagues to change this, but the College will support the application of annual job-planning against templates developed by faculties, as we already do for the approval of new posts. Consultant job mobility is now the rule, rather than the exception, and we each hold important cards through our employment.

The College will administer an Accreditation Scheme for Trust HR Departments

To set and monitor standards for the treatment of psychiatrists at work, particularly rota cover planning and the management of short-notice vacancy cover. Individual Trusts will receive quality ratings for their performance which will be published, helping resident and consultant psychiatrists when they are choosing where they work.

We will repair the broken connection between resident doctors, consultants and SAS psychiatrists.

The demands of on-call rotas and administrative burden (particularly the EPR) have diminished connectivity between residents and their consultant trainers. Enhanced supervision, reverse mentoring and a fundamental review of the training syllabus and use of workplace-based assessments will create more opportunities for residents and consultants to sit and work together.

Introduce a Psychiatry examination for CT1 entry and post allocation.

The Work Psychology Group, who currently administer the Multi-Specialty Recruitment Assessment, have capacity and willingness to provide a specific Psychiatry exam for the August 2027 CT1 intake. There are many good reasons to do this, only one is that our selection of only residents who have positively chosen Psychiatry should reduce the disappointing proportion (currently 50%) who leave us before ST4.

Give more responsibility and decision-making power to resident doctors and their representatives within the College.

Psychiatry and the College have a long tradition of being influenced by those who have most recently joined us, and this keeps us agile and relevant. NHS and professional processes have increasingly talked down to and not listened to resident doctors. They are not children* and we should recognise this in the ways we train them and support them in their work. They face financial pressures that didn’t apply to earlier generations and I want the College to acknowledge this by reducing the costs of MRCPsych exams (they will contribute later through their membership fees for 30 years), making no charge for exam preparation courses and providing free access to an enhanced bank of exam questions that will be sufficiently comprehensive and trusted to put private providers of question banks out of business.

*I am proud that one of my children is currently a CT3, so I should declare an additional personal interest in the welfare and happiness of our residents.

The College will work with partners in the NHS and Independent Sector to create additional training capacity alongside the conventional routes without diminishing standards.

Even if we could fill all available ST posts, we would not generate sufficient CCT-holders to meet workforce requirements. Trusts and the Independent Sector (who already provide some core training posts but have also depended on the NHS to train their consultants) have an appetite for employing MRCPsych-holders in supervised 12-month posts, whose content the College would review and approve. After completion of the required years of training, postholders would be supported to gain their CCT through the portfolio route. This will offer more flexibility to access training as well as capacity.

The College will support SAS doctors who wish to sit the MRCPsych through tailored online exam preparation courses and will provide a streamlined and supported portfolio route to CCT for those who already have MRCPsych.

I understand that there will be SAS doctors who are happy in their role and do not seek further training and advancement. However, we will make these accessible and realistically achievable for all who want them.

The College will support capacity building in Academic Psychiatry by seeking philanthropic support for PhD fellowships and endowments to support post-doctoral bridging fellowships to enable early career researchers to gain independent funding.

The success of Academic Psychiatry is vital to the Membership and Fellowship of the College, and we depend upon leadership in research, innovation and teaching to improve and maintain our practice and knowledge. Colleagues who follow an academic career pathway need our support at these two critical pinch points. I particularly want to see more IMGs and women following an academic training pathway in our specialties and believe the College’s support can make this happen.

The College will make more use of the knowledge and expertise of the Academic Faculty to rapidly counter the misinformation of antipsychiatry with rigor and authority.

Every good psychiatrist should be critical and sceptical, but the organisations and individuals who use unscientific or anecdote-based methods to sow doubt and mistrust about mental health diagnosis and treatments can do real harm to vulnerable people.

Finally, I am acutely conscious of how Psychiatry is perceived in different cultures, both within the UK and beyond. Our patients experience stigma and prejudice, and we face this too, as our roles, expertise and influence are constantly eroded. I understand the difficulties psychiatrists face in different communities around the world and am proud that these doctors look to the College for direction, training and support.