The Committee was founded by Council in 1950 as a standing committee of the RCOG, its terms of reference were: 'to advise the Council on matters relating to the National Health Act in Scotland'. (extract from Council minutes 20 May 1950: reference T16 p.1). Its first meeting was held on 17 July 1950 in Edinburgh, and committee meetings took place regularly in either Edinburgh or Glasgow. In 1968 following discussions with Council, the Committee was reconstituted as an executive sub-committee of Council. The new terms of reference of the Scottish Executive Committee were "to advise Council on matters relating to legislation and practice in Scotland affecting the objects and interests of its members, and to communicate on behalf of Council with the appropriate Scottish authorities on these matters and others of particular relevance to Scotland". By 2008 its remit was more general: "to advise on specialty-related matters within Scotland; to keep under review the provision of training and service; to monitor and advise on workforce issues". Minutes of all meetings were kept by the secretary and submitted to RCOG Council, this practice continues today.
The Welsh Executive Committee was established by Council in 1972 as a standing committee of the Royal College of Obstetricians and Gynaecologists (RCOG) to represent the views of the College to the Welsh Office during the reorganisation of health services in Wales. Its first meeting took place on 23 July 1972 with J R E James serving as Chairman; predominately meetings were held at Llandrindod Wells Hospital. In 2008 its remit was: to discuss and advise upon specialty related matters, particularly within the Principality of Wales. Minutes were kept by the Secretary and submitted to the Council of the RCOG for ratification, this practice continues presently.
An Accreditation Sub-Committee was established in 1970 to direct the accreditation of training and report to Council. The committee approved following procedure: - a member of the College should be eligible to apply for accreditation after three years further approved experience and training in obstetrics and gynaecology beyond the requirements of the MRCOG examination, of which two years were to be subsequent to admission to the membership of the RCOG and normally in a post of responsibility corresponding to that of a senior registrar in an NHS hospital; the administration of accreditation should be the responsibility of the Postgraduate Medical Education Committee. (Council minutes 26 Sept 1970; Archives reference: B13/1) Later known as the Accreditation Panel, and from 1973 as the Accreditation Committee, it became the Higher Training Committee (HTC) in 1984. Its role was to "oversee and regulate all matters pertaining to higher training" and was responsible for: inspecting and recognising higher training posts at registrar and senior registrar levels; agreeing higher training programmes for accreditation; monitoring the progress of trainees; recommending individuals to Council for accreditation; advising Council on the regulations for accreditation. In December 1985 a Subspecialty Board was established as a sub-committee of the Higher Training Committee; in July 1988 this Board became an independent standing committee. In 1998 the Higher Training Committee's functions relating to the recognition of specialist registrar posts was passed to the Hospital Recognition Committee (HRC). The Higher Training Committee continued to carry out its other functions under the new name of the Specialist Training Committee from 1999. The Specialist Training Committee was disbanded in July 2007 and was replaced by the Specialty Education Advisory Committee (SEAC). The function of the Committee is to be responsible for the content, structure and delivery of the Specialty Training Programme and to advise the eligibility of doctors for the award of the Certificate of Completion of Training. All the above committees were/are serviced by the College's Postgraduate Training Department (PGT) and reported to the Education Board.
A Subspecialty Board first met in December 1984 as a sub-committee of the Higher Training Committee. The Board was created to fulfil some of the recommendations of the Working Party on Further Specialisation within Obstetrics and Gynaecology and the Sub-specialisation Advisory Group. In July 1988 the Board became a standing committee. Its present remit is to advise and keep under review the development of subspecialisation in four fields (gynaecological oncology, reproductive medicine, maternal and fetal medicine, and urogynaecology) including requirements and regulations for subspecialist training and accreditation. It is also responsible for establishing the criteria and procedures for approval of subspecialty trainees, training centres and training programmes, and for subspecialist accreditation on completion of training. The Committee:
- Ensures visits are arranged to assess prospective training centres and trainees in post.
- Makes recommendations to the Education Board regarding the recognition of centres and programmes on the basis of advice provided in the visitors' reports.
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Makes recommendations to the Education Board regarding the award of certificates of Subspecialist Accreditation on the basis of advice provided in visitors' reports following trainee final review visits.
- Provides feedback to programme directors on the progress of trainees based on information submitted in the visitors' reports following mid-term review visits.
- Liaises with programme directors to ensure the syllabi, requirements for training and the various application and report forms are updated appropriately.
- Keeps statistics on current and past trainees, including manpower and funding information, and the number of centres and programmes approved.
The Committee reports to the Education Board, meeting four times a year and is serviced by the College's Postgraduate Training Department.
The Ethics (or Ethical) Committee was established in 1982 to consider the ethical aspects and legal implications of matters of concern affecting the practice of obstetrics and gynaecology. It has considered a wide range of issues such as abortion, assisted reproduction, sex selection, female genital mutilation, the use of fetuses for research, gene therapy, court-authorised obstetric intervention, patient consent, personal health information and critical care decisions.
The Publications Panel was set up in 1978 to consider the format, typesetting, binding and print runs of College scientific publications (ref: RCOG/B16/1, internal memo 22/1/85). It reported to the Finance and Executive Committee. In February 1985 the Panel was reformed to 'meet only when necessary to discuss printers quotations, publishers proposals, print quantities and handling charges to Fellows and Members' (ref: RCOG/B16/1, agenda Feb 1985). The Panel was chaired by the Honorary Treasurer.
The European Committee of the RCOG was established in 1991 and held its first meeting in September that year. It was set up to monitor developments in Europe, as it was felt that the many changes taking place required more than an ad hoc approach from the College. It worked closely with a number of Europoean organisations, including the European College of Obstetrics and Gynaecology (ECOG), of which the RCOG was a founder member, and the European Board of Gynaecology and Obstetrics (EBGO). These two organisations later merged to become the European Board and College of Obstetrics and Gynaecology (EBCOG), a section of the Union Européenne des Medécins Spécialistes (UEMS), based in Brussels. The Committee took a particular interest in the uniformity and reciprocity of training and in employment issues. It was disbanded in 1998.
In 1987 the Joint Planning Advisory Committee (JPAC) of the Department of Health invited a submission from the RCOG on training grade numbers. Ad hoc meetings were held to formulate a response. This was followed by an occasional Manpower Working Party which met from 1988 to advise Council on these issues. The Working Party began to undertake annual censuses to identify numbers in training, career prospects and related areas of concern and also to hold annual meetings to update members of the profession in manpower issues and to allow sharing of views between the College, the Department of Health, purchasers and providers of health care. Special surveys and studies on specific issues were also undertaken. By 1990 the Working Party had gradually evolved into full committee but did not adopt a formal constitution and terms of reference until 1992, when it was decided that its role was 'to advise Council on all matters relating to manpower in obstetrics and gynaecology' and 'to keep Council informed of the census results and manpower and staffing trends which are identified.' In 1997 it was decided that the term 'manpower' was outdated and the committee was renamed the Medical Workforce Advisory Committee (MWAC).
This Committee was established to act as a channel of communication between trainees and the RCOG and as a forum for discussion of issues relevant to training in obstetrics and gynaecology. The idea for the committee originally arose in the early 1990s in response to health service reform, the reduction of working hours and changing working practices of junior doctors, the Calman reforms in medical education, and concerns about the retention and recruitment of trainees in obstetrics and gynaecology. It was to be a constituted as a democratically-elected standing committee of the RCOG, members being elected by other trainees, and would liaise with the College about examinations, accreditation and training issues in the light of the current health service reforms. This national committee was to be accompanied by regional committees that would liaise with Regional College Advisers, Postgraduate Deans and District Tutors about local matters. An Interim Trainees Committee was established in 1993, with Dr Susan Bewley as Chair. Elections were held early in 1994 and the National Trainees Committee proper held its first meeting in July 1994. In 1998 it became known as the Trainees Committee. In addition to giving them a voice within the RCOG, the committee organised a series of surveys of trainees, to ascertain their views on training in obstetrics and gynaecology, working patterns, remuneration and the effect of health service reforms.
The External Affairs Committee was set up on April 6th 1933 to deal with external matters not specifically the concern of any one College Committee, such as matters of public and national health, and with public enquiries. It was also known as the External Relations Committee. Its activities were gradually taken over by Finance and Executive Committee during the Second World War, and it is last mentioned as a functioning committee in Council and Finance and Executive Committee minutes in 1943. The last minutes surviving in the minute book (ref: RCOG/T4) date from 16 June 1939.
The Academic Committee was established in 1996 under the chairmanship of Professor E M Symonds, to promote and safeguard all aspects of academic obstetrics and gynaecology including research and research training, undergraduate and postgraduate teaching and academic jobs and training, particularly in relation to recruitment and retention, and to monitor academic staff and funding in obstetrics and gynaecology. It worked closely with the Association of Professors of Obstetrics and Gynaecology and the RCOG Scientific Advisory Committee.
The Consumers' Forum was set up in 1993 to provide a multidisciplinary forum for the exchange of views and information between organisations representing and working on behalf of consumers of healthcare services and the specialty of obstetrics and gynaecology. It aimed to ensure that consumer perspectives informed and influenced practice through contributing to working party reports, clinical guidelines and other College activities. Core Forum group members were drawn from organisations whose focus directly related to gynaecology, obstretics or reproductive health (e.g. Maternity Alliance, National Childbirth Trust, Family Planning Association) and from organisations that provided consumer perspectives, but did not have a direct focus on gynaecology or women's health (e.g. the Patients' Association).
The Clinical Effectiveness Standards Board (CESB) was established in 1999 with responsibility for strategy and policy in relation to the College's clinical effectiveness and governance programme. Its main objectives included: development of a co-ordinated and structured programme of audit and guideline activity; co-ordination of a clinical effectiveness programme among the clinical and scientific meetings of the College; co-ordination and development of the College's programme in relation to quality improvement, particularly risk management, accreditation of services and consumer issues. It included representatives from the Department of Health, the National Institute of Clinical Excellence (NICE), the National Confidential Enquiries, the British Association of Medical Managers, other Royal Medical Colleges, and consumers. It took over co-ordination existing activities including clinical guidelines, Personal Assessment in Continuing Education (PACE) Reviews, and audits. It oversaw the work of the new Clinical Effectiveness Support Unit (CESU). The CESB held its last meeting in April 2000, when a new structure of governance was introduced, including a new Standards Board. From that date, the Guidelines and Audit Committee reported to the Standards Board, which also oversaw the work of CESU.
The Education Board was established in November 1992 on the recommendation of the Futures Working Party of the College. Its remit was 'to act as a forum to disseminate information and to act as required on particular items of educational interest in its widest sense' (Education Board: minutes of preliminary meeting, 20 Nov 1992, ref: B24M/1 p. 1). It took reports from the relevant standing committees and discussed those matters arising from their activities that would not normally have received an airing at Council. These included the Examinations, Higher Training, Hospital Recognition, Subspecialty, Continuing Professional Development, Manpower, and Meetings Committees. In 2000, the RCOG put in place a new board structure in order to free-up Council's time to concentrate on strategic and specialty wide issues. The Education Board became one of three boards (along with Standards and Services) that were given executive and decision-making authority and were able to ratify the decisions of reporting committees and groups. They were responsible directly to Council and met quarterly. The remit of the Education Board became: to facilitate the ongoing development of valid, fair and appropriate College examination processes; to promote and facilitate the development of the continuing professional development programme; to facilitate the initiation and development of the distance learning programme and related education initiatives; and to co-ordinate and facilitate the development of education in its widest sense (Finance and Executive Committee: minutes, 4 May 2000, ref: A3/30/4). At this date it had the following reporting committees: Examinations, Continuing Professional Development, Standing Joint RCOG/RCR, Meetings, CAL [Computer Assisted Learning] Editorial Board. In 2002, in order to forge closer ties between examinations and training, a revised Board structure was established and the reporting of the three training committees (Specialist Training, Subspecialty, Trainees) was diverted from the Standards Board to the Education Board. By 2008, the Education Board's remit was as follows: to co-ordinate postgraduate training, assessment and testing of training and accreditation of place of training; to facilitate the continuing development of valid, fair and appropriate College examination processes; to facilitate the initiation and development of distance learning programmes; to co-ordinate and facilitate the development of specialist education, training and assessment in the widest sense, in accordance with the College curricula.
The Publications Management Committee was established in June 1993. Its remit was to be responsible for financial and management decisions relating to publications, including study group proceedings. It was to meet four times per annum, and report to the Finance and Executive Committee. It is serviced by, and oversees the functions of the Publications Department. Presently, the main functions of the Committee are:
- to oversee the financial management of titles published under the imprint of RCOG Press.
- to oversee the work of The Obstetrician & Gynaecologist Editorial Board and the StratOG Editorial Board.
- to receive and approve proposals for new publications to be published under the imprimatur of RCOG Press.
- to oversee the operation of the RCOG Bookshop.
- to receive and approve proposals for new regalia/gifts and to monitor their sales.
- to consider new ventures.
From 1992 the Committee oversaw the work of The Diplomate Editorial Board, until publication was suspended in 1999.
The Editorial Board was established in 1992 to plan and oversee publication of 'The Diplomate', reporting directly to the Publications Management Committee. The objective was 'to provide an essential update of techniques and important clinical developments in obstetrics and gynaecology - thereby presenting continuing medical education in an outstanding, understandable and readable form.' (The Diplomate No. 1 Vol. 1 1992, Archives ref P3/1/1). The publication was primarily aimed at Diplomates of the RCOG (those who had completed the College's Diploma in Obstetrics and Gynaecology, the DRCOG), but it was available for sale to any interested parties. The first 'Diplomate' was published in March 1994. It lost money throughout its existence; consequently the final volume was published in January 1999. Production of 'The Diplomate' was the responsibility of the Publications Officer; its Editor-in-Chief was John Studd FRCOG.
This committee was formed after it was decided to combine the responsibilities of the Audit Committee (disbanded in April 1999) with the administration and production of RCOG guidelines, formerly a responsibility of the Scientific Advisory Committee (SAC). The first meeting of the new committee, known initially as the Guideline and Audit Sub Committee (GASC), and later the Guidelines and Audit Committee (GAC) took place in April 1999. Reporting to the Clinical Effectiveness and Standards Board, and later the Standards Board, it oversaw the development of guidelines and co-ordinated audit and guideline activity in obstetrics and gynaecology and prepared funding applications to support this work.
The House Committee met on only a few occasions during 2003 with the following remit: to advise and make recommendations on all matters relating to the care of College buildings including maintenance, health and safety, environmental health and security; to oversee the maintenance of a register of assets and to review the condition of fixtures and fittings, including paintings, furniture and fabrics; to develop, monitor and evaluate space allocation and the use of the building; and to develop and regularly review the domestic and social functions of the College. It reported to the College's Services Board.
In 2000, the RCOG put in place a new board structure in order to free-up Council's time to concentrate on strategic and specialty wide issues. The three boards (Standards, Services and Education) were given executive and decision-making authority and were able to ratify the decisions of reporting committees and groups. They were responsible directly to Council and met quarterly. The first meeting of the Standards Board took place in July 2000. It assumed some functions of the previous Clinical Effectiveness and Standards Board but also dealt with training and manpower issues. Its initial remit was: development of a structured programme of audit and guideline activity and the co-ordination of a clinical effectiveness programme; development of clinical governance encompassing continuous professional development and revalidation; recognition of UK and overseas training posts and the future accreditation of services; monitoring and development of College programmes leading to Specialist Registration; and consideration of the impact of medical workforce issues on the specialty. As the College began to undertake new work in the area of clinical governance and standards, the Board acquired new functions and in May 2007 a new remit was agreed: to develop the overall strategic direction in relation to professional, clinical and service standards; to consider the views of external organisations and the Consumers Forum; to consider scientific and ethical issues and their impact on the practice of obstetrics and gynaecology; to direct and oversee the RCOG clinical guidelines and audit programmes and activities in relation to service standards, including the development of service models; to supervise continuing professional development, appraisal and revalidation activites and to ensure that satisfactory programmes were established for doctors and trusts requesting support from the College.
The Committee was established in 1930 to select members to be elevated to the fellowship. Fellows were Members who were judged worthy by their peers in distinguishing themselves in the field of obstetrics and gynaecology. Initially the Committee sat twice annually: in the autumn proposals were put forward for elevation, then after the Committee members had considered the list, a second meeting in the winter confirmed the names to be put to Council. Although the exact administrative arrangements varied, by the 1990s, the procedure was as follows:
1) Recommendations for elevation to Fellowship were invited from all Fellows. Members with sufficient experience were also encouraged to seek elevation by returning a CV form. The College Vice Presidents reviewed the papers in order to assess eligibility, with the assistance of the Chairmen of Overseas Reference and Representative Committees, if applicable. All cases were then put before the Fellowship Selection Committee before a final list was presented to Council for approval.
2) Nominations for Fellows Ad Eundem were collected by the Fellowship Selection Secretary throughout the year. The Finance and Executive Committee considered all the nominations and produced a shortlist. This was then brought to the Fellowship Selection Committee for approval.
In 1998 the process of Fellowship selection was reviewed and discussed. A simplified process was augmented and the Committee was disbanded. Discussions about those eligible for Fellowship became the responsibility of the Finance and Executive Committee, who then put the names to Council. The administrative departments of the College (the Membership Services Department and then the Administration Department) assumed responsibility for the procedure for selecting Members for elevation to the Fellowship, arranging admission ceremonies and maintaining the records of all Fellows, Members and Diplomates.
In 2000, the RCOG put in place a new board structure to free-up Council's time to concentrate on strategic and specialty wide issues. The three boards (Standards, Services and Education) were given executive and decision-making authority and were able to ratify the decisions of reporting committees and groups. They were be responsible to Council and met quarterly. The Services Board was set up to develop and co-ordinate services to Fellows and Members, Trainees, members of the public, the media and RCOG internal departments. Its original terms of reference were to co-ordinate and facilitate publishing activities, including responsibility for editorial production, management, marketing and distribution services. Its remit was also to co-ordinate the production of information to Fellows and Members, the public and the media; whether paper, electronic or verbal/oral. The Board was intended to have executive and decision-making authority in addition to ratifying decisions by reporting committees. It was also expected to report matters of political, financial importance and/or which had personnel implications, to the Finance and Executive Group (FEG). It was also, ultimately, answerable to Council. Its original membership consisted of the Chairman (Honorary Officer), the Chairmen of the Publications Management Committee, the Information Technology Committee, the Information Services Committee and the Website Working Group, the Public Relations Officer, a Fellows and Members representative each from Council, the Head of the Services Division and any other 'relevant managerial staff' according to agenda items, i.e. they were to attend on an ad hoc basis. A later remit was agreed or dated 23rd January 2002, but it is apparent that there were amendments made to the membership in the early stages of its existence. In 2003 the Services Board was disbanded because Council felt that there was duplication of reporting. Responsibility for awards, overseas activities, fellowship selection, publications management and press were passed to the Finance and Executive Group. A new Services Committee was established on 23rd May 2003, reporting to Finance and Executive. It incorporated the remits from the old Services Board, House Committee and Information Services Committee and was responsible for the activities of Administration, Facilities, Information Services, Information Technology, Membership Services and Premises. However, in 2005 Council ratified Finance and Executive's decision for the Services Committee to revert to its former title and executive status as the Services Board. So despite some to-and-froing, by 2008 the Services Board's remit was essentially little changed from that of its establishment in 2000. The Board was to develop and co-ordinate services for Fellows, Members, Trainees, Associates and Affiliates, and to assist in supporting College strategy by developing new services and regularly reviewing the provision of current services provided by the College departments of Administration, Facilities, Information Services, Information Technology, Premises, Communications and External Affairs, and Publications. It retained its status as an executive authority and had the power to ratify the decisions of the following groups and committees that report to it: Public Affairs Committee, Publications Committee, Services Group, Website Group, Cross-Departmental Marketing and Focus Group, and Red Eventful Cuisine/RCOG Group.
The Committee held its first meeting in July 2001. It was established 'in response to the need for standards and benchmarks required by various external agencies as well as to assist Fellows and Members discharge their general clinical governance duties.' It had three key areas of responsibility: engagement with the National Health Service and review of national policy-making; developing, implementing and monitoring clinical and service standards to ensure patient safety; developing, implementing and monitoring professional standards for good medical practice. The Committee reported to the Standards Board. In May 2007 it was renamed the Professional and Clinical Standards Committee and a College Officer charged with responsibility for each of its three key areas. Its further activities included: developing service models in line with College recommendations; ensuring implementation of College policy on performance and service reviews; establishing and overseeing the reskilling/refresher training policy.
In order to assist the work of the Clinical Standards Department and the Standards Board in planning the development of clinical standards, clinical directors of obstetrics and gynaecology in the UK were invited to a meeting in October 2000 to consider the College's approach in this area; to enable liaison with clinical directors and to define how the College's programme of work might help them. From this date regular bi-annual meetings were held 'to identify issues of importance to those at the coal-face and to exchange experiences and views.'
The first edition of The Obstetrician and Gynaecologist appeared in July 1999 as a quarterly journal aimed particularly at those participating in continuing medical education (CME, later known as CPD, continuing professional development) programmes. It included multiple-choice questions to be completed and submitted in return for the award of CME / CPD credits. The responsibilities of Editorial Board members were to advise on the commissioning of review articles in their area of specialty; commission and/or construct multiple-choice questions with explanation of answers; edit and subsequently proof-read their commissioned articles; write guest editorials; advise on new scientific, clinical and technical developments, clinical governance, risk management, areas of educational importance and medico-legal matters, and on the potential need for coverage in the journal; and to proof-read complete editions of the journal. The Board held its first meeting in June 1999.
The Reinstatement Committee was established in 1999 to consider how applications for reinstatement to the College Register from those removed as a result of GMC (or other) disciplinary action should be assessed. The remit of the Committee was:
1) To consider all applications for reinstatement to the RCOG Register of Fellows and Members from those who have been removed for reasons of misconduct;
2) To make all necessary and proper enquiries, as it saw fit, and to act according to equity and rules of natural justice;
3) To produce guidelines on the assessment procedure to be followed by both the applicant and the Committee, including appropriate criteria for reinstatement and an indication of the timeframe for the procedure;
4) To recommend to Council, in writing, the reinstatement, or otherwise, for each application. In 2001 the Committee reported to Council on progress and advised that it was necessary for the College to set up systems to ensure equity following rules of natural justice. This was particularly pertinent following the 1998 Human Rights Act. It was also recommended that the Committee deal with both removal and reinstatement. In 2001 a Removal and Reinstatement Committee was established in order to:
1) Review the membership of the College of those Fellows and Members who had been removed from the Register of Medical Practitioners maintained by the GMC or by the relevant body of any country overseas;
2) Review the membership of the College of those Fellows and Members referred to it by the President or his/her deputy where it was thought the individual had brought the College and/or profession into disrepute;
3) Assess applications for reinstatement received in the College from those who had previously been removed from the College Register for misconduct;
4) Comply with the regulations for removal from or reinstatement to the College Register as approved by Council. The Committee was to reach an agreed decision, which, if necessary, was a majority decision, and advised Council on these decisions. All discussions of the Committee were confidential to the Committee.
In July 1988 the College established a working party 'to review current post-graduate activities of the College and to consider the need, feasibility and the format of assessment of the individual's maintenance of skills'. In 1991 this reported that the majority of consultants were not taking advantage of the existing educational opportunities offered by the College. It recommended that the College develop a programme of mandatory Continuing Medical Education (CME) for all its Fellows and Members in active specialist practice. This began in January 1994. The RCOG was the first of the UK Colleges to establish such a programme and also the first to offer it (from January 2000) to overseas members. The programme catered for consultants and other members of career grade staff not in training posts. The scheme was developed and overseen by the CME Committee, which held its first meeting in July 1992, and reported to the newly-established Education Board. It was administered by the Postgraduate Education Department. The first 5-year CME cycle was completed in December 1998. In 1998 CME also became part of the wider sphere of Continuing Professional Development (CPD) and in 1999 the CME Committee changed its name to the CPD Committee. In January 2002 the CME programme also changed its name to the CPD programme. At this date the programme was expanded to take into account, not just the continuing medical education needs of obstetricians and gynaecologists, but also broader professional development (i.e. non-clinical or non-specialist clinical activities). The Postgraduate Education Department was disbanded in October 2003 and the CPD Office was transferred to the Clinical Governance and Standards Department.
In 2005, the Post Graduate Medical Education Board (PMETB) was established as an independent regulatory body responsible for postgraduate medical education and training. It assumed its statutory powers on 30 September 2005 taking over the responsibilities of the Specialist Training Authority of the Medical Royal Colleges (STA) and the Joint Committee on Postgraduate Training for General Practice (JCPTGP). PMETB's statutory responsibilities included establishing, promoting, developing and maintaining standards and requirements for postgraduate medical education and training across the UK. In order to practice in the UK, doctors are legally required to be on the registers of specialists and general practicioners (GPs) maintained by the General Medical Council (GMC). A major facet of PMETB's work was to ensure that doctors were appropriately qualified and certified for application to the specialist and general practice (GP) registers. In response to this national development, the Equivalence of Training Committee was set up in August 2005, reporting to the Education Board. Its remit was to: redefine "equivalence" in respect of Specialist Registration; determine the standards required for an NHS Consultant within the specialty of obstetrics and gynaecology; agree methods of assessment according to guidance issued by PMETB; assess applications and submit recommendations to PMETB; liaise with PMETB on all appropriate issues; consider the liability to the College and how this may be indemnified. The Committee's primary function was to assess applications from O&G doctors applying to be included on the Specialist Register maintained by the General Medical Council: assessing and judging if a doctor's medical experience can be seen to be equivalent to the medical training they would have undertaken if they had passed the MRCOG. Previously the College had been responsible for deciding who should be entered onto the Specialist Register, but PMETB as an independent body took over this function in 2005. The Equivalence of Training Committee was established to report to the PMETB with recommendations on the equivalence of training, the College was no longer responsible for making the actual decision.
The Services Committee was established when Council decided to disband the Services Board in 2003. The new Services Committee took over a large proportion of what had been the Services Boards' responsibilities, and reported to Finance and Executive. Its remit was dated 24th March 2003; the main objective of the committee was to develop and co-ordinate services for Fellows and Members in the British Isles and Overseas. Its broadest terms of reference were to regularly develop and review a strategic plan, in relation to the provision of services by the Facilities Department, the Information Services Department, the Information Technology Department, the Membership Services Department and the Premises Department. More specifically, the Committee was to frame policies for access to, and storage of, rare books and manuscripts, instruments, personal papers and artefacts of historical interest for the benefit of Fellows, Members and suitably accredited visitors. It was also to keep abreast of, and advise upon, the development of computerised services within the College and to ensure that the services themselves were integrated with national developments. Additionally, it was to develop, monitor and evaluate the use of the RCOG website and to frame polices for the development of membership services. Finally, it was to advise and make recommendations concerning all matters relating to the care of the buildings and assets at 27 Sussex Place and 8 Kent Terrace. The Committee met on a quarterly basis from 2003 to 2005. Its existence was short-lived because in 2005 Council ratified the decision for the Services Committee to revert back to its former title and executive status as the Services Board.
The development of international activities was a priority within the College's three-year strategy, 2004-2007. Initial focus was on collaborative work with other agencies to assist in reducing maternal mortality in developing countries and to raise the standard of reproductive healthcare worldwide. The first stage was to establish an International Executive Board under the Chairmanship of the Senior Vice President who had responsibility for international affairs. The Board met quarterly and reported to Council. It included representatives of other organisations including the Liverpool School of Tropical Medicine, FIGO, and the World Health Organisation. It had the following remit:
- To co-ordinate and promote an RCOG strategy on the improvement of reproductive healthcare worldwide to reduce maternal mortality.
- To establish and monitor progress of the RCOG Foundation.
- To consider income generation initiatives to ensure that there were sufficient funds available to sustain this area of work.
- To work in partnership with other UK and International Agencies to strengthen links, to facilitate a multi-disciplinary approach and to encourage dialogue.
- To co-ordinate the development of clinical standards and educational tools for under-resourced countries.
- To develop a framework for improvements in reproductive health in developing countries.
- To lobby governments, including the health ministers of commonwealth countries to influence and educate on the problems and solutions to maternal mortality.
- To assist in the exchange of skilled personnel and training programmes.
- To collaborate with RCOG international representative committees and to encourage dialogue at a national level in all countries.
An International Advisory Group was also established in 2006 to support and advise the Board.
The Hospital Recognition Committee (HRC) was first established in 1944 as a sub-committee of the Examination Committee. It became a full standing committee in 1947. From 1935 the inspection and recognition of hospitals had been a regular part of the Examination Committee's work. The impetus behind the establishment of the Hospital Recognition Sub-committee in 1944 was provided by the Interdepartmental Committee on Medical Schools (Goodenough Committee). The Hospital Recognition Sub-committee was established to draw up a list of hospitals which could be recognised for training to consultant status. The Sub-committee reported in January 1945. Its earliest extant minutes (numbered K1) date from September 1946, and show that the Sub-committee was performing the functions previously routinely performed by the Examination Committee in administering the recognition of hospital posts. The first meeting of the HRC as a full standing committee took place on 19 March 1947 (K2). In the 1950s and 1960s its membership was co-extensive with that of the Examination Committee. In 1973, however, Council undertook a review of the College's committees and decided to streamline the Examination Committee, making it into a small executive committee. The existing composition and functions of the HRC were maintained. In 1998 the HRC took over the functions of the Higher Training Committee (HTC) (which had been dissolved) relating to recognition of Specialist Registrar hospital posts. The HRC's current remit is: to undertake regular assessment and, where appropriate, recognise as satisfactory, training in obstetrics and gynaecology in defined posts, against defined standards, for hospitals who request such recognition, both in the UK and overseas; to make recommendations for the improvement of training and monitor the implementation of such recommendations. The HRC is serviced by the College's Postgraduate Training Department.
The Journal of Obstetrics and Gynaecology of the British Empire was first published in 1902. It was owned by the Journal of Obstetrics and Gynaecology of the British Empire Publishing Company Limited. From 1933 the meetings of the board of directors of the Company took place in the College's premises. In 1950 the ownership of the Journal was acquired by the College and the Company was wound up. The Journal Committee was set up by the College following its acquisition of the Journal in 1950. In 1980 the Committee was reconstituted as a separate Journal Business Committee (renamed the Journal Management Board in 1988) to run the organisational and business aspects of the Journal, and an Editorial Committee to decide editorial policy and function. In 1992 these bodies were renamed the Journal Management Committee and Journal Editorial Board respectively and in 2000 they became BJOG Management Board and BJOG Editorial Board. The Journal has changed its name on several occasions since it was founded. It became The Journal of Obstetrics and Gynaecology of the British Commonwealth, from 1975 it was published as British Journal of Obstetrics and Gynaecology and, in January 2002 BJOG: An International Journal of Obstetrics and Gynaecology.
The establishment featured in the early vision for the College. In April 1933, A E Giles (1864-1936) was elected as the first Honorary Librarian and a Library Committee was formed. Giles became Resident Librarian in 1937. After the Second World War this post was discontinued, and in 1946 W J Bishop (1903- 1961) became part-time librarian (later Consultant Librarian). Hitherto the collection had been primarily historical, but when the College moved to new purpose-built premises in 1960, the Library was an important element in the design of the new building and it extended its activities to cover current literature in the specialty. Grant funding from the Wellcome Trust enabled major developments in the 1960s and in 1970 the Library premises were further extended. Meanwhile, the rare book collections continued to grow. Notable donors included Roy Samuel Dobbin (1873-1939), Sir Eardley Holland (1879-1967), and Miles Phillips (1875-1965). In 2000, the Library Committee changed its name to become the Information Services Committee in order to reflect the developing activities of the Library in this area. In 2001 it assumed additional responsibilities with regard to Information Technology and the College website from the previous Information Technology Committee and Website Working Group. In the same year, the Library became the major constituent, along with the College Archives, of a new department, the Information Services Department. The Information Services Committee met for the last time in March 2003. The Information Services Department continued to function, reporting to Services Board, and in 2005 acquired responsibility for the College web-site.
In 1947 a Standard Maternity Hospital Report Committee was set up by the College to encourage maternity hospitals and departments to publish annual medical reports in order to maintain a high standard of practice. In 1948 it published a standard form for them to adopt in order that comparisons might be made over time. This was widely adopted in the UK and Commonwealth and revised in the 1950s and 1960s. In 1973 the Committee changed its name to the Obstetrical and Gynaecological Statistics Committee, and in 1977 to the Statistics and Epidemiology Committee. In 1978 the Committee became a sub-committee of the Scientific Advisory and Pathology Committee. It reverted to a full committee in 1983. During these years the Committee took an active role in the advent of computerisation in relation to the collection and analysis of maternity data and also in disease definition, classification and coding systems. After the collection and analysis of data from Fellows and Members of the College about laparoscopy in 1978, other statistical studies on particular topics followed. In 1990 the Committee was renamed the Audit Committee as it was envisaged that audit was likely to be an increasingly large component of its work. An Audit Unit, funded by the Department of Health and based at St Mary's Hospital in Manchester, was established in 1991 under the supervision of the Audit Committee. In 1999, despite the fact that some members felt that their original remit with regard to statistics and epidemiology would be sacrificed, both the Committee and Unit were wound up and their responsibilities transferred to the Guidelines and Audit Sub-committee and Clinical Effectiveness Support Unit.
Following the Royal Commission on Medical Education and the establishment of the Central Committee on Postgraduate Medical Education it was felt, in 1967, that the College should increase its role in sponsoring and organising postgraduate education and an ad hoc Sub-committee on Continuing Education met to discuss the issue. This led in 1968 to the establishment of a Postgraduate Medical Education Committee to deal with postgraduate training for the three year period from registration up to the MRCOG examination and beyond. It was to oversee the administration of existing programmes, such as demonstrations, conferences, symposia and scientific meetings, and also to determine overall policy with regard to postgradute training regionally and locally. It was renamed the Postgraduate Committee in 1973. The Committee was disbanded in 1992 when it was replaced by the Education Board. From 1968 Regional Advisers (subsequently known as College Advisers and then Regional College Advisers) enabled the College to be better informed about postgraduate training at a local level. Their role included promoting the views of the College locally, providing the College with information on education and training in their regions, giving advice on the specialty to those organising training and also to trainees. From the early 1970s meetings of these Advisers were held quarterly and their discussions reported to the Postgraduate Committee.
Committees and Councils of the RCOG were set up internationally in various countries. The earliest were Reference Committees, which were set up and appointed to advise Council on local matters, such as the recognition of training posts and the training programmes of individual trainees, and to encourage local scientific meetings and social gatherings of Fellows and Members. The first reference committee was set up in Canada in 1932, closely followed by one in India and subsequently in Australia, New Zealand and South Africa. Gradually Regional Councils replaced Reference Committees in Australia, Canada, New Zealand and South Africa. Australia and New Zealand replaced their Councils with their own Royal Colleges of Obstetrics and Gynaecology in 1980 and 1982 respectively. Representative Committees were set up as the corporate body of College membership in a particular country or region and nominated and elected by the Fellows of that country or region. Functions were to bring together the collective advice of Fellows and Members and to undertake tasks on the College's behalf which were also in the interests of the country. In the 1980's the remaining Regional Councils were replaced by Representative Committees. The Dominions Committee was founded as a sub-committee of the RCOG in 1945 and became a full committee in 1952. It comprised representatives from the dominions (Canada, South Africa, Australia, New Zealand and India) and met in London. The meetings were consequently infrequent and the Committee was disbanded in 1958. The Overseas Policy Committee based in England, met from 1960 to 1962 when it became known as the Overseas Committee. Its terms of reference were: to consider development and change in countries overseas, particularly within the Commonwealth, in so far as they affect the aims and objectives of the College; to consider with the regional councils and reference committees means of fostering a close relationship between Fellows and Members abroad; to help with the placing of recommended postgraduates in recognised training posts in England and abroad; to be concerned with arrangements for the reception, both professional and social, of visitors from overseas. By 1967 the Overseas Committee had been superseded by the appointment of an Adviser to Overseas Candidates and after 1967 there is no record of the Committee meeting again.
The Population Investigation Committee (PIC) was established by the Eugenics Society in 1936 to promote and undertake inquiries into various aspects of population questions. In 1945 a Joint Committee of the Royal College of Obstetricians and Gynaecologists and the PIC was established with the aim of conducting a survey of maternity services in selected areas throughout England, Scotland and Wales; the survey was funded by the Nuffield Foundation. All women in Great Britain who had given birth during a single week in March 1946 were interviewed by health visitors, and information collated on their use of maternity services, economic and social background, infant feeding and survival of the baby. The results were published in Maternity in Great Britain (Oxford University Press, 1948). In 1948 the Joint Committee's scope was broadened to include the study of child health and development, and a Follow-up Survey Sub-committee comprising RCOG, PIC and the Institute of Child Health (London School of Economics, University of London), was established to conduct a survey of the children enrolled in the 1946 survey. Two studies were made, in 1948 and 1950, again with funds from the Nuffield Foundation. In 1951 the College withdrew from the Joint Committee on the grounds that the work now extended beyond the scope of the College.
The Representative Committee was formed in 1943 at the invitation of the Minister for Health who asked the British Medical Association (BMA), in collaboration with the royal colleges, to form a committee representative of all branches of the medical profession to discuss with him the problems involved in establishing a comprehensive national health service. The following bodies were represented on the committee: Medical Planning Committee; BMA; Royal College of Surgeons of England; Royal College of Physicians; Royal College of Obstetricians and Gynaecologists; Royal College of Physicians of Edinburgh; Royal College of Surgeons of Edinburgh; Royal Faculty of Physicians and Surgeons, Glasgow; Society of Apothecaries; Society of Medical Officers of Health; Medical Women's Federation; Provincial Teaching Hospitals' Staffs' Association. The purpose of the committee was to explore the medical problems raised by the Beveridge Report and to promote the views of the majority of the medical professions. In 1944 the Representative Committee was restyled as the National Health Service Negotiating Committee; it was disbanded in December 1948 following the establishment of a Joint Committee of the Royal Colleges, the Royal Scottish Corporations and the Consultants and Specialists Committee (established by the BMA), which continued to represent consultants and specialists in negotiation with the Government in matters arising from the National Health Service Acts.
The birth of the world's first baby conceived using in vitro fertilisation (IVF), in July 1978, and advances in fertilisation and embryology led to the appointment of a Committee of Inquiry in 1982. Chaired by Baroness Warnock, it was established 'against [a] background of public excitement and concern' about human fertilisation and embryology". The Committee reported in 1984 (the Warnock Report). It recommended the establishment of a new statutory licensing authority to regulate both research and infertility services. In March 1985 the Medical Research Council (MRC) and Royal College of Obstetricians and Gynaecologists (RCOG) founded the Voluntary Licensing Authority for Human in vitro Fertilisation and Embryology (VLA) as an interim measure to regulate work on human in vitro fertilisation until the introduction of government legislation. The authority was given two functions: to grant licences to those wishing to offer infertility treatment; and to grant licences to researchers wishing to work with human gametes (sperm and eggs) and embryos. Applications for licences, accompanied by specific research proposals, were made to the authority by centres involved in such work. A visit was normally then made to the centre by members of the authority, which then made a decision on whether to grant a licence. The Authority was based at the Medical Research Council premises in Park Crescent, London. In 1987, following a period of consultation, the Government published a White Paper, Human Fertilisation and Embryology: A Framework for Legislation. The legislation which subsequently came into being was the Human Fertilisation and Embryology Act 1990 (the HFE Act).
The first meeting of the Standing Advisory Committee on Obstetric Anaesthesia and Analgesia was held on 16 February 1982. The Committee was comprised of three representatives of the Royal College of Gynaecologists and three representatives of the Faculty of Anaesthetists, to 'consider and make recommendations on matters of common interest to its parent bodies' (minutes, ref: C20/5). It agreed on the following areas of common interest in teaching: anaesthesia for operative deliveries, pain relief in labour, obstetric intensive care and resuscitation of the newborn. In 1987 a Working Party on Resuscitation of the Newborn was formed by the Committee and included representatives from the Royal Colleges of Obstetricians and Gynaecologists, Anaesthetists, and Midwives, and from the British Paediatric Association. Its aim was to produce two instruction manuals covering basic resuscitation of the newborn and the special skills needed for advanced resuscitation. From 1995 the Standing Advisory Committee became known as the Standing Joint Committee of the Royal College of Obstetricians and Gynaecologists and the Royal College of Anaesthetists, following a review of the functions the committee performed. Its new terms of reference became: to discuss and advise on matters of mutual interest and concern in both obstetric and gynaecological anaesthesia, and to report routinely on discussions by submission of minutes to Councils. The Chair reported to the Finance and Executive Committee, then later to the Standards Board; traditionally the committee met twice a year.
Advisory appointments committees were set up by regional hospital boards in 1955 to select consultants for appointment in hospitals around the country. Committee members were external assessors who came from a different area to where the appointment was being made. Method of selection of assessors was as follows: requests would be made to the relevant medical college for nominations for membership of committees, and those persons nominated approached directly by the President of the College.
A joint working party on gynaecological pathology was set up on the recommendation of the RCOG's Scientific Advisory Committee (SAC) under the chairmanship of Mr S C Simmons. The working party was not given precise terms of reference but invited to report on all aspects of gynaecological histopathology exclusive of cytology. It reported in July 1988. In November 1986, a joint working party on fetal and perinatal pathology was established under the chairmanship of Professor G M Stirrat. Its remit was to consider earlier recommendations on the same subject made by a SAC sub-committee on fetal and perinatal pathology which had been disbanded in March 1986. The working party produced its final report in November 1988. In 1998 a working party was formed to review and update the 1988 fetal and perinatal pathology report. The party also included a co-opted member to represent the Royal College of Paediatrics and Child Health. Its first meeting took place on 11 December 1998, with a final report published in June 2001. The working party addressed several topics, including: subspecialisation and regionalisation; minimal standards for perinatal autopsy; neural investigation; DNA imaging; the role of IT; training; ultrasound; consent; transportation of babies over long distances; funding; HIV testing; stillbirth; storage of tissue.
The Joint Steering Group of the Royal College of Obstetricians and Gynaecologists and Faculty of Family Planning and Reproductive Health Care on teenage pregnancy was set up in July 1993. Its terms of reference were in line with the definition in Section D of the government document "Health of the Nation"(1993):
- To reduce the rate of conception amongst the under 16s by at least 50% by the year 2000.
- To reduce the number of unintended teenage pregnancies.
- To ensure the provision of effective family planning services for those people who wanted them. The first chairman was Stanley Simmons PRCOG, followed by David Bromham, chairman of the Faculty of Family Planning and Reproductive Health Care (FFPRHC). Members of the group also included representatives of the British Medical Association, the Royal College of Nursing, the Department of Health, the Health Education Authority and the Brook Advisory service. On 24th August 1993 it established three working groups to consider: emergency contraception, its availability, access and promotion; the need and content of research and audit; all aspects of sex education and promotion in relation to teenagers and other related groups. In 1994 the second working group passed its research and findings to the Faculty of Family Planning and Reproductive Health Care who were establishing an audit unit, and ceased to investigate further. The Steering Group organised a consensus conference on emergency hormonal contraception in December 1994; a book was produced.
In April 1995 an Expert Advisory Group (EAG) chaired by the Chief Medical Officer published "A Policy Framework for Commissioning Cancer Services". The guiding principle of this report was that all patients wherever they live should recieve high quality cancer care to maximise both cure rates and quality of life. Its purpose was to act as a strategic framework to assist in the planning of cancer services in the UK. It recommended that professional bodies develop guidance on the level of expertise and support required to manage different cancers. In response, the British Gynaecological Cancer Society (BGCS) and the RCOG established a Joint Working Group to provide guidance on the recommendations of the report in relation to gynaecological cancer. A draft report was circulated to Fellows and Members as a Consultation Document, and responses considered before publication of the final report in January 1997.
The first meeting of the Joint Standing Committee of the RCOG and RCM took place on 11 May 1988. The objectives of the Committee were to "consider and make recommendations on matters of common interest to parent bodies". It did not have an executive function and reported to the Councils of the RCM and RCOG; meetings took place at least twice a year.
A first RCOG report in 1994 on minimum standards of care in labour attempted to establish guidelines for staffing, equipment and general facilities on the labour ward. Following acceptance of the increased involvement of the consultant obstetrician in the labour ward, the Joint Working Group of the Royal College of Midwives and the RCOG aimed to produce guidance about the essential minimum midwife and medical staff numbers required to support women in labour. The final report was published in 1999 and acknowledged the value of multidisciplinary involvement, making recommendations to improve organisation, practice and result in safer childbirth.
The Joint Committee of the Royal Medical Colleges, the Royal Scottish Corporations, and the Central Consultants and Specialists Committee of the British Medical Association was established in 1948 in order to provide a body which could speak for consultants, particularly in the impending negotiations with the government on matters arising out of the National Health Service Acts and the report of the Spens Committee on the Remuneration of Consultants and Specialists. In 1952 the Committee was renamed the Joint Consultants Committee and continued to provide a common voice on issues relating to hospital consultants.
This Working Party was a multidisciplinary group set up by the National Childbirth Trust (NCT) in 2000. It was also supported by the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG), amongst others. It acted as an independent multidisciplinary body that campaigned for improvements in maternity care. It was formed to raise awareness of the public health implications of the rising caesarean section rate; to highlight the health and social needs of women and their families; and to emphasise the contribution that women-centred maternity services might make to the promotion of public health. In 2001, the NCT, RCM and RCOG, commissioned by the Working Party, published a commissioning toolkit for Primary Care Trusts designed to help them to update themselves on current thinking in maternity care provision and to improve local maternity services. In 2006 a second edition of this report was produced.
The terms of reference of this Working Party, established in November 2005 as a joint Working Party between the College and the Association of Professors of Obstetrics and Gynaecology (APOG), were as follows:
- To consider ways of improving recruitment to obstetrics and gynaecology at undergraduate level
- To make specific recommendations to individual university departments of obstetrics and gynaecology and agree reasonable targets
- To arrange an annual meeting of academic departments in the UK to exchange ideas, identify areas of good practice and develop an agenda for the recruitment of medical students to the specialty
- To consider how RCOG prizes and awards can be developed to enhance recruitment
- To recommend a system for recognising excellence among clinical teachers of obstetrics and gynaecology in the UK and Irish Medical Schools
In February 2006 APOG, which had been in existence for over 25 years as an association of senior academics was disbanded and replaced by a new grouping, the Academic Association of Obstetrics and Gynaecology (AAOG), open to clinical and relevant non-clinical academics of all grades, as well as to NHS consultants who had a strong interest in academic work. The Working Party continued its work and a final joint RCOG / AAOG report was published in December 2006.
Following on from two previous reports 'Towards Safer Childbirth' between the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives in 1994 and 1999, this third working party incorporated membership from the Royal Colleges of Anaesthetists, and Paediatrics and Child Health. The group reviewed the topic following changes in the National Health Service and concern over staffing levels and multiprofessional working.
In 2001 the College and the Faculty issued a joint statement outlining the need to further develop community gynaecology. A joint working group was formed which reported in 2001. The main recommendations were that the name of the subspecialty should be changed from Consultant in Community Gynaecology to Consultant in Sexual and Reproductive Health (SRH); that a Joint Committee of the Faculty and the College should be set up as a separate committee and not as a subcommittee of the Subspecialty Committee. The Committee was to:
- report directly to the Standards Board of the RCOG and the Higher Training Committee of the Faculty
- be responsible for Additional Training and Special Skills modules relating to SRH
- be responsible for improvements and changes in the modular log book for SRH.