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22

Recognise educational opportunities in smaller units

Morecambe Bay Investigation · Report of the Morecambe Bay Investigation · Issued 3 March 2015 · Addressed to: NHS England

Government responseDepartment of Health and Social Care: Accepted in part (Jul 2015)

DeliveryDHSC and NHS England say completed (Feb 2026)Department of Health and Social Care says in progress (Feb 2020)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

We believe that the educational opportunities afforded by smaller units, particularly in delivering a broad range of care with a high personal level of responsibility, have been insufficiently recognised and exploited. We recommend that a review be carried out of the opportunities and challenges to assist such units in promoting services and the benefits to larger units of linking with them. Action: Health Education England, the Royal College of Obstetricians and Gynaecologists, the Royal College of Paediatrics and Child Health, the Royal College of Midwives.

Morecambe Bay Investigation, Report of the Morecambe Bay Investigation · 3 Mar 2015 Source PDF →

Published evidence summary

AI-generated evidence summary

In commentary published in February 2026, the Department of Health and Social Care and NHS England recorded the recommendation as implemented and closed, stating that the Thirlwall Inquiry had noted action taken (DHSC and NHS England, Feb 2026). The Thirlwall Inquiry legal team found in its February 2026 review that Health Education England published the findings of its review in spring 2016, which recommended that all trusts and learning education providers continue to support clinical education and training (The Thirlwall Inquiry legal team, Feb 2026).

AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026.

Government response

●Department of Health and Social Care · Accepted in part · 16 Jul 2015

Words of: Department of Health, Learning not blaming (Cm 9113), government response to the Morecambe Bay Investigation and two other reports, July 2015

19. We accept this recommendation in principle. Work already underway by Health Education England addresses this recommendation. Health Education England is committed to supporting efforts to improve the quality of patient care by ensuring that its quality management infrastructure ensures the delivery of high quality training in sites where safe services are provided. 20. Health Education England recognises that there are particular challenges in attracting and retaining students, trainees and learners to work in smaller and/or isolated hospitals and that this can exacerbate problems such as those described at Furness General Hospital. 21. They have established a Working Group to consider the issues raised by the Investigation in relation to making best use of smaller units in the provision of training. While focussing on maternity services this group will look at the broader issues for trainees from other professions. Health Education England intends to complete its initial review by the spring of 2016. 22. Health Education England will also use its wider work on quality management of placements and training posts to explore opportunities to improve training provision and take-up in hospitals such as Furness General.

Response document: Learning not blaming: The government response to the Freedom to Speak Up consultation, the Public Administration Select Committee report 'Investigating Clinical Incidents in the NHS', and the Morecambe Bay Investigation

Site note: This is the Department of Health's response, "Learning not blaming" (Cm 9113, July 2015), to the Morecambe Bay Investigation and two other reports. The department has been the Department of Health and Social Care since January 2018, and the rows are filed under that name. Every word is the department's, including where it reports what another body has done or will do.

Site note: The recommendation is addressed to Health Education England; the passage is the Department of Health's account, not that body's.

Delivery

●DHSC and NHS England say completed · 27 Feb 2026

The Thirlwall Inquiry has noted action taken in response to this recommendation. .

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented – Closed”. Table row: section 23.2 No. 22, PDF page 644.

Site note: DHSC and NHS England's entry for this recommendation says that the Thirlwall Inquiry noted action taken on it. The entry gives no other account of what was done.

●Department of Health and Social Care says in progress · 27 Feb 2020

The Health Education England (HEE) working group undertook a comprehensive review of education and training issues for staff working in smaller units and rural areas and published its report in 2016.

The 2019 Maternity Workforce Strategy which superseded the work of the HEE group, recommended that HEE undertake a further review to consider both the benefits and risks of rural settings.

In August 2019 HEE established a Programme Board to oversee the review, agreement and delivery of the equitable distribution of post-foundation medical training posts in England.

From: Maternity Services (written question UIN 19796)

Site note: Written answer of 27 February 2020 by Nadine Dorries for the Department of Health and Social Care. The question cites the Morecambe Bay Investigation report and asks what has been done on this recommendation. The recommendation is addressed to Health Education England; this is the Department's answer, not theirs.

What other bodies have found

In their own words. These do not change the delivery statement above.

●Thirlwall Inquiry legal team · 27 Feb 2026

Department of Health response (July 2015):

‘Health Education England (HEE) … established a Working Group to consider the issues raised by the Investigation in relation to making best use of smaller units in the provision of training. HEE intends to complete its initial review by the spring of 2016.’ (p. 70)

HEE published the findings of this in Spring 2016: this review recommends that all trusts and learning education providers (LEPs) continue to support clinical education and training. This review makes a number of other recommendations.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). The review colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team and/or DHSC and NHS England, that a recommendation has been clearly implemented. Table row: section 23.2 No. 22, PDF page 644.

Earlier findings (1)

●Thirlwall Inquiry legal team · 15 May 2024

Department of Health response (July 2015):

‘Health Education England (HEE) … established a Working Group to consider the issues raised by the Investigation in relation to making best use of smaller units in the provision of training. HEE intends to complete its initial review by the spring of 2016.’ (p. 70)

Health Education England published the findings of this in Spring 2016: this review recommends that all trusts and learning education providers continue to support clinical education and training. This review makes a number of other recommendations.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 20.2 No. 22, PDF page 605.

How this page is built

The recommendation and the government responses are verbatim from primary documents. Delivery statements and other bodies' findings are shown in their own words, each with its source. The summary is written by this site and labelled as such. The Index does not paraphrase sources or characterise intent; it records what has been published.