Medical training

Accepted.
The General Medical Council has stated its commitment to a thorough and consistent inspection regime, and to building on its quality assurance arrangements to address the issues raised in this recommendation.
The General Medical Council is working with the Academy of Medical Royal Colleges and with Postgraduate Deans to develop a more explicit statement about how Colleges should support visits to local providers. The General Medical Council’s Quality Improvement Framework is clear that Deans must draw on a range of external advice to support their scrutiny of local providers, including from patients and the public, as well as from doctors.
The evidence pack supporting the General Medical Council inspection teams contain information from the Care Quality Commission and other external organisations. The outcomes of visits and information about serious concerns which the General Medical Council is monitoring are shared with the Care Quality Commission.
In February 2012, the General Medical Council Chair, Professor Sir Peter Rubin, and the four UK Chief Medical Officers wrote a joint letter to NHS organisations setting out the importance of releasing clinical staff to perform roles that improve the overall quality of patient care, medical education and the effective running of the health service.

In 2012 the GMC reviewed its quality assurance processes for medical education and training. The review made wide-ranging recommendations which were taken forward to help address the education and training concerns raised in the report and the GMC made subsequent changes to its approach to quality assurance in 2018. These included enhancing the role of Medical Royal Colleges in supporting its quality assurance activities; revising its standards for medical education and training; developing the appointment process for the medical specialists involved in visits; restricting the inspection cycle; and enhancing the transparency and accessibility of visit reports. At its visits, the GMC may use medical and clinical specialists, students, doctors in training and lay associates, to ensure a breadth of expertise and representation.

Additionally, where a training institution gives rise to concerns which relate to patient safety or quality of education, it may be subject to enhanced monitoring within the GMC’s quality assurance process. To ensure transparency, details of these concerns are published on the GMC’s website. The GMC provides additional information on enhanced monitoring in response to recommendation 162 below.

Please see our response to recommendation 152 above for detail on the Quality Framework for training providers and the NHS Long-term workforce Plan.

The General Medical Council considered this recommendation as part of its Review of Quality Assurance of Medical Education and Training. The final report was published on its website in February 2014 and work has begun to develop an action plan to address this recommendation. The plan will include different phases to:
• scope and understand the current appointment processes and training required by each part of the system
• map the appointment processes and training undertaken and understand the similarities and differences.
• agree a way forward with all concerned organisations designed to minimise the requirement to repeat generic training and develop a mechanism for co-badging visitors and inspectors for the future. The General Medical Council anticipate that this would help the move towards a more ‘collective’ assurance process for regulation in the future. The General Medical Council are also considering how to enhance college support for visits to local providers and this will form part of the initial scoping to implement the recommendations from the final report.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the evidence pack supporting General Medical Council inspection teams contained information from the Care Quality Commission and other external organisations.

The General Medical Council expressed its commitment on a through and consistent inspection regime. The General Medical Council’s final October 2014 update report accepted the recommendation at (ii). It is unclear from the final update report whether the other recommendations were accepted.

In the February 2015 Culture Change report, the Government said that the General Medical Council had begun scoping work to address this recommendation.