Training and training establishments as a source of safety information

Accepted.
The General Medical Council has made it clear that it views surveys of medical students and doctors in training as vital in assessing the quality of education and an important tool in evaluating the standards of care provided to patients. The General Medical Council is now including questions about the quality of care provided to patients in the National Training Survey. The General Medical Council also surveys medical students ahead of formal visits to their medical schools, and is committed to considering, by 2015, whether to survey all medical students, as is done with doctors in training, in 2015. The results of the National Training Survey of trainees are published on the General Medical Council’s web site and are shared with other regulators such as the Care Quality Commission, for example, to support their recent inspections of Acute Hospitals.

In 2014 the GMC began including more patient safety questions in its National Training Survey (NTS). The questions ask how participants feel that concerns raised in their responses to the survey will be addressed and how that information will allow local providers to identify patient safety problems that may not have been reported. All the concerns raised with the GMC are bought to the attention of local education and training boards (LETBs), deaneries and local education providers to investigate further and take action where needed. The changes made are then reported back to the GMC.

The GMC routinely shared published information about the fitness to practise of individual doctors and the quality of medical education and training with the CQC. Some examples of current routine information sharing include:

• Information provided by the GMC for CQC inspection activity, including data from the GMC’s annual national training survey, primarily through provision of the Regulator / Designated Body Dashboard.

• The GMC shares its monthly summary on enhanced monitoring with the CQC. This lists all organisations delivering medical education or training where the GMC’s Education team has active concerns, has set conditions on approval, or is preparing to remove approval from a training environment.

The GMC also shares emerging and urgent concerns with the CQC, and other health and social care regulators, through the Emerging Concerns Protocol. The protocol is an agreement to provide a mechanism for organisations with a role in the quality and safety of care provision to share information that may indicate risks to people who use services, their carers, their families, or healthcare professionals. Areas of information sharing include: concerns about individuals or groups of professionals; concerns about healthcare systems and the healthcare environment (including the learning environments of professionals); and concerns that might have an impact on trust and confidence in professionals or the healthcare professions generally.

NHS England

The National Education Training Survey (NETS) is the only national survey open to all undergraduate and postgraduate students and trainees undertaking a practice placement or training post in healthcare as part of their education and training programme.

This includes profession specific questions for student nurses, student midwives, allied health professional learners, pharmacy learners, healthcare science trainees, paramedicine learners, doctors and dentists in training, and independent learners. These were last reviewed in October 2023.

Health Education England has now merged with NHS England.

The 2014 National Training Survey, now closed, achieved a response rate of over 98 % of trainees. Comments relating to patient safety and undermining have now been analysed and included in the General Medical Council’s monitoring processes with Deaneries and Local Education Training Boards if appropriate. The General Medical Council published its key findings from the 2014 survey on their website in June. The results showed a rise in overall satisfaction levels from previous years, with overall scores for educational supervision, induction, handover and adequate experience improving. In November 2014 the General Medical Council published two further reports Concerns about patient safety which includes an analysis of the patient safety concerns raised and Undermining covering bullying and undermining behaviour and the General Medical Council’s plans to work with others to combat this kind of behaviour in clinical environments.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the General Medical Council was now including questions about quality of care provided to patients in the National Training Survey, and that the General Medical Council was also surveying students ahead of formal visits to their medical schools.

The General Medical Council’s National Training Survey was amended to include more information for participants about how concerns raised in their responses to the survey would be addressed and how that information would allow local providers to identify patient safety problems that may not have been provided.