Training and training establishments as a source of safety information

Accepted.
The General Medical Council has made it clear that it views visits as an important tool within its quality assurance programme for assuring high quality training and protection of patients. The General Medical Council taken a policy decision to publish information on validated concerns about an educational setting on its website, and will implement this more transparent approach in late 2013 or early 2014. The General Medical Council’s review of quality assurance in education is considering how to strengthen the role of visits and how the General Medical Council reports on them. The General Medical Council will share its proposals in the first half of 2014.

In the GMC’s quality assurance processes, training visits make a very important contribution to the protection of patients. Every year, the GMC ask each LETB and Deanery to outline how they meet the GMC’s standards in Promoting Excellence through completion and submission of a self-assessment questionnaire. The GMC then analyse this questionnaire and conduct various quality activities with each organisation to do a deeper dive into areas outlined in their self-assessment. The GMC does quality activities such as talking to students/trainees and educators, visits, looking at evidence from other bodies and data analysis. This allows it to check on how an organisation is addressing areas of concern and to identify areas of good practice. The GMC may set requirements and recommendations to drive improvements and to ensure the timely identification and resolution of issues including patient safety concerns. It produces an annual summary of quality activity for the organisation which is published.

The other type of training visits it has is via the enhanced monitoring process. When a concern is escalated to enhanced monitoring, it will attend at least one locally organised visit (organised by the LETB/Deanery) per year to the trust or department to do a more thorough check on the progress of the concern(s). In between these visits, the GMC gets regular updates on progress from the LETB or Deanery during meetings, via the quality reporting system, via trust improvement/ action plans and via other quality activities.

Please see response to recommendation 152 above.

At the end of March 2014, the General Medical Council began publishing on its website information about validated education concerns that are subject to enhanced monitoring by the General Medical Council. Cases subject to enhanced monitoring relate by the General Medical Council. Cases subject to enhanced monitoring relate to patient safety or quality of education issues in a local education provider and can come from a variety of sources (visits, routine monitoring, Deanery Reports). The aim of publishing this information is to increase the transparency of our monitoring process. A quarterly publishing system is now in place.

This recommendation was considered as part of the General Medical Council’s Review of Quality Assurance of Medical Education and Training. The final report of the review includes a recommendation that reports should give greater attention to the transparency and accessibility of information for patients and the public, students and trainees. As part of the action plan to strengthen the role of visits the General Medical Council:
• have introduced a document register section at the end of each visit report to detail which evidence documentation has been used and how it has contributed to the findings
• have developed a 5 year visits schedule.
• will pilot the General Medical Council inspection teams to observe the environment in which clinical teaching occurs.

This recommendation was accepted by the Government.

At the end of March 2014, the General Medical Council began publishing information about validated education concerns subject to enhanced monitoring by the General Medical Council.

The General Medical Council introduced a document register section at the end of each visit report to detail what evidence has been used and how it has contributed to findings; developed 5-year visits schedule; and decided to pilot General Medical Council inspection teams to observe the environment in which clinical teaching occurs.