F171 Accepted

Deans

Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: NHS England

Source — verbatim from the inquiry

Inquiry recommendation

All Local Education and Training Boards should have a post of medically qualified postgraduate dean responsible for all aspects of postgraduate medical education.

Mid Staffs Inquiry, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · 6 Feb 2013 Source PDF →

Published evidence summary

Publicly available evidence relating to this recommendation:

- Health Education England established Local Education and Training Boards (LETBs) across England, each with a medically qualified postgraduate dean responsible for all aspects of postgraduate medical education in their area. Postgraduate deans are senior medical professionals responsible for the quality of medical training, trainee welfare, and the interface between training and patient safety (HEE governance arrangements).
- Following the abolition of HEE and the transfer of its functions to NHS England from 1 April 2023 under the Health and Care Act 2022 (section 96), the postgraduate dean function has been maintained within NHS England's Workforce, Training and Education directorate. Postgraduate deans continue to exercise their responsibilities for postgraduate medical education at regional level within the NHS England structure (Health and Care Act 2022, s.96; NHS England WT&E).
- The GMC's quality assurance framework requires each region to have a postgraduate dean responsible for the management and quality assurance of postgraduate medical training. The postgraduate dean is the GMC's primary point of contact for quality assurance at regional level and is responsible for routine quality management, triggered visits, and escalation of concerns about training environments (GMC quality assurance framework).
- The government's response in "Hard Truths" (Cm 8777, November 2013) confirmed that all LETBs should have a medically qualified postgraduate dean responsible for all aspects of postgraduate medical education (Hard Truths, DHSC, November 2013).

Response — verbatim from government

Department of Health and Social Care

The government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf

Department of Health and Social Care · 19 Nov 2013 Written response →

Evidence trail — what's actually happened since

  • 6 Feb 2023 · Academic Review - Ten Years After Francis Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS. View source → Reasonable Progress
  • 11 Feb 2015 · UK Government - Culture Change in the NHS Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year. View source → Good Progress
  • 19 Nov 2013 · UK Government - Hard Truths Vol 1 & 2 Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted. View source → Good Progress
  • 3 Dec 2012 · GMC - Medical Revalidation GMC medical revalidation launched December 2012. All licensed doctors must demonstrate fitness to practise every five years through appraisal and evidence. Francis Report endorsed and recommended strengthening revalidation. View source → Confirmed Completed

Each entry above links to a primary source — gov.uk written statement, consultation response document, or inspection report. The Index does not characterise government intent; it tracks what has been published.

How this page is built

Source and Response are verbatim from primary documents. The Evidence trail records published activity since — written statements, consultation outcomes, inspection findings, parliamentary references. The Index does not paraphrase or characterise intent; it tracks what has been published. Where the evidence is the absence of action (a missed deadline, a slipped timetable), that absence is documented from primary sources rather than inferred.

This recommendation's data is verified periodically against primary sources. The Index is monitored for staleness weekly.