Strengthening the quality of education and training through enhanced monitoring

When local action alone is not enough to address concerns about the safety and quality of education and training, we can participate in visits to educational and training settings to support deaneries in Northern Ireland, Scotland, and Wales, and Health Education England local offices to manage such concerns.

We also work with other bodies to encourage them to make the improvements needed to meet our standards. We call this enhanced monitoring.

The issues that trigger this sort of intervention are those that relate to patient safety, the safety of doctors in training and the quality of the learning environment, which can’t be resolved locally without our support.

In most cases, the process leads to a turnaround, with NHS organisations, deaneries and HEE all working together to correct the failings. When this doesn’t happen, our ultimate sanction allows us to withdraw approval for specific settings to be used for training.

In 2018, we dealt with 66 issues that needed enhanced monitoring. By working in partnership with deaneries and health boards, we found evidence of improvements and were able to close cases at 12 organisations. Ultimately, this assured patients and doctors that the identified issues had been addressed. We continue to monitor and support improvement in the other cases.

We now publish any updates to enhanced monitoring cases on our website within 24 hours. The public should know where we have identified issues that affect them and what steps are being taken in response. Publishing this information gives some assurance that organisations are meeting our standards.

We also believe that transparency drives improvement. Publishing this information encourages a culture of information sharing and openness around quality improvement. Educational and training organisations have the opportunity to learn from one another and improve training environments. They are publicly accountable for making sure that trusts and health boards provide safe, high-quality training.

Enhanced monitoring led to improved quality of training at Caithness General Hospital

Caithness General Hospital, in Wick (Scotland), was going through our enhanced monitoring process from March 2015 because of concerns about patient safety linked to training.

We used enhanced monitoring to support NES and NHS Highland to find a safe and sustainable solution to the lack of senior supervision at the hospital.

In Autumn 2018, we were able to lift our enhanced monitoring, following a report from NES – responsible for managing training across the country – which proved that Caithness was providing a supportive training environment for doctors in training.

This was confirmed by the positive feedback we heard from doctors in training at the hospital. Most had requested a placement at the hospital because they’d heard about the excellent training experience. They also told us they’d encourage to others to train there, because it would make them a more confident doctor.