Enhanced monitoring of issues in medical education and training

We use enhanced monitoring to promote and encourage local management of concerns. Specifically about the quality and safety of medical education and training.

We require more frequent progress updates from those responsible for managing these concerns. We can provide representation on a locally-led visit to investigate a concern or check on progress. We publish information on enhanced monitoring cases on our website. We share information with other healthcare regulators where appropriate.

Issues that need enhanced monitoring are those that could affect patient safety, training progression or quality. Issues are usually referred to us if they meet the following criteria:

• Persistent and serious patient safety concerns
• Doctors in training's safety is at risk
• Doctors in training are not getting the experience required
• Local quality management processes alone are insufficient to address the issue.

Concerns may be referred to the enhanced monitoring process by postgraduate training organisations, royal colleges and faculties. We can also escalate a concern to this process as a result of our own evidence or information from other sources (like patients and doctors in training).

Where possible we work with all organisations to address the concern and develop a sustainable solution. Sometimes we need to work with other regulators and organisations to make improvements. When local processes fail to address serious concerns, we may decide to use our legal powers to place conditions on the approval of postgraduate training posts. We may attach conditions to any approval we have already given. If it becomes clear that it is unlikely the conditions will be met, we may decide to withdraw our approval for training.

We publish information about issues which are under enhanced monitoring. This promotes transparency, drives improvement and helps organisations to learn from one another. We have a duty to show that concerns about quality and safety are being addressed.