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Enhanced monitoring

When deaneries and local offices are concerned about the training of doctors, they need to work with trusts and health boards to make improvements. 

If the situation doesn’t improve, they tell us. We then work with all the organisations involved to improve the quality of training through what we refer to as our enhanced monitoring process. 

Enhanced monitoring of issues in medical education and training

We use enhanced monitoring to support medical training organisations with concerns about the quality and safety of 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 require enhanced monitoring are those that could affect patient safety or 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 deaneries, local education and training boards, and 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 that 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.

What enhanced monitoring issues do we publish?

We only publish information about issues that have been verified. This means we have discussed the issues with the relevant organisation and they have put plans in place to address the problems.

We don't publish issues that could identify any individuals or relate to information that is not yet in the public domain.

Why do we publish enhanced monitoring issues?

We believe that transparency drives improvement. Publishing this information encourages a culture of information sharing and openness around quality improvement.

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.

In addition, 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.

Find out more about the information we collect on our GMC data explorer.