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Enhanced monitoring update

Web News

19 Jun 2017

The General Medical Council has today published its quarterly update of postgraduate training sites which are subject to the enhanced monitoring process.

Enhanced monitoring is the process by which the GMC works with medical schools, deaneries and local education and training boards to satisfactorily and sustainably address concerns about the quality and safety of medical education and training.

Issues that require enhanced monitoring are those that could adversely affect patient safety, doctors’ progress in training, or the quality of the training environment.

In the latest quarterly update nine hospital departments have now entered enhanced monitoring and two have been removed after making the required improvements.

As of June 12 2017 there are a total of 81 cases in enhanced monitoring, of which 65 meet our criteria for publication.

To see the full summary visit:

Of these published cases:

  • Of the cases, two sites are subject to GMC conditions - North Middlesex University Hospital NHS Trust & East Kent Hospitals University NHS Foundation Trust.
  • 11 of 65 cases relate to core medical training (17%) while there were eight cases involving paediatrics (12%).
  • 36 cases were down to poor levels of clinical supervision (55%) while 17 cases involved rota issues (26%).

The nine new sites in enhanced monitoring are:

Education Provider Site Specialty Education concerns
Health Education Kent, Surrey and Sussex Brighton and Sussex University Hospitals NHS Trust - Royal Sussex County Hospital Obstetrics and
Access to educational resources, Clinical supervision (weekdays), Handover, Supportive environment.
Health Education South London King's College Hospital NHS Foundation Trust - Princess Royal University Hospital Core Medical Training Kent Surrey and Sussex, Foundation - South Thames, Paediatrics Clinical supervision (weekdays), Handover, Induction, Rota issues, Supportive environment.
Health Education North West London Chelsea and Westminster Hospital NHS Foundation Trust

Obstetrics and gynaecology

Core Surgical Training

Clinical supervision (out of hours), Clinical supervision (weekdays), Educational supervision, Rota issues, Supportive environment, Workload.
Health Education North West Stockport NHS Foundation Trust - Stepping Hill Hospital Emergency medicine Clinical supervision (out of hours), Clinical supervision (weekdays).
Health Education Kent, Surrey and Sussex East Sussex Healthcare NHS Trust - Conquest Hospital, Eastbourne District General Hospital. Core Medical Training Access to educational resources, Feedback, Handover, Induction, Local teaching, Regional teaching, Rota issues, Workload.
NHS Education for Scotland (NES) NHA Ayrshire & Arran - University Hospital Ayr Acute Internal Medicine, General (internal) Medicine Trainees not gaining adequate experience, Clinical supervision (out of hours), Clinical supervision (weekdays), Feedback received from senior clinicians, Handover, Local teaching, Overall satisfaction.
NHS Education for Scotland (NES) NHS Grampian - Aberdeen Maternity Hospital Neonatal Medicine Trainees not gaining adequate experience or enough feedback from senior clinicians.
Health Education Thames Valley Oxford University Hospitals NHS Foundation Trust - John Radcliffe Hospital Neurosurgery Trainees not gaining adequate experience.

The two sites that have been removed following improvement are:

Education Provider Site Specialty Education Improvements
Health Education East Midlands University Hospitals of Leicester NHS Trust - Leicester Royal Infirmary Ophthalmology Reduction in concerns raised in annual national training survey; HEE to provide regular updates on training.
Health Education North West University Hospitals of Morecambe Bay NHS Foundation Trust - Furness General Hospital, Royal Lancaster Infirmary Obstetrics and Gynaecology We joined HEENW on a split site visit and concluded that the Trust had made clear progress in addressing the enhanced monitoring concerns, and it was felt that the improvements made were sustainable.
About enhanced monitoring

We regulate all stages of doctors' training and professional development in the UK. We promote high standards and ensure that medical education and training reflects the needs of patients, medical students and trainees, and the health service as a whole.

When medical schools, deaneries and local education and training boards are concerned about the training of medical students or 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.

Issues that require enhanced monitoring are those that we believe could adversely affect patient safety, doctors’ progress in training, or the quality of the training environment.

We have the power under the Medical Act (1983) to approve training environments. This includes whole sites and specific training programmes and posts within a site. If problems persist we can withdraw training or make trusts subject to conditions.

What do we publish?

We only publish information about issues that have been verified. This means we have been in touch with the medical school, deanery or local education and training board to discuss the issues and they have confirmed that there are plans in place to address the problems.

We do not publish cases where when the information risks identifying any individuals (eg a doctor), or when it relates to information that is not yet in the public domain.

Notes to editors

The General Medical Council (GMC) is an independent organisation that helps to protect patients and improve medical education and practice across the UK.

  • We decide which doctors are qualified to work here and we oversee UK medical education and training.
  • We set the standards that doctors need to follow, and make sure that they continue to meet these standards throughout their careers.
  • We take action when we believe a doctor may be putting the safety of patients, or the public's confidence in doctors, at risk.

We are not here to protect doctors - their interests are protected by others. Our job is to protect the public.

We are independent of government and the medical profession and accountable to Parliament. Our powers are given to us by Parliament through the Medical Act 1983.

We are a registered charity (number 1089278 with the Charity Commission for England and Wales, and number SC037750 with the Office of the Scottish Charity Regulator), we have to show that our aims are for public benefit.

The GMC Media Relations Office can be contacted on 020 7189 5454, email

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