Enhanced monitoring update

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.

Since the latest quarterly update three hospital departments have entered enhanced monitoring, and eight have been removed after making the required improvements.

As of 7 May 2018 there are a total of 45 cases in enhanced monitoring, all of which  meet our criteria for publication. See the full summary.

Of these published cases:

  • Three are subject to GMC conditions - North Middlesex University Hospital NHS Trust, East Kent Hospitals University NHS Foundation Trust and Weston Area Health NHS Trust.
  • Five relate to trainee safety (11%).
  • 11 relate to core workload (24%). 26 cases were linked to poor levels of clinical supervision (58%) while 10 cases involved rota issues (21%) 

The three new sites in enhanced monitoring are:

Education Provider

Site

Specialty

Education concerns

Health Education North West

Blackpool Victoria Hospital, Blackpool Teaching Hospitals NHS Foundation Trust

Emergency Medicine

Clinical supervision (out of hours), Clinical supervision (weekdays), feedback, handover, rota issues

NHS Education for Scotland (NES)

Glasgow Royal Infirmary/Princess Royal Maternity Hospital, NHS Greater Glasgow and Clyde

Obstetrics and gynaecology

Adequate experience, Local teaching, Regional teaching

NHS Education for Scotland (NES)

NHS Tayside

General adult mental health services

Educational governance, Supportive environment

The eight sites that have been removed following improvement are:

Education Provider

Site

Specialty

Education Improvements

NHS Education for Scotland (NES)

University Hospital Monklands, NHS Lanarkshire

General Surgery

Improvements have been made and enhanced monitoring is no longer required.

Health Education North West

Tameside General Hospital ,Tameside and Glossop Integrated Care NHS Foundation Trust

N/A

Concerns about doctors in training being left in a vulnerable position have been addressed and issues have been resolved.

Northern Ireland Medical and Dental Training Agency

Belfast City Hospital, Royal Victoria Hospital, Belfast Health and Social Care Trust

General (internal) Medicine

Concerns relating to patient safety, supervision, workload and handover for doctors in general internal medicine posts have been addressed and solutions in place are effective and sustainable.

Northern Ireland Medical and Dental Training Agency

Altnagelvin Area Hospital ,Western Health and Social Care Trust

Obstetrics and Gynaecology

Significant progress made regarding concerns of unacceptable professional behaviour of some members of senior medical staff.

NHS Education for Scotland (NES)

University Hospital Hairmyres, NHS Lanarkshire

General Surgery

Following several visits it was evident that significant progress had been made.

Northern Ireland Medical & Dental Training Agency

South West Acute Hospital, Western Health and Social Care Trust

Acute Internal Medicine

Monitoring no longer required due to progress being made following a serious concern about out of hours supervision for foundation doctors in training.

Health Education East Midlands

Nottingham University NHS Trust - Queen's Medical Centre Campus Nottingham, University Hospitals NHS Trust

Neurosurgery

Really good engagement was demonstrated towards addressing workloads concerns during a visit last year and improvements have been sustained.

Health Education Yorkshire and The Humber

Pinderfields General Hospital, Pontefract General Infirmary ,Mid Yorkshire Hospitals NHS Trust

Obstetrics and gynaecology

Concerns relating to workload and work intensity have now been addressed.

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.

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