Enhanced monitoring update

We have published our quarterly update of postgraduate training sites which are subject to enhanced monitoring.

Enhanced monitoring is the process by which we work 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 had their enhanced monitoring cases published for the first time and four have been removed after making the required improvements.

As of February 2, 2018 there are a total of 53 cases in enhanced monitoring, of which 52 meet our criteria for publication.*

See the full summary visit

Of these published cases:

  • Two sites are subject to GMC conditions - North Middlesex University Hospital NHS Trust & East Kent Hospitals University NHS Foundation Trust.
  • 33 cases were down to poor levels of clinical supervision (62%) while six cases were for emergency medicine departments (11%).

The nine cases in enhanced monitoring being published for the first time are:

Education Provider Site Specialty Education Concerns
Wales Deanery Aneurin Bevan University Local Health Board Core Medical Training, Foundation, General Practice Adequate experience, Clinical supervision (out of hours), Local teaching.
Wales Deanery The Royal Glamorgan Hospital - Cwm Taf University Local Health Board Higher Medicine Trainees not gaining adequate experience, Feedback.
Wales Deanery University Hospital of Wales - Cardiff & Vale University Local Health Board Paediatric surgery Trainees gaining adequate experience, Clinical supervision (out of hours), Clinical supervision (weekdays), Educational governance, Educational supervision, Feedback, Local teaching, Overall satisfaction, Staff behaviour, Supportive environment, Trainee safety.
NHS Education for Scotland (NES) Tayside - Ninewells Hospital General surgery Clinical supervision (out of hours), Clinical supervision (weekdays), Rota issues.
Health Education Yorkshire and the Humber Barnsley Hospital - Barnsley Hospital NHS Foundation Trust Respiratory medicine Staff behaviour, clinical supervision.
Health Education North Central and East London King George Hospital - Barking, Havering and Redbridge University Hospitals NHS Trust Foundation, General Practice Clinical supervision (out of hours), Workload or work intensity.
Health Education North West London Northwick Park Hospital - London North West Healthcare NHS Trust Haematology Clinical supervision (out of hours), Poor access to education, Workload or work intensity.
Northern Ireland Medical & Dental Training Agency Royal Victoria Hospital - Belfast Health and Social Care Trust Anaesthetics Staff behaviour, clinical supervision.
Health Education East of England Colchester General Hospital - Colchester Hospital University NHS Foundation Trust Emergency medicine, General (internal) medicine, Geriatric medicine Clinical supervision (out of hours), Clinical supervision (weekdays), Handover, Poor access to education.

The four sites that have been removed following improvement are:

Education Provider Site Specialty Education Improvements
Health Education West Midlands County Hospital - University Hospitals of North Midlands NHS Trust Paediatrics Paediatric medicine training is no longer undertaken at either of the hospitals formerly managed by Mid Staffordshire NHS Foundation Trust (County Hospital formerly known as Stafford Hospital & Cannock Chase Hospital).
Health Education West Midlands Heartlands Hospital - Heart of England NHS Foundation Trust Trauma and orthopaedic surgery Improvements have been noted in recent years and the trust has reported no further issues. We are confident that the improvements are
sustainable.
Health Education North West University Hospital Aintree - Aintree University Hospital NHS Foundation Trust Core Medical Training, Foundation, General (internal) medicine In October 2017, Health Education England North West confirmed that improvements have been sustained and the issues are now resolved.
Health Education North Central and East London Queen’s Hospital - Barking, Havering and Redbridge University Hospitals NHS Trust Foundation Medicine Trainees were re-introduced in August 2017 and feedback to date has been positive.

 

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.