Recommendation F155: Medical training
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The General Medical Council should set out a standard requirement for routine visits to each local education provider, and programme in accordance with the following principles: The Postgraduate Dean should be responsible for managing the process at the level of the Local Educational Training Board, as part of overall deanery functions. The Royal Colleges should be enlisted to support such visits and to provide the relevant specialist expertise where required. There should be lay or patient representation on visits to ensure that patient interests are maintained as the priority. Such visits should be informed by all other sources of information and, if relevant, coordinated with the work of the Care Quality Commission and other forms of review. The Department of Health should provide appropriate resources to ensure that an effective programme of monitoring training by visits can be carried out. All healthcare organisations must be required to release healthcare professionals to support the visits programme. It should also be recognised that the benefits in professional development and dissemination of good practice are of significant value.
In brief (written by this site)
In commentary provided in September 2024 and published in February 2026, the Department of Health and Social Care and NHS England stated that the General Medical Council updated its quality assurance approach in 2018, enhancing the role of Medical Royal Colleges and using lay associates on visits (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that while an October 2014 update report accepted one part of the recommendation, it was unclear whether the other recommendations were accepted (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted.
The General Medical Council has stated its commitment to a thorough and consistent inspection regime, and to building on its quality assurance arrangements to address the issues raised in this recommendation.
The General Medical Council is working with the Academy of Medical Royal Colleges and with Postgraduate Deans to develop a more explicit statement about how Colleges should support visits to local providers. The General Medical Council’s Quality Improvement Framework is clear that Deans must draw on a range of external advice to support their scrutiny of local providers, including from patients and the public, as well as from doctors.
The evidence pack supporting the General Medical Council inspection teams contain information from the Care Quality Commission and other external organisations. The outcomes of visits and information about serious concerns which the General Medical Council is monitoring are shared with the Care Quality Commission.
In February 2012, the General Medical Council Chair, Professor Sir Peter Rubin, and the four UK Chief Medical Officers wrote a joint letter to NHS organisations setting out the importance of releasing clinical staff to perform roles that improve the overall quality of patient care, medical education and the effective running of the health service.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
In 2012 the GMC reviewed its quality assurance processes for medical education and training. The review made wide-ranging recommendations which were taken forward to help address the education and training concerns raised in the report and the GMC made subsequent changes to its approach to quality assurance in 2018. These included enhancing the role of Medical Royal Colleges in supporting its quality assurance activities; revising its standards for medical education and training; developing the appointment process for the medical specialists involved in visits; restricting the inspection cycle; and enhancing the transparency and accessibility of visit reports. At its visits, the GMC may use medical and clinical specialists, students, doctors in training and lay associates, to ensure a breadth of expertise and representation.
Additionally, where a training institution gives rise to concerns which relate to patient safety or quality of education, it may be subject to enhanced monitoring within the GMC’s quality assurance process. To ensure transparency, details of these concerns are published on the GMC’s website. The GMC provides additional information on enhanced monitoring in response to recommendation 162 below.
Please see our response to recommendation 152 above for detail on the Quality Framework for training providers and the NHS Long-term workforce Plan.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 155, PDF page 498-499.
Department of Health and Social Care says in progress (11 February 2015)
The General Medical Council considered this recommendation as part of its Review of Quality Assurance of Medical Education and Training. The final report was published on its website in February 2014 and work has begun to develop an action plan to address this recommendation. The plan will include different phases to:
• scope and understand the current appointment processes and training required by each part of the system
• map the appointment processes and training undertaken and understand the similarities and differences.
• agree a way forward with all concerned organisations designed to minimise the requirement to repeat generic training and develop a mechanism for co-badging visitors and inspectors for the future. The General Medical Council anticipate that this would help the move towards a more ‘collective’ assurance process for regulation in the future. The General Medical Council are also considering how to enhance college support for visits to local providers and this will form part of the initial scoping to implement the recommendations from the final report.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
Site note: The Inquiry addressed this recommendation to the General Medical Council, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said that the evidence pack supporting General Medical Council inspection teams contained information from the Care Quality Commission and other external organisations.
The General Medical Council expressed its commitment on a through and consistent inspection regime. The General Medical Council’s final October 2014 update report accepted the recommendation at (ii). It is unclear from the final update report whether the other recommendations were accepted.
In the February 2015 Culture Change report, the Government said that the General Medical Council had begun scoping work to address this recommendation.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 155, PDF page 466.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding