Deans
All Local Education and Training Boards should have a post of medically qualified postgraduate dean responsible for all aspects of postgraduate medical education.
- Following the abolition of HEE and the transfer of its functions to NHS England from 1 April 2023 under the Health and Care Act 2022 (section 96), the postgraduate dean function has been maintained within NHS England's Workforce, Training and Education directorate. Postgraduate deans continue to exercise their responsibilities for postgraduate medical education at regional level within the NHS England structure (Health and Care Act 2022, s.96; NHS England WT&E).
- The GMC's quality assurance framework requires each region to have a postgraduate dean responsible for the management and quality assurance of postgraduate medical training. The postgraduate dean is the GMC's primary point of contact for quality assurance at regional level and is responsible for routine quality management, triggered visits, and escalation of concerns about training environments (GMC quality assurance framework).
- The government's response in "Hard Truths" (Cm 8777, November 2013) confirmed that all LETBs should have a medically qualified postgraduate dean responsible for all aspects of postgraduate medical education (Hard Truths, DHSC, November 2013).
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.
GMC medical revalidation launched December 2012. All licensed doctors must demonstrate fitness to practise every five years through appraisal and evidence. Francis Report endorsed and recommended strengthening revalidation.