Recommendation 158

Student and tutor feedback on safety and quality

The General Medical Council should amend its standards for undergraduate medical education to include a requirement that providers actively seek feedback from students and tutors on compliance by placement providers with minimum standards of patient safety and quality of care, and should generally place the highest priority on the safety of patients.

The General Medical Council has made it clear that it places a high priority on feedback from students and tutors in ensuring both quality education and patient safety, and will look to reinforce this through its Review of Quality Assurance in Education. The General Medical Council will share its proposals in the first half of 2014.


Students and clinicians in training are the eyes and ears of the service today and the safety leaders of the future. As they move around during their training, they can spot where safety doesn’t seem to be a priority, there is poor communication, and the concerns of patients and staff are not being listened to. As the future stars of a stronger safety culture, they need to be trained not only in safe care of the patient in front of them – already central to training – but in all the elements crucial to creating safer clinical systems: understanding human factors, measurement and audit, effective multidisciplinary team working, safe handovers of care, learning from error and near misses, and the tools of improvement science.

The General Medical Council is reviewing its standards of medical education and training, as set out in Tomorrow’s Doctors and The Trainee Doctor. The review will consider the importance of student, Trainee and trainer feedback on their training experience, including supervision, support and learning opportunities. A new standards framework will be consulted on in early 2015.

Currently two Local Education Training Boards have a live non-medical feedback system, with all other Local Education Training Boards gathering information by other means, including formal evaluations of placements, informal feedback to the Local Education Training Board and Higher Education Institutions as well as placement providers, questionnaires, focus groups, specific interviews as part of a quality assurance process, etc.  This happens across all Local Education Training Boards, developed in partnership with relevant parties involved in the process of quality improvement. All Local Education Training Boards collect trainee intelligence through the National General Medical Council survey.

Through the Health Education England Commission on Education and Training for Patient Safety comprehensive proposals for enhancing safety training for all health and care professionals are being brought forward, including producing a film to help staff and learners in the NHS to raise concerns if they experience or witness practice which puts patients at risk.

The General Medical Council is working with the Medical Schools Council and key partners to ensure that medical students and doctors in training are supported to become the leading lights of excellence in safety, with students starting this autumn seen as patient safety champions from day one. The General Medical Council will showcase current best practice at its conference in March and publish a report. The 5000 new Health Foundation NHS improvement ‘fellows’ will work with medical educators to bring the most up-to-date knowledge on improving safety to the heart of training. The General Medical Council has focused on safety throughout its revised standards for education and training, published for consultation in January 2015, and expanded the questions on safety in its annual survey of all trainees. Through its visits to check the quality of medical education and training, it will work with providers to improve standards and tackle safety concerns, and its regional liaison service will expand its work with students and doctors in training on raising concerns and improving safety.