Recommendation 152

Training standards concerns

Any organisation which in the course of a review, inspection or other performance of its duties, identifies concerns potentially relevant to the acceptability of training provided by a healthcare provider, must be required to inform the relevant training regulator of those concerns.

In the new health and care system architecture, memoranda of understanding exist between key partners such as Health Education England and the Care Quality Commission, to share information and concerns about the quality and safety of providers. Memoranda of understanding and other protocols for sharing information also exist between the Care Quality Commission and the General Medical Council and the Nursing and Midwifery Council. Health Education England will work with the system and professional regulators to develop these further.

The recently established quality surveillance groups bring together the different parts of the system to share information including shared views of risks to quality and any early warning signs of risk about poor quality. Health Education England as well as the system and professional regulators are members of the regional quality surveillance groups.


The national guidance for the operation of Quality Surveillance Groups was updated in March 2014 to reflect early experience of sharing information between system regulators and commissioners. Early discussions about information causing concern are now occurring before meetings between local representatives of NHS England, the Care Quality Commission, Monitor and Health Education England, with some shared quality monitoring visits occurring where this is relevant.

Quality Surveillance Groups are beginning to review health care economies rather than just acute care providers and plan themed meetings, considering specific risk areas across providers, for example the provision of intermediate care or older person’s services. Quality monitoring visits are also evolving – Health Education England is developing a multi-professional approach to visiting, encompassing the education and training culture and environment for all healthcare professionals.

As Health Education England and the Care Quality Commission refine their acute, community and primary care visiting processes, updated memoranda of understanding will be required and there will be increasing opportunities to incorporate experience of quality monitoring processes in to clinician’s training.  Health Education England is finalising the memoranda of understanding with the Care Quality Commission. Health Education England is also currently working with the professional regulators to develop a series of memoranda of understanding, where appropriate, to support the ongoing working relationships with the aim of promoting patient safety and high quality education and training.