Guidance on Quality Assurance in the system-first era

First steps for PGME with HoS/TPD input

Background

In the new NHSE structure responsibility for training and education Quality Assurance sits with the Integrated Care System and Local Education Provider.   

Providers are not starting from scratch as they have always held responsibility for the quality of their learning environment and training.  However, providers will no longer have access to centrally supported quality panels to aid their quality assurance for postgraduate medical posts.      

This guidance is designed for those Postgraduate Medical Education (PGME) departments who are concerned about how to set up or develop robust quality assurance processes in the absence of quality panels.  There are good examples of how this is already working in practice in the south west.  There are good examples of how providers quality assure the education of other healthcare professionals who learn and work with them.

There is an opportunity for providers to look at education quality assurance across all professional groups, to triangulate feedback, to allow shared learning and multi-professional improvement plans.

Starting point

  1. Identification of multi-professional education leads within a Trust. Review this list of those who attended the autumn multi-professional education quality review, liaise with your director of nursing and head of people/workforce. 
  2. Census of current available intelligence- NETS, NTS, student survey, yearly Foundation school quality surveys, yearly School of Primary Care quality surveys, Specialty Advisory Committee (SAC) yearly quality feedback (not for all specialties, usually sent from SAC to college tutor). 
  3. Consideration of other sources of information that may impact on the quality of training or the quality of the learning environment- Guardian of safe working reports, Freedom to Speak up reports, CQC reports, staff survey. 
  4. Explore the governance team who work on CQC reports - how they pull together the areas for learning, how they share with the board, how they link to the Integrated Care Board System Quality Group (SQG). 
  5. Explore the multi-professional systems that manage issues flagged to a regulator such as a Coroners notice, CQC mandated action, Nursing and Midwifery council report, HCPC, whistleblowing concern

Sketch out your system 

  1. Consider how medical education quality can fit into the existing quality and governance systems, benefiting from the existing links to the System Quality Group (held within each Integrated Care System monthly), Trust board meetings and benefiting from shared, multiprofessional improvement work – i.e. map what already exists. 
  2. Identify meetings that could become multi-professional and include medical learners, to build on what is already in place. 
  3. Identify the need for any new multi-professional quality meetings or whether the DME wishes to nominate a deputy responsible for education quality. 
  4. Identify the person within your Trust who will represent your education quality concerns at the ICS System Quality Group. 
  5. Consider which areas of learning may be a blind spot, without quality data - is this a small specialty, would it benefit from a multi-profession push to complete NETS, is there a need for a learner focus group or do you need to ask the specialty School to help with intelligence? 
  6. Decide on how you will record quality concerns and improvement actions, ideally with consistency across professions.  This will make it much easier when education and training quality questions come up in CQC visits, if there is a concern raised or if a survey flags a problem. 

Example systems 

One Trust has a multi-professional quality assurance framework with regular meetings and inputs from all professional education leads.  They share education quality concerns, collectively review new quality intelligence, consider multi-professional actions and agree on issues that require escalation to the SQG.  This group has close working with the Trust Cultural Insights group which is essential for improvement actions if there are concerns about acceptable behaviour and the learning environment.  Education leads within this group have quarterly meetings with finance to ensure there is a clear link between available funds for education and their improvement work. 

Another Trust has a deputy DME responsible for education quality and runs a Trust Education Group, chaired by an overall Head of Education, reporting directly to the executive team. It has excellent oversight and provides a joined-up strategy for high quality multi-professional education. 

One Trust has a direct link with the board via the DME and Head of Workforce Transformation (including multi-professional education) reporting directly to the People and Culture committee regarding education and training.  They hope to build on this existing link when further developing their multi-professional quality assurance system. 

Actions for Schools/TPDs

  • Consider a nominated member of school board with responsibility for quality to be the point of liaison with trusts and the quality team. For example, the School of Surgery now has a Deputy HoS with quality remit. 
  • Consider your specialities – are there any with small numbers that would benefit from School support to a provider’s quality assurance process – discuss these with providers early to inform a joint approach if required. 
  • If you have existing quality processes or surveys that reflect quality of medical education in our providers please share this information with providers, so that they are aware of the intelligence available to them and the timing of this intelligence.  Please also inform the quality team who can assist providers by holding a central repository of school-based or College/specialty-based intelligence. 
  • Provide subject matter expertise to NHSE SW quality team, College Tutors and others within trust in collating data and managing concerns. 
  • Agree on a method of managing education concerns that are raised within the school, such as feedback at a training event, or lack of support that is evident via ARCP submissions.  Remember the NHS England SW WT&E Escalating concerns form to share concerns; https://www.hee.nhs.uk/our-work/quality/raising-concerns 

Quality Team support 

  • Sessions on interpretation of the NETS and NTS data. 
  • Regular sessions to discuss challenging situations, arranged via a booked slot – Education Quality Assurance Advisory Group (EQAAG).  These sessions will support education quality across all professions. 
  • Dashboard of quality information to be co-produced prior to each autumn Multi-professional Education Quality review. 
  • Good practice sharing via the South West WT+E Stakeholder newsletter. 
  • Escalating Concerns form for educators as well as trainees; https://www.hee.nhs.uk/our-work/quality/raising-concerns 

This page was last updated November 29th 2024 (22 days ago)