Agreed principles and guidance around training in the independent sector for organisations working under the COVID-19 national contract

Classification: official
Publication approval reference: C0730

From: NHS England and NHS Improvement and Health Education England

To: NHS commissioners, providers and Independent Sector providers

Agreed principles and guidance around training in the Independent Sector for organisations working under the COVID 19 National Contract.

Contracting arrangements between commissioners and independent sector (IS) healthcare providers recognise the range of both healthcare providers and of healthcare professionals delivering services, in multi-professional teams. Postgraduate medical trainees are an integral and essential part of these teams.

Trainees of all levels of seniority should be enabled to practise across different environments with appropriate levels of education, training and supervision in place. Postgraduate Deans act on behalf of the regulator as responsible officers for trainees and have a duty to ensure that all learning environments are compliant with GMC standards.

This support is already enshrined and factored into the standard contracting arrangements between commissioners and providers. Although a formal obligation is absent from some of the current national NHS England contracts with some IS hospital providers, continuation of prior arrangements to accommodate trainees should be unaffected. There are agreed plans underway to ensure that the appropriate contract mechanisms are re-inserted into a revision of the national contracts between the NHS and IS providers to reflect this ongoing requirement of support.

All IS, regulatory, training and NHS partners have committed to co-operate closely to make these arrangements work. NHS England and NHS Improvement have already extended indemnity arrangements for trainees within the current national contract. Health Education England Postgraduate Deans are registering all participating providers with the GMC as recognised training sites providing that the environments comply with their regulatory standards for education and training. The CQC have indicated that trainees working in the IS do not contravene any of its registration criteria providing that there are adequate employment checks and supervisory arrangements in place.

To further support discussions and planning at a local level, a document detailing the high-level principles and practical guidance around supporting and facilitating training in the Independent Sector is being developed and will be finalised in consultation with partners from NHS England and Improvement, Health Education England, the Royal College of Surgeons, the General Medical Council, Care Quality Commission and the IHPN on behalf of the Independent Sector.

It is also intended that the principles document will be accompanied by a further detailed, operationally focused paper outlining key mechanisms to underpin and support its implementation. However, this letter is intended to clearly indicate that these documents will consolidate updated guidance and that there are already adequate indemnities, existing successful arrangements and advice available from the regulatory bodies to ensure that trainees can be accommodated in independent sector facilities.

Position statements from CQC and IHPN along with supervision and operational guidance are available on the FutureNHS Collaboration platform. Please email if you have any problems following this link.

We would like to thank you for your continued efforts, both to deliver the service patients need and provide the training environments to ensure we have a highly skilled and competent registrar and consultant workforce supply going forwards.

We look forward to continuing to work closely across organisations and systems to support the learning and development of the future clinical workforce.


Celia Ingham-Clark | Medical Director for Professional Leadership and Clinical Effectiveness | NHS England and NHS Improvement

Sheona MacLeod | Acting Director of Education and Quality and Executive Medical Director | Health Education England