Executive summary
NHS England Workforce Training and Education Yorkshire and the Humber (NHS England WT&E YH) would like to thank the education and senior leadership team representatives for attending this Senior Leader Engagement (SLE) meeting.
Since their last SLE, Bradford Teaching Hospitals NHS Foundation trust has advanced its education strategy, expanded partnerships, and introduced innovative training programmes, such as the laparoscopic course and organ donation simulation. Workforce developments include digital learning initiatives, plans to introduce a leadership fellow to focus on multiprofessional learning, and student assistantship pilots. Support for International Medical Graduates (IMGs) and international nurses remain a strength, with structured induction, mentoring, and career development resources.
Multiprofessional education is thriving, with the Safe Learning Environment Charter (SLEC) embedded in maternity, creative simulation use, and initiatives like learner forums and ‘reflect and recharge’ sessions enhancing engagement and feedback.
The trust’s commitment to Equality, Diversity and Inclusion (EDI) is evident through the Strategic Diversity Council and inclusive leadership programmes. Efforts to address health inequalities and foster belonging are supported by targeted training and provision of safe spaces for dialogue.
While progress is clear in supervision, simulation, fellowships, and EDI, workload pressures continue to challenge training quality and the sustainability of expansion efforts. Sustained attention to workload pressures will be essential to maintaining quality and supporting future growth.
Review overview
Background to the review
Senior Leader Engagement (SLE) meetings aim to strengthen working relationships with senior leaders, and to develop an understanding around the commitment to the education and training quality agenda.
Evidence
- 2024 Trust Self-Assessment (SA)
- 2024 National Education and Training Survey (NETS)
- 2024 General Medical Council (GMC) National Training Survey (NTS) scores and ranks
- 2025 General Medical Council (GMC) National Training Survey (NTS) scores and ranks
- 2024 Guardian of Safe Working Hours (GoSWH) Report, Oct-Dec
- 2024/25 Annual Freedom to Speak up Guardian (FTSUG) Report
- 2025 Quality Intelligence Summary
- 2024/25 Practice Assessment Record & Evaluation (PARE) data
- 2024 NHS England Deans’ Equality, Diversity and Inclusion Committee Summary
Who we met with
- Postgraduate Medical Education Lead
- Director of Education
- Head of Education and Training
- Education Manager Business Development and Governance
- Equality, Diversity and Inclusion Lead
- Education Manager Professional Education and Workforce Development
- Head of Therapies for NMAHP
- Deputy Director of Education
- Lead for Dentistry
- Acting Chief Medical Officer
- Chief Nurse
- Chief Executive Officer
Review panel
- Education Quality Review Lead, Muzzammil Nusrath (Chair), Quality Associate Dean
- Specialty Expert, James Spencer, Postgraduate Dental Dean
- Specialty Expert, Lyndsay Murden, Senior Workforce Lead
- Education Quality Manager, Vicky Jones, Quality Support Manager
- Lay Representative, David Ita
- Support Role, Michele Hannon, Quality Administrator
Review findings
The trust began their update by reflecting on the progress and challenges since their last SLE meeting which took place on 10 October 2023. A major milestone this year has been the development of the trust’s second five-year education strategy, which places a strong emphasis on workforce development, the learning environment and educator support. Notably, the strategy now includes two new objectives: fostering research, innovation, and improvement, and to influence healthcare education through external collaboration. This marks a shift from a previously internal focus to a more outward-looking, system-wide approach.
One of the trust’s key successes has been its investment in education through strengthened partnerships and the expansion of the education team. Although financial constraints may limit future growth, the current team is well-resourced and active. The trust has also introduced innovative training programmes, such as a simulation course on organ donation and an intermediate laparoscopic course which is the only one of its kind outside London. A robust local quality assurance process has been implemented to analyse and triangulate data, enabling the identification of themes and the development of action plans where issues have arisen.
The trust described some of the challenges currently faced including the main training facility, Field House, which has ample simulation (SIM) provision, but the building is outdated and inflexible. The basic structure of the training rooms and the need for roof replacement poses risks to future expansion. A further challenge is that service pressures are significantly impacting training delivery, making it difficult to secure faculty time. Cultural issues persist in some areas, though the trust is actively using the SLEC framework to address these concerns.
In terms of workforce development, the trust described work undertaken to explore virtual and digital learning including virtual reality for undergraduate learners, with plans to extend this to foundation doctors. A leadership fellow focusing on multiprofessional learning will be appointed in the next 12 months to introduce a student supported service. The trust is also evaluating a medical student assistantship model, where students work in band 3 roles performing basic ward tasks. Whilst unsuccessful in securing foundation expansion for surgical specialties, the trust has achieved some specialty growth in obstetrics & gynaecology (O&G) and medicine. Additional initiatives include a Healthcare Assistant (HCA) upskilling programme, a chief registrar, a chief nurse fellowship role starting this year, and undergraduate simulation courses.
Support for IMGs and international nurses is another area of strength. The Deputy Director of Education serves as IMG lead and a separate Locally Employed Doctor (LED) tutor is in post, both playing a key leadership role. The trust has developed a proactive process for identifying IMGs and advocates for extending the supernumerary period beyond the standard two weeks. Their IMG induction is highly regarded, and they offer structured supervision for LEDs, with aspirations for formal recognition of this time in future job planning guidance. International nurses benefit from career clinics aimed at supporting Nursing and Midwifery Council (NMC) registration. Further support includes a comprehensive NHS orientation day for IMGs, featuring an enhanced induction and networking opportunities. While a WhatsApp group was initially trialled, the trust is considering the introduction of a formal mentoring programme. Additional resources include a communication skills course and a linguistics workshop, and the trust is making efforts to provide fairer feedback around differential attainment with cognisance of the different ways in which learners respond and is engaging with the General Medical Council (GMC) on this.
In the National Education and Training Survey (NETS), the trust performed strongly, scoring highly in 11 out of 13 domains when benchmarked against local trusts. However, persistent concerns around bullying, sexual safety, and discrimination highlight the need for collaborative, system-wide solutions due to the prevalence of these concerns across trusts. The trust’s Sexual Safety Group is actively addressing these concerns. Specialties such as anaesthetics, cardiology, radiology, paediatrics, and neonates received excellent feedback in NETS, while General Practice – O&G, and histopathology showed areas for improvement. Ophthalmology, which was previously underperforming, has shown marked progress.
The 2025 GMC survey reinforced these findings with the trust ranking 55 out of 230 for educational supervision and receiving commendations for good practice in anaesthetics, emergency medicine, intensive care, and ophthalmology. However, foundation surgery received the poorest feedback in recent years, prompting the development of a targeted action plan. Workload remains a significant challenge, particularly in emergency medicine (EM) for foundation year 2 (FY2) doctors and in surgical environments for foundation year 1 (FY1) doctors. The trust is trialling self-rostering in EM and anaesthetics which has received positive feedback and there are plans to expand this to O&G. The EXCEL programme in EM is also being used to enhance patient care and workforce planning by reducing demand on emergency care and creating more effective care pathways. Specialty expansion in O&G and medicine, alongside initiatives like the medical student assistantship, Hospital at Night, and local teaching programme refinement, are being explored to alleviate workforce pressures. Regional teaching, especially in internal medicine, continues to receive poor feedback. Feedback regarding stroke medicine from the GMC National Training Survey (NTS) patient safety, bullying, and undermining process has been summarised and submitted to the GMC for review. The trust will monitor these areas locally to determine whether further action is needed. Separately, an internal survey indicated that 67% of respondents were satisfied with how their training needs were being met, suggesting a generally positive perception of the educational environment.
Undergraduate medical student Multi-Professional Education and Training (MPET) scores have improved year on year, supported by innovative practices and increased investment. Feedback via the practice assessment record and evaluation (PARE) system has led to process improvements, including anonymised feedback mechanisms. The introduction of the SLEC and ward accreditation initiatives are helping to assess and improve learner experiences. Action plans are in place to address low scores in information technology (IT) and library services, and workload concerns have been incorporated into these plans. PARE feedback is consistent with national performance, particularly around staffing levels and workload.
Undergraduate medical education has been strengthened through the recruitment of a senior education fellow and junior medical education fellows, contributing to a diverse multidisciplinary team. The trust has gained national recognition for its work at educational conferences and has improved clinical support access for students. A well-evaluated SIM on-call programme for fifth-year students and a local ‘Introduction to Medicine’ day for those embarking on a career in medicine are further examples of the trust’s commitment to inclusive education and supporting the widening participation agenda.
Multiprofessional good practice includes embedding the SLEC in maternity through roadshows and targeted engagement. Simulation is used creatively, including live-streamed SIM content at induction sessions. Listening events for nursing staff, a monthly multiprofessional learner forum, reward and recognition initiatives for students nominated for delivering good practice, and celebration cards for staff who have demonstrated exceptional commitment, all contribute to a supportive learning culture. The trust also holds reflect and recharge sessions which involve working with peers on challenges. The sessions are facilitated by the education team and feedback is actively gathered through QR codes, thus improving accessibility to the evaluation process.
In medical education, the trust hosted the practical assessment of clinical examination skills (PACES) exam in March, which received excellent feedback. The trust launched their first educational supervision course for senior registrars and introduced a voluntary FY1 peer meeting to support transition. Health toolbox will also be integrated into induction from August 2025.
The trust has invested significantly in facilities. Basic Life Support (BLS) kiosks are now available 24/7 for use by staff and the public to allow skills practice at any time. Outdoor meeting pods at Field House have been installed for learner use, and new simulation equipment includes a high-fidelity maternity mannequin. The trust is the first in the UK to have this equipment and there will be training sessions for learners to utilise the above equipment. The library team has expanded its services to include academic skills support, literacy proof reading and assignment planning. There has been a national reduction in funding and the trust has lost access to oxford handbook; solutions to mitigate the impact are being explored.
The trust has demonstrated a strong commitment to collaborative education and training through its growing partnerships with Higher Education Institutions (HEIs). A key development has been the trust’s collaboration with all partner universities on the five-year education strategy plan. The University of Bradford partnership has led to the delivery of a Professional Nurse Advocate (PNA) course and an innovative interpreting course, enabling multilingual staff to apply their language skills in clinical settings. Meanwhile, the University of Greater Manchester has expanded its footprint by opening a new site at Lister Mills in Bradford, offering Nursing Associate and Registered Nurse programmes. Leeds Trinity University is also contributing to the regional education landscape with a new nursing programme, developed in collaboration with the trust.
The trust has also implemented a shadowing initiative in dental training, allowing doctors to gain experience in ward rounds and inpatient care. The programme launched earlier in the year and attracted 11 candidates and has received positive feedback. It remains unclear how many of those who expressed interest have secured roles, and follow-up is recommended.
Workforce planning remains a pressing issue. While the trust has introduced successful initiatives such as the Excel programme, self-rostering, and Hospital at Night, there is recognition that a more cohesive and strategic approach is needed. Plans for Physician Associate (PA) expansion have been paused, but the recent appointment of a new Chief Medical Officer (CMO) and the advertisement for an Associate Medical Director role focused on workforce planning, signal a renewed focus on leadership and sustainability in medical staffing.
In terms of medical workforce expansion, the trust submitted a bid for 6 additional FY1 doctors in August, with an additional 6 the following year, supported by the Executive team. Feedback from surgical departments suggests that increasing numbers would significantly improve both workload and training quality. Specialty expansion is underway, with two new higher training posts in O&G introduced to support a two-tier middle grade rota. Rota resilience has been a challenge due to the demands of the O&G curriculum, which requires senior supervision of junior staff. Additional posts are being sought in renal medicine, plastic surgery, and general surgery, with a total of nine to ten new specialty Postgraduate Doctor in Training (PDiT) expected in the autumn. The trust has also successfully retained a third registrar post in Oral and Maxillofacial Surgery (OMFS), thanks to the support of the Director of Medical Education (DME). Updates on the NHS Education Learning Agreement and associated tariff are expected imminently, which will help inform future planning and resource allocation.
The trust has demonstrated a strong and proactive commitment to Equality, Diversity and Inclusion (EDI), embedding it as a core value across its workforce and educational environment. A key strength lies in the establishment of the Strategic Diversity Council which was initiated during the COVID-19 pandemic and chaired by the CEO. This council brings together over 40 members, including representatives from staff equality networks, ensuring that diverse voices are heard and influence decisions at the highest strategic level.
A central focus of the trust’s EDI work is empowering managers and leaders to take ownership of inclusive practices. This is supported through a culture and leadership programme, alongside targeted training on civility, dignity, respect, and professional behaviours. The trust is also working to build capability around addressing health inequalities, with a range of creative and innovative initiatives underway. By providing safe spaces and encouraging open dialogue, the trust aims to promote a culture of inclusivity and belonging.
Intersectionality is a key principle guiding the trust’s approach, recognising the importance of addressing the needs of individuals across all nine protected characteristics. The Chair of Chairs network plays a vital role in bringing these perspectives together. The trust has also made significant progress in sexual safety, with a dedicated Sexual Safety Charter and policy on sexual misconduct. Learners are central to this work, and the trust is collaborating with university partners to tackle discrimination and promote safety. The trust’s workforce is now 43% ethnically diverse, surpassing its previous target of 35%, which is seen as a vital contributor to patient care and experience. While the senior leadership team is already in the higher quartile for diversity, the trust remains committed to further improvement. Staff networks grounded in lived experience, are a cornerstone of the trust’s inclusive culture, enabling meaningful engagement and positive organisational impact.
Recognition of the trust’s EDI efforts includes being named Best Employer for EDI by the Nursing Times in 2023 and receiving a Health Service Journal (HSJ) award for meeting the needs of Muslim staff. The Spiritual, Pastoral and Religious Care (SPaRC) Team initiative, developed around Ramadan, has also gained national recognition. Internally, year-on-year improvements in staff survey results and hospital data reflect the positive impact of these initiatives, including a narrowing gender pay gap in a workforce that is 77% female. The trust is also engaging with trans and non-binary staff to ensure their voices are heard and respected. Training remains a key enabler of change. A half-day, face-to-face training session for managers on dignity and respect has been well received, and the trust is planning a full-day EDI conference with a theme of belonging. An anti-racist strategy is also in place with a focus on race equality and the development of a toolkit to support anti-racist practice. Cultural competency and humility training are being rolled out across departments, and policies are under review to ensure they support sexual safety and address bullying and harassment effectively.
In response to external scrutiny, the trust acknowledged that it has received Freedom of Information (FOI) requests, particularly around recruitment to EDI roles and issues related to trans inclusion. However, these have not specifically related to learners. The trust remains open and transparent, welcoming questions and feedback to continue improving its inclusive practices.
The Guardian of Safe Working Hours’ (GoSWH) annual report highlighted a significant increase of 155% in exception reports over the past year. Whilst the trust attributed this rise to improved awareness and understanding of the reporting process, particularly around working patterns, it was suggested that growing workload pressures may also be a contributing factor. Most reports related to working hours, with few reports relating to missed educational opportunities. However, the trust continues to experience high locum expenditure, especially in general medicine and emergency medicine, to cover these rota gaps. The data suggests that while reporting is becoming more embedded in the culture, the underlying issues, particularly workload, are beginning to impact the quality of training programmes. This is especially relevant in education exception reporting, where missed learning opportunities due to service pressures can compromise the educational experience of PDiT.
In closing, it was acknowledged that while the trust has made commendable progress in areas such as supervision, SIM, education fellowships, and EDI, the pressures of workload continue to impact the quality of training and the sustainability of expansion efforts.
Good practice
Description | Domain and standard |
---|---|
Strategic Diversity Council – initiated during COVID and chaired by the CEO. This council brings together over 40 members, including representatives from staff equality networks, ensuring that diverse voices are heard and influence decisions at the highest strategic level. | 2.2 |
EXCEL programme – a three-year plan to improve the delivery of urgent and emergency care, enhancing the experience for both patients, staff and learners. | 1.5 |
‘Introduction to Medicine’ offers support to the future workforce and supports the widening participation agenda. | 1.8 |
Reflect and recharge session offering the opportunity of a safe space to discuss experiences. | 1.7 |
The Trust was named Best Employer for EDI by the Nursing Times in 2023 and received a Health Service Journal (HSJ) award for meeting the needs of Muslim staff. The SPaRC Team initiative, developed around Ramadan, also gained national recognition. | 2.2 |
Report approval
Report completed by: Kim Mills, Quality Support manager
Review lead: Muzzammil Nusrath, Quality Associate Dean
Date approved by review lead: 19 August 2025
NHS England authorised signature: Jon Hossain, Clinical Director of Quality
Date authorised: 19 August 2025
Final report submitted to organisation: 11 September 2025