Executive summary
The higher specialty resident doctors we met with were open, engaged, provided useful perspectives and, overall, the visit was positive, with no concerns regarding training and patient safety identified. In addition, a constructive and open discussion with departmental educators took place, along with proactive and supportive engagement from the wider educational leadership team.
Areas working well and good practice identified:
- The gastroenterology department has established a strong, engaged and supportive culture.
- The educational lead plays a central role in aligning training opportunities to individual needs and was commended for their contribution.
- A particularly positive training experience within the out of hours gastrointestinal bleed service was reported.
- Feedback from registrars aligned closely with that provided by both the educational supervisors and the Education team throughout the process.
- The Education team functions as a strong, cohesive unit, demonstrating a clear understanding of the challenges and a commitment to continuous improvement. Their work is supported by broad engagement across the department, multiple avenues for raising concerns, and the presence of dedicated well-being officers.
- There is a clear reporting process to the board, with strong leadership engagement throughout.
High level areas for improvement and recommendations:
- Educational supervisors would benefit from improved access to educational development and continuing professional development (CPD) opportunities. Greater consideration is needed for how curriculum and educational support can be embedded, to strengthen their role and ongoing professional development.
- There is a need to balance educators’ clinical duties with adequate time for educational supervision. Limited allocated time may affect the consistency and quality of resident doctor support.
- Educational appraisals are a key opportunity to embed good supervisory practice, and further work is needed to strengthen the process and address existing challenges.
- The nutritional service is experiencing pressures due to the high volume of educational activity and training demands.
It should be noted that the absence of internal medicine training (IMT) resident doctors, possibly due to annual leave and/or the timing of the visit, meant that we were unable to engage with this key group of doctors. Therefore, a complete picture of the current training environment in the gastroenterology department could not be formed at this time. Nonetheless, the visit did provide some valuable insights, and the trust has demonstrated a commitment to enhancing the training experience and has made notable progress in this area.
NHS England are confident that the recommendations outlined in this report, will be carefully reviewed and addressed. Routine monitoring will continue in line with standard procedures and there are no current concerns that require additional support or intervention through the Intensive Support Framework (ISF) process.
Review overview
Background to the review
A targeted learner educator meeting was undertaken in the gastroenterology department to gain a deeper understanding of the learning experience of IMT Stage 1 doctors and Group 1 registrars. Prompted by the findings of the 2024 GMC National Training Survey (NTS) and the National Education and Training Survey (NETS), this visit aimed to better understand the experience of resident doctors within the gastroenterology department. The focus was on exploring the survey feedback in more depth and identifying both, examples of effective practices, and areas for quality improvement in the training environment.
Who we met with
Learners
- Group 1 medical registrars in gastroenterology
Educators
- Educators in gastroenterology medicine
Education team
- Educational leads
Review panel
- Education Quality Review Lead – Dr Gordon Wood, Deputy Head of School, WM Medicine
- External Specialty Expert – Dr Helen Steed, DME, Gastroenterology Consultant – Royal Wolverhampton
- Deputy Quality Manager – Joycelyn Boyce, NHS England
Review findings
Educators
Educational supervisors shared a range of reflections on their experience, with several positive aspects emerging. A newly appointed departmental education lead reported feeling well supported in their role. They highlighted a comprehensive handover, access to a locally delivered educational supervisory course and dedicated time for both educational supervision and rota responsibilities. This suggests a strong local commitment to supporting new educators as they step into their roles.
A recurring theme was the need for greater clarity around the expectations of the educational supervisor role, particularly regarding GMC accreditation requirements and the revalidation process.
Initial educator training was seen as beneficial, though there was a call for more targeted, curriculum-specific content and more regular communication around updates. Some supervisors noted that while curriculum updates were previously provided, they had not received recent communications.
Overall, the feedback highlighted both the strength of local support structures and the opportunity to further enhance the educational environment through clearer guidance, improved communication, and continued investment in the development of educational supervisors.
Education team
The education team showed a proactive and reflective approach in response to concerns highlighted in the 2024 GMC NTS and the NETS regarding discriminatory behaviours and sexual safety. They undertook reflective discussions with both consultants and resident doctors. While no current issues were identified, it was acknowledged that previous concerns may have related to former staff members.
Gastroenterology has established a strong, engaged and supportive culture. The current educator supervisor team were described as positive, engaged and committed to fostering a supportive and inclusive environment. The visit also identified several educational strengths, including a well-received induction process and strong supervision, with trainers recognised for their expertise and support.
Training
Training opportunities are accessible and aligned with individual training needs, and a particularly positive training experience within the out of hours GI bleed service was reported.
Workload
Operational pressures, particularly around triage and management of medical outliers, had been identified as a challenge, with workload described as unsuitable. Following service redesign and the introduction of dedicated consultant cover, feedback in March 2025, indicated an improvement in workload distribution and resident doctors experience.
In addition, the nutritional service is experiencing pressures due to the high volume of educational activity and training demands.
Educator appraisal
Professional development and appraisal processes are being strengthened, with ongoing efforts to embed education appraisal within wider appraisal systems. Additionally, a newly implemented tracker system is supporting greater oversight and assurance in this area.
Areas that are working well
| Description | Reference number and or domain(s) and standard(s) |
|---|---|
| Governance There is a clear reporting process to the Trust Board, with strong leadership engagement throughout and ensuring that training is aligned with organisational objectives. | 2.1 |
| Culture and behaviours Gastroenterology has established a strong, engaged and supportive culture. The work of the educational lead is central to ensuring training opportunities are both accessible and aligned with individual training needs, and should be formally recognised. The education team functions as a strong, cohesive unit, demonstrating a clear understanding of departmental challenges and a commitment to continuous improvement. Their work is supported by broad engagement across the department, multiple avenues for raising concerns, and the presence of dedicated well-being officers. | 1.1, 1.4 |
| Teaching and training Training opportunities are accessible and aligned with individual training needs, and a particularly positive training experience within the out of hours GI bleed service was reported. | 5.1 |
Good practice
| Description | Reference number and or domain(s) and standard(s) |
|---|---|
| Educational Lead The educational lead has demonstrated exceptional commitment by aligning training with individual needs and personally managing the rota to ensure there is a balance between gastroenterology and general internal medicine (GIM) commitments. This contribution, often made in their own time, significantly enhances the training environment. | 2.1 |
| Education team The education team functions as a strong, cohesive unit, demonstrating a clear understanding of departmental challenges and a commitment to continuous improvement. Their work is supported by broad engagement across the department, multiple avenues for raising concerns, and the presence of dedicated well-being officers. | 2.1, 2.4 |
Recommendations
| Recommendation | Reference number and or domain(s) and standard(s) |
|---|---|
| Educator training Enhance access to targeted CPD and training to ensure educational supervisors are well-equipped and up to date in their roles. | 4.3 |
| Job planning Provide clearer guidance and safeguards within job plans to ensure educational supervisors have adequate time to fulfil their training responsibilities alongside clinical duties. | 4.2 |
| Educator appraisals Further work is needed to strengthen the educator appraisal process and address challenges. | 4.3 |
| Work pressures It is recommended that the department explore whether current capacity and resources within nutritional services are aligned with the growing demands of educational activity and training, to support sustainable delivery over time. | 5.6 |
Report approval
Report completed by: Joycelyn Boyce, Deputy Quality Manager
Review lead: Dr Gordon Wood, Deputy Head of School, WM Medicine
Date approved by review lead: 12 May 2025
NHS England authorised signature: Prof. Andy Whallett, West Midlands Postgraduate Dean
Date authorised: 28 May 2025
Final report submitted to organisation: 2 July 2025