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The GMC as a 21st century patient safety organisation: the role of education

Professor Terence Stephenson, chair of the General Medical Council, recently spoke at the Developing Excellence in Medical Education conference. Here he talks about the GMC’s work to put safety and quality at the heart of medical education.

As doctors we go into medicine to make people better. However, there is the uncomfortable truth that sometimes our actions cause patients harm. Adverse events in hospitals come ranked in the top 20 risk factors for all deaths, coming above alcohol and drugs. 

Efforts to reduce such events depend largely on educating medical students and doctors so they have the knowledge, skills and behaviours to practise safely and to improve the safety of the systems in which they work. Every health professional has a responsibility to champion patient safety in their teams and wider organisations. Good medical practice, our profession’s core guidance, says we ‘must promote and encourage a culture that allows all staff to raise concerns openly and safely’. 

The GMC has transformed itself in recent years. It is now firmly established as a patient safety body, and through various initiatives we are working hard with the profession to help make patients safer. We don’t just do this by taking action against doctors who put patients at risk. We also do this more positively by influencing and encouraging a greater focus on patient safety in the training that doctors receive. 

Let me tell you about three ways we are doing that. 

New standards 

First, we have our new education standards, which came into force in January. Our new standards put the safety of patients, quality of care and fairness at the heart of training medical students and doctors. They also place a heavy responsibility on the organisations providing their training to get the learning environment and culture for those doctors right and safe. 

Patient safety focus 

Second, we are encouraging a greater focus on patient safety in the postgraduate curricula studied by doctors in training. Working closely with the Academy of Medical Royal Colleges, we are developing a new framework of generic professional capabilities – a common set of professional skills and behaviours – which every doctor will have to meet by the time they complete their training. Again, this framework emphasises the importance of patient safety. Over time the medical royal colleges will be updating their curricula for postgraduate medical education to ensure doctors in their specialties can meet these standards. Of course it’s important that we help doctors to sustain these professional skills and behaviours once they have developed them. That’s one of the driving principles behind revalidation. 

National training survey 

Finally, there is our national training survey. Doctors in training are a valued source of information for us, providing views from the frontline and flagging patient safety issues. Sir Robert Francis QC called them “the eyes and ears of the health service” and with good reason. Every year we provide doctors in training with the chance to share their perceptions of their education and the culture of the organisation in which they are placed. The results of this national survey – a rich source of patient safety intelligence for doctors, their employers and the organisations that regulate them – highlights the importance of doctors being trained in a supportive environment. 

Patient safety lies at the heart of medicine. Our challenge is to make sure that doctors feel supported to deliver safe and effective care on a daily basis. This requires changes to the way they are trained and educated. The challenge for employers is to ensure that the environments in which they train doctors are safe. Our new standards, Promoting excellence, will help them to do this and it is important they make them a priority. After all, a safe environment for training is a safe environment for patients.About the author 

Professor Terence Stephenson has spent most of his career specialising in paediatric medicine and paediatric emergencies. He still practises medicine and is currently Nuffield Professor of Child Health at the Institute of Child Health at University College London and an honorary consultant paediatrician at UCL Hospitals NHS FT & Great Ormond Street Hospital for Children NHS FT.

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