What is an approved learning environment?
In the context of GP education, an approved learning environment (LE) is one that provides training for GP resident doctors and has one or more approved educators.
Only NHS England approved LEs can train GP resident doctors. Practices can also be approved for other types of training (medical students, GP retainers, returners, and resident doctors) but we would encourage all practices to be approved to the standards of an LE in the Midlands.
Historically, individual practices would make a single application to NHS England to gain training status approval. Whilst single applications can still be made, approval has been gained for a larger footprint of GP practices working together (such as within a Primary Care Network (PCN) to be approved as a LE, subject to meeting certain quality and safety criteria.
It is important that the agreed safety standards for PCNs or ‘at scale’ learning environments evidence their understanding and planned adherence to these standards at the point of application, approval, and subsequent on-going quality monitoring.
Approved LEs should approach their local Higher Education Institution (HEI), GP training programme or GP school informally to discuss their aspirations to become a recognised learning environment.
However. the formal first-time application process begins by contacting the local training hub, informing them of the intention to apply and the completion of the application form or equivalent online process. The training hub’s Multi-Disciplinary Assessment Team (MDAT) facilitates the approval process.
Existing LEs wanting to expand the learner groups they host who have previously undergone a LE approval process which has followed NHS England’s Quality Framework or who are an existing learning environment would contact their local training hub to confirm if the use of the learning environment self-declaration process is appropriate. Discussions may also involve relevant HEI teams.
The recommendation for approval by the MDAT will then be reviewed and ratified by a Quality Recognition and Recommendation Panel (QRRP) at NHS England.
Training Hub multi-disciplinary assessment team
The Training Hub MDAT consists of a minimum of three members and must include at least one of the following:
- Training Hub quality lead
- clinical lead
- GPN lead
Other members may include a:
- representative from a HEI
- clinical ambassador
- GP associate dean (AD)
- training programme director (TPD)
- learner representative
- practice manager from an approved learning environment
The training hub will confirm the specific requirements, timeframes and support.
Quality recognition and recommendation panel
The Quality Recognition and Recommendation Panel (QRRP) is facilitated by NHSE and meets monthly.
The QRRP is facilitated by NHSE and meets monthly. The panel includes the chair (NHSE senior business manager), a primary care dean (PCD) or primary care associate dean (PCAD), a GP head of school, and a representative from a non-medical professional group. It reviews newly approved training sites to confirm additions/changes to rotations for Midlands training programmes.
If the learning environment has been approved before
The approval process is managed through the GP school:
- Educator approval is facilitated by the GP school (primary care and community team).
- An educator approval visit is carried out by the associate postgraduate dean (APD).
- Following approval, the ES record and GMC register are updated.
- GP trainer completes an annual GP educator self‑declaration.
If the learning environment has not been approved before
The process involves both the GP school and the NHSE Training Hubs:
- Educator approval is facilitated by the GP school
- An educator approval visit is carried out by the associate postgraduate dean (APD).
- GP trainer completes an annual GP educator self‑declaration, facilitated by the GP school.
- Learning environment approval is facilitated by the NHSE Training Hub.
- Training Hub submits an LE approval recommendation, which is ratified by NHSE GPREP.
- Learning environment completes an annual LE self‑declaration, facilitated by the Training Hub.
- ES record and GMC register are updated.
For more information, visit our Midlands learning environment approvals NHS Futures site.
Figure 1: Quality recognition and recommendation panel process.
Further information on the GP educator role primary care approved learning environments in the West Midlands.
Find out more about becoming an approved learning environment, your local Training Hub details, and the GP educator role in the West Midlands, click on our pages below: