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Shape of Training Review

The Shape of Training Review was chaired by Sir David Greenaway and reported in October 2013. Work on implementation continues.

Statement issued 17 February 2015 by the UK Shape of Training Steering Group:

The report of the independent Shape of Training Review, led by Professor Sir David Greenaway, was published in October 2013. The review was established to understand whether the way in which doctors are trained meets the current and future healthcare needs of patients across the UK. As the healthcare needs and expectations of patients are changing and the way services are delivered will evolve, Professor Greenaway’s review outlined 19 recommendations to the UK Governments suggesting how changes to the structure of medical training can help deliver high quality care for the future.

UK Health Ministers asked officials to consider the recommendations and make policy proposals, where possible, on the basis of a four-nation consensus. A UK Shape of Training Steering Group (STSG) was convened for this purpose. In 2014, the STSG organised six UK-wide stakeholder workshops to explore how the recommendations arising from the report might work in practice.

UK Health Ministers broadly welcomed the report and they have now approved development activity which will explore how medical training might be adapted to meet future patient and service needs under the umbrella of the Shape of Training initiative. This will be taken forward in a planned way, and overseen by the STSG to maintain consistency and ensure appropriate stakeholder engagement. This work will be supported by an impact analysis.

Specifically, the STSG has endorsed the following general and specific proposals:
those aspects of the current training system that have been shown to work well and are fit for purpose should remain;

  • any significant changes to medical training should be consistent with the key principles outlined within the Greenaway report, and taken forward in a measured and incremental way to avoid service and training disruption;
  • any significant changes to medical training such as alterations to curricula must reflect the UK basis of medical training and be approved by the GMC;
  • Groups should be developed in each country with appropriate stakeholder representation, with the remit to develop proposals as agreed by Ministers through the STSG, taking account of the different strategic priorities and requirements in each country; and
  • to expand its membership to include representation from the BMA, Employers, Patients, doctors in training and Chairs of each countries groups.

The next steps will focus on the following specific activities:
a) further work will be undertaken to describe how doctors’ training can be more generic to better meet the current and future needs of patients. This will
include a mapping exercise led by the Academy of Medical Royal Colleges
and supported by the GMC to look at the extent to which Colleges have or
can develop the generic components of their curricula

b) measures to be scoped out, based on evidence collected through pilots, how
to further develop the careers of doctors who are outside formal postgraduate
training and who are not consultants, such as SAS grade doctors;

c) measures to better prepare doctors to work across the interface between
primary, secondary care and the community with more flexibility in training
between the sectors ; and

d) the STSG will support the GMC as they develop and pilot credentialing
working with all stakeholders with an interest in this aspect of Shape of

Patients, service users and healthcare professionals should be assured that any
proposed changes to training will be properly considered, modelled and costed and
consulted upon before any changes are made. Patients’ interests will be at the heart
of any proposals.