Approval of primary care approved learning environments in the East Midlands

What is an approved learning environment?

In the context of GP training, an approved learning environment (LE) provides training for GP residents and has one or more approved trainers. Only NHS England (NHSE) approved LEs can train GP residents. Practices can also be approved for other types of training (medical students, GP retainers, returners, and foundation 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 NHSE Workforce, Training, and Education (WT&E) 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 learning environment, 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 ongoing quality monitoring.

Approved learning environments 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 their local training hub, informing them of the intention to apply, and completing the learning environment application form or equivalent online process.

The training hub’s Multi-Disciplinary Assessment Team (MDAT) facilitates the approval process. Learning environments that want to expand the learner groups they host who have previously undergone a learning environments approval process that has followed the NHSE Quality Framework or those in an existing primary care approved learning environment would contact their local training hub to confirm if the use of the learning environment self-declaration process is appropriate. Discussions may 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: the Training Hub Quality Lead, Clinical Lead, or GP Nurse Lead. Other members may include a representative from a HEI, Clinical Ambassador, GP Associate Dean (AD), Training Programme Director (TPD), Learner Representative, or a Practice Manager from an approved learning environment. The training hub will confirm the specific requirements, timeframes, and support.

Quality recognition and recommendation panel

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:

1. Educator approval is facilitated by the GP School (Primary Care & Community Team).
2. An educator approval visit is carried out by the Associate Postgraduate Dean (APD).
3. Following approval, the ES record and GMC register are updated.
4. 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:

1. Educator approval is facilitated by the GP School
2. An educator approval visit is carried out by the Associate Postgraduate Dean (APD).
3. GP Trainer completes an annual GP educator self‑declaration, facilitated by the GP School.
4. Learning environment approval is facilitated by the NHSE training hub.
5. Training hub submits an LE approval recommendation, which is ratified by NHSE GPREP/
6. Learning environment completes an annual LE self‑declaration, facilitated by the training hub.
7. 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 primary care approved learning environments and GP educators in the East Midlands

Find out more about becoming an approved learning environment, your local training hubs details, and the GP educator role in the East Midlands, click on our pages below.