The ‘diagnostic report’ sets out the current state of medical training and identifies 11 recommendations, including four key priorities: making training more flexible, building on excellence beyond formal routes, addressing damaging bottlenecks, and rebuilding inclusive team structures where doctors feel valued.
The report concludes that the gap between current practice and future needs is significant and that action must be taken. It goes on to outline a range of next steps, namely continued engagement with relevant bodies – including the medical royal colleges - and a set of principles to support this work.
RCPCH reflections
Royal College of Paediatrics and Child Health (RCPCH) welcomes the publication of NHS England’s Medical Training Review: Phase 1 Diagnostic Report and commends the extensive engagement undertaken to inform its findings. We understand that 8000 responses to the consultation were received, with the majority from resident doctors, – which demonstrates the importance of this work and ambition to get things right amongst the professions.
Members can find a copy of our submission to the review on the website. As an organisation, we are pleased to see that many of the themes and priorities identified through our submission are reflected in the report and its conclusions.
We particularly support the four key recommendations outlined:
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Making training more flexible
The RCPCH has long championed flexible training pathways, recognising the diverse needs of our doctors in training and the importance of work-life balance. We welcome the emphasis on flexibility and urge that reforms ensure equitable access to less-than-full-time training and portfolio careers across all specialties.
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Aligning training reform with paediatric workforce needs
Our submission emphasised the importance of ensuring that training reform is responsive to specific workforce challenges, particularly those facing paediatrics. These include a workforce under sustained pressure, with accelerating patient demand, increasing complexity, and extensive waiting times placing significant strain on services. Our submission highlighted that rota gaps, staff burnout, and unfilled vacancies are intensifying concerns about the sustainability of training.
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Supporting and Enabling Educators
We strongly support Recommendation 7, which calls for a strategy to deliver educators who are supported and enabled to train the future medical workforce in a fit-for-purpose environment, with transparent funding and reduced bureaucracy.
Our submission emphasised the critical role of educators in delivering high-quality paediatric training. However, we also highlighted the increasing pressures they face, including rising clinical demands, lack of protected time, and administrative burdens. These challenges risk undermining the sustainability of the educator workforce and the quality of training.
We welcome the call for transparent and sustainable funding for education and training roles, and urge NHS England to work with HEE, employers, and colleges to ensure that educators are given the time, resources, and recognition they need. Reducing unnecessary bureaucracy and streamlining processes will be essential to enable educators to focus on what matters most: supporting doctors in training and delivering excellent care.
We also note the report’s emphasis on the need for systemic reform rather than incremental change, however as with previous reforms, we will remain positively cautious that this one will have the progressive aims intended. At the same time, to embed any long- term success, the reforms must be supported and fully invested in by government using a strong action plan over time.
Paediatrics, as a specialty with a strong track record in curriculum innovation and trainee support, stands ready to contribute to the next phase of the review. We urge that future reforms be co-designed with doctors in training, educators, and importantly with patients including children, young people and their families, and that they reflect the unique needs of child health services. Children and young people are a unique group, so the doctors who care for them must have their training requirements specifically considered with their needs in mind. Finally, it is useful to see NHS England’s commitment to continued collaboration with medical royal colleges and we look forward to working with NHS England, the GMC, postgraduate deans, and other stakeholders to shape a training system that is fit for the future and delivers the best outcomes for children and young people.
As an organisation we are working hard to support the paediatric and child health workforce through its training and further forward into their life long careers. We are also submitting evidence to the new 10 Year Workforce Plan announced by the Department of Health and Social Care and have established a Child Health Workforce Alliance, bringing together over 25 organisations. Members can find out more information on our workforce calls to government, and our Thrive Paediatrics hub.