Emergency Care Advanced Clinical Practitioners

No content found


What is credentialing?

Credentialing is a process whereby individuals provide evidence to demonstrate that they have achieved defined competencies. In the case of the Emergency Care ACP Curriculum, ACPs (predominantly nurses and paramedics working in emergency care) will use an e-portfolio to collect evidence against each requirement in the Emergency Care ACP curriculum. A trained panel will assess the evidence to decide whether the trainee ACP has achieved the defined competences required in the curriculum.

Who created the Emergency Care ACP curriculum?

The Emergency Care ACP curriculum was co-produced by the Royal College of Emergency Medicine (RCEM)/Health Education England (HEE) ACP Curriculum Development Group. For details of who attended this group, please visit the ‘Acknowledgements’ section of the curriculum.

Why did RCEM and HEE decide to co-produce an Emergency Care ACP curriculum? What are the benefits of this curriculum

The RCEM/HEE Emergency Medicine Workforce Implementation Group (EMWIG) had a number of work streams and subgroups with the intention to establish and develop a multi-professional workforce to meet future demands for emergency care. One working group under EMWIG was the RCEM/HEE ACP Working Group. Higher Education Institutions provide high quality Masters level courses in advanced practice. However, these do not include specialty specific competences or nationally defined curricula. There is variation in the range of competences acquired, and no standardisation of the level of competence of the practitioner.

A national curriculum provides standardisation and consistency, benefits to patient safety, and allows transferability of competences from employer to employer. The long term aim is that employers will have a workforce consisting of qualified, credentialed ACPs.

What are the benefits of credentialing?

Benefits of ACP credentialing are as follows: 

  • The ACP would be confirmed as having reached a nationally recognised standard of competence, as evidenced by WPBAs completed by consultants and supervisors in Emergency Medicine
  • An ACP with a RCEM approved credentialed portfolio would be recognised as they move geographical boundaries
  • A statement of competence would be possible which would detail what an ACP is competent to do within a defined scope of practice
  • Trainee ACPs will be working within a learning environment, the quality of which is overseen by Health Education England Quality Framework
  • The learning environment in the ED for junior doctors and other learners will be strengthened by credentialed ACPs resulting in patient safety benefits. 

Are there any events planned to discuss Emergency Care ACP developments?

There will be a conference in late 2018 which will be an opportunity for CPD, networking and hearing more about developments in the ACP workforce. 

Is the curriculum for England only, or all of the United Kingdom?

Whilst the curriculum has been co-produced by Health Education England and The Royal College of Emergency Medicine, it is available to applicants across the UK subject to approval by their employer.

Do I have to credential?

No you can register and utilise the portfolio without credentialing- it is useful as a tool to demonstrate progress, scope of practice and to collect evidence for revalidation. However we do recommend working towards credentialing for all ACPs and so would recommend ACPs reading the guidance on credentialing here as the time required to collect the evidence is considerable.

Who can apply for credentialing?

At the current time, only nurses and paramedics can be formally considered for credentialing. Other healthcare professionals working in emergency care are  welcome to register and use our portfolio and to use the curriculum as a guide to their emergency care skills development. 

Do I need an RCEM ePortfolio and Associate Membership (ACP) to be credentialed?

Yes, it is a mandatory requirement for ACPs who wish to be credentialed to have an ePortfolio and be registered as an associate with The Royal College of Emergency Medicine. Access to ePortfolio is a membership benefit and no separate charge is made. 

How do I get an ePortfolio and register for Associate Membership?

ACPs need to complete the online application form available on the RCEM website. To access the application form and to obtain more information about the fees and process, please visit our membership pages.

How do I apply for credentialing?

There are two application windows each year: one in Spring and one in Autumn.  Before applying, applicants and their named Educational Supervisors should make sure that all evidence detailed in that window's checklist is on ePortfolio.  The Spring 2019 application window is open from 22 February to 22 March - more details are available here.  The credentialing panel will sit on 17 May 2019. 

What is the cost for credentialing?

The fee for credentialing from 2018 is £295.00, payable at the time of application.  There will be no discount for re-application following an unsuccessful attempt.

Do I apply for credentialing/ePortfolio/associate membership once or every year?

  • Credentialing: ACPs are required to apply within the application window for the credentialing panel at which they wish to be assessed.  ACPs who are assessed and do not meet the required criteria to credential will be required to reapply for a future credentialing panel.
  • Associate membership: fees should be paid to RCEM annually to maintain associate membership and access to ePortfolio.

Can I use the RCEM ACP ePortfolio if I am an ACP not working in Emergency Care?

Only ACPs working in Emergency Care are eligible to register for the ePortfolio. ACPs in Paediatric Emergency Care are supported through the RCEM process. ACPs who work within other specialties should contact the ‘parent’ College for the specialty (e.g. for surgical specialties contact the Royal College of Surgeons).

I have used the RCEM ePortfolio for a number of years – but have used the ‘ACCS’ version on the system. Can I transfer my old ePortfolio content to the new ACP version of the ePortfolio?

Yes, but you will need to go through your current ACCS curriculum and re-link all items (WBAs and your personal library) to the appropriate ACP curriculum. Each equivalent curriculum item has the same code and name so this should hopefully aid the process. If you are experiencing difficulties please contact the ePortfolio team at the Royal College of Emergency Medicine.

I am a well-established ACP in emergency medicine with several years’ experience. Is there a mechanism in which I can be ‘signed off’ as having achieved the competences of the Emergency Care ACP curriculum without going through the credentialing process?

No, there is no separate ‘sign off’ /equivalence process for those with several years’ experience. The only mechanism to be credentialed is to be assessed and signed off against the Emergency Care ACP curriculum via the new credentialing process. Clearly you are still able to work as an ACP but to have the competences credentialed against the ACP curriculum, it is necessary to collect and provide evidence on ePortfolio, as set out in the curriculum.

What will the credentialing process be like? Do I attend in person? What am I required to submit? Who is on the panel? What paperwork is used?

Please see the 'Guide to Emergency Care ACP Credentialing' for full details on the requirements and process for credentialing.  ACPs should note that they are not required to attend in person. 

When I go through the credentialing process, can I get certain sections of the curriculum credentialed via the ePortfolio and related paperwork, or does the credentialing process require sign off of the whole curriculum?

The credentialing process signs off evidence against the curriculum as a whole; it is not intended to credential specific sections.

Can I use evidence that is more than 3 years old? I have worked for over 5 years as an ACP.

The majority of evidence should be within 36 months; however some evidence would be accepted if it is within 5 years and is accompanied by reflection on the progression of your skills in those 5 years. Likewise, if you have achieved courses that remain valid and ‘in-date’, then the relevant certificates may be uploaded to demonstrate achievement/competence. Where there is a clear expiry date, this is applicable and cannot be extended (e.g. ALS). 

What happens after I am credentialed?

Once you are credentialed, your name will be held on a register with the Royal College of Emergency Medicine, and you will receive a certificate of confirmation.

Has the credentialing pilot been evaluated?

Yes. Formal feedback was sought from those who have gone through the credentialing process, the trained assessors and others involved with the process. The ACP Working Group submitted an evaluation report to the College's Education Committee. The Education Committee made a recommendation to the College Council in July 2017 for the permanent continuation of the Emergency Care ACP Credential, which was approved. 

This is an important development for multiple stakeholders. How is this being communicated?

The communication strategy will allow discussion with and feedback from multiple stakeholders. With so many organisations and individuals interested this will take time. We would be pleased to hear from you, along with any initial feedback in the meantime: acp@rcem.ac.uk

Are Emergency Care ACPs a replacement for ACCS Emergency Medicine doctors?

No. It is noted that there are varying roles and responsibilities within the Emergency Department, and it is recognised that ACPs are part of the ED multi-professional team and are often key players in providing support and stability within the learning environment.  The credentialing process is not designed to produce senior decision makers. 

Is credentialing part of revalidation planning?

No, credentialing processes and revalidation processes are two separate stand-alone processes; however, evidence can be used across both processes. It is noted however that healthcare professionals, once they have obtained a specific, defined scope of practice, are accountable within the defined scope of practice. Accordingly, it is the responsibility of those credentialed to be able to account to the roles and responsibility they undertake and keep up to date with the requirements of the job.

Can I be credentialed if I am not able to prescribe independently?

In 2018 the legislation was approved to allow paramedics to undertake non-medical prescribing. From (and including) the autumn 2019 credentialing window, all ACPs wishing to credential will need to demonstrate their independent prescriber certificate. Until then, paramedics are only required to demonstrate that they have undertaken a pharmacology module. 

Do I have to have an ATLS course as a provider?

Although some ATLS courses will accept experienced ACPs as full providers, this is by no means every course and is subject to the course director's discretion. Consequently we would advise ACPs to seek out a European Trauma Course (ETC) in their locality as all these courses are multi-professional.   Paediatric only ACPs should note that they too must have an ATLS or ETC course certificate (in date).

I am an adult trained nurse – can I work as a Paed ACP?

Nurses who trained before project 2000 will have some paediatric base training although those trained more recently will not necessarily have had this. We would expect adult background nurse ACPs working with children to have undergone additional training in paediatric emergency medicine as appropriate. The scope or practice for ACPs is an individual employer responsibility to define. Providing the ACP submits sufficient quality evidence of the paediatric competences, credentialing as an adult/paediatric ACP will be possible.