Advanced Clinical Practitioners - Emergency Care
Emergency Care Advanced Clinical Practitioner Curriculum
The Royal College of Emergency Medicine (RCEM) and Health Education England (HEE) are pleased to announce their co-production of an Emergency Care Advanced Clinical Practitioner (ACP) Curriculum, which has full endorsement by the Royal College of Nursing (RCN).
The pilot curriculum has been developed by a working party with representatives from Health Education England, the Royal College of Emergency Medicine and specialists in Emergency Care, and was published in May 2015.
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. The Emergency Care Advanced Clinical Practitioner (ACP) curriculum provides an opportunity for standardisation and consistency.
EC ACP curriculum (Adult and Paediatric)
EC ACP curriculum (Adult only)
EC ACP curriculum (Paediatric only)
An Assessment Descriptors document is a supplement to the curriculum.
A formal process has now been established in order that Emergency Care ACPs can demonstrate the competences required within the curriculum. The first, formal credentialing process took place in June 2016, with ACPs gaining access to the Royal College of Emergency Medicine e-portfolio (adapted for Emergency Care ACPs) from June 2015.
Robert Crouch, Consultant Nurse at University Hospital Southampton NHS Foundation Trust and Chair of the HEE/RCEM Emergency Care ACP Curriculum Development Group commented, “This has been a very positive development for RCEM and HEE, and we are pleased to have received wide-spread support for this development from so many individuals and organisations, including the Royal College of Nursing. I am particularly grateful to the Curriculum Development Group for their hard work and enthusiasm throughout this development”.
Trainee Emergency Care Advanced Clinical Practitioner (EC-ACP), established ACPs who wish to credential, and supervisors who are providing the clinical and educational support for the EC-ACP process should refer to The Guide to RCEM Emergency Care ACP Credentialing
for further guidance on the process and documentation to be used..
The Emergency Medicine Advanced Clinical Practitioners’ Forum is a new and exciting initiative intended to provide a focus and representation for ACPs and trainee ACPs (tACPs) within the College.
More information can be found here
We are undertaking virtual meetings at the moment, due to the COVID-19 crisis.
You can access recordings of the meetings here. Please note that this access is only available to current members of RCEM.
Online ACP Teaching sessions
We are also holding online teaching sessions for ACPs.
You can access recordings of these sessions here. Please note that this access is only available to current members of RCEM.
The College is committed to supporting a multi-professional workforce, including Advanced Clinical Practitioners. Developing a programme of development for ACPs is a huge amount of work and is not simply about preparing for credentialing. The work cannot be underestimated and it may be helpful to visit or speak to leads where there are established programmes to hear about the challenges and solutions. Most regions also have an ACP lead or a long established site where there will be someone to give advice –this practical programme advice is not within the remit of the ACP Credentialing Panel or the ACP forum.
The clinical and educational supervision of an individual ACP is also a time consuming role, usually over three years or more. This is not unlike developing our medical trainees or any other group, so similar principles apply of enabling attendance at formal teaching, shop floor supervision, completion of workplace based assessment and some kind of annual review of practice and keeping up-to-date. Supervision is about feedback and support for developing skills and must not focus only on the portfolio and evidence, but on the individual developing clinical competence to the ST3 equivalent level.
Emergency Care ACP Supervisor Training Day
The next EC-ACP Supervisor Training day will be held on 11 November 2020. This will be hosted remotely due to Covid-19. Registration is now open
Please note that this training is aimed at ACP Supervisors who will be signing off the final ACP credentialing checklist. It is not suitable for ACPs intending to credential. If you are a credentialed ACP currently supervising tACPs and wish to attend this training, please email email@example.com prior to registering.
Presentations from the RCEM EC-ACP Supervisor Training Day which took place on 13 September 2019 can be downloaded below:
Session 1: Outline of the credentialing process
Session 2: The nature of supervision
Session 3: The portfolio and curriculum
Session 4: Common competences
Session 5: Major and acute presentations
Session 6: MastersPGDip, academic declaration, CV and experience needed
Session 7: Practical procedures
Session 8: The STR and FGS
Session 9: The checklists
We recommend that all educational supervisors of ACPs complete the RCEM ACP Supervisor Training but recognise that this may not have been possible at the beginning of supervision for current tACPs. We are providing three training days in 2020 to offer maximum flexibility to colleagues, and would anticipate that all supervisors complete training over the next 12-18 months. The final sign-off for credentialing must be by a trained RCEM supervisor who understands the final credentialing process. This should be the educational supervisor who has worked with the ACP over the years and is able to evaluate their performance in the workplace and agree, with the other members of the supervising faculty, that they are ready to credential. In exceptional circumstances it may be possible for an educational supervisor who has been trained from a neighbouring department to complete the sign-off if there is no one formally trained at the site. However this will only be acceptable if there has been a documented meeting with the local ES and ACP and that there is evidence that the visiting supervisor has properly reviewed all evidence and seen the ACP in practise at some point. This is likely to take 6-8 hours and a meeting of a minimum of 2 hours to discuss the evidence.
Emergency Care ACP credentialing process from 2018
A new process was introduced in 2018 following a successful pilot. From 2018 there will be no face-to-face meeting between assessors and applicants and there will be no detailed feedback before the credentialing day. ACPs who wish to apply must be confident, along with their supervisors, that they will have appropriate evidence on ePortfolio before the end of the application window (anything uploaded afterwards will not count) of acquisition of all required competences. Please refer to the guidance for further information.
New credentialing application fee structure from Autumn 2020
A new application fee structure will be introduced for the Autumn 2020 credentialing window:
New application: £295
Full resubmission (for ACPs who have received a prior “unsuccessful” outcome, or a “limited resubmission” outcome awarded prior to the Spring 2020 credentialing window): £295
Limited resubmission (for ACPs who received a “limited resubmission” outcome in the Spring 2020 credentialing window): £75
NB: if a “limited resubmission” outcome was awarded prior to the Spring 2020 credentialing window, the application will be recognised as a “full resubmission”
ACPs, Credentialing and COVID
Candidates for the Autumn 2020 window should continue to collect evidence in their portfolio and work towards submission for credentialing which will open on 28 August 2020 with the panel meeting on 12 November 2020.
ACPs who are nearing completion of the portfolio will be anxious about access to mandatory courses and workplace based assessments. We recognise that there is a significant reduction in opportunities for WPBAs and possibly for supervision meetings. The chief priorities are clinical safety and patient/staff wellbeing. We would recommend supervision meetings by Skype or other electronic device - it is critical to continue to seek the guidance and support of your educational supervisor at this time.
However, as the process for credentialing is purely based on examination of evidence, there will be no opportunity for a change in the amount and type of evidence required. This may mean that applicants will need to defer their application for 6 months until Spring 2021. We will apply the rules for currency of evidence (all within 5 years and majority in 3) flexibly for each individual.
In addition, and specifically relating to mandatory courses (and those only), a life support course booked for within 6 months of the credentialing date with evidence of the place allocated will be accepted and the credential approved AFTER the submission of successful completion of the course.
The guidance on the RCEM website will provide information on all other aspects of credentialing. We anticipate that the Spring 2021 credentialing window will be significantly large, so we advise ACPs to apply early once the window opens.
Autumn 2020 EC-ACP Credentialing application window
The application window for the Autumn 2020 EC-ACP credentialing opportunity will open on Friday 28 August and close at midnight on Friday 11 September. The ACP credentialing Panel will meet on 12 November 2020. Please ensure all evidence is uploaded to your ePortfolio no later than midnight on Friday 11 September. Any evidence uploaded after this date will not be accepted.
Click to submit
Autumn 2020 checklists
Checklists for Autumn 2020 can be downloaded below. Please ensure you use the correct checklist and upload all pages to your ePortfolio. Previous versions of the checklist, i.e. valid for windows prior to Autumn 2020 will be refused. Please note that only the relevant item(s) of evidence should be listed on the checklist. The ACP's Educational Supervisor must sign the checklist and confirm that all required evidence is present.
ACP seeing both adults and children
ACP seeing adults only
ACP seeing children only
ACPs should note the following changes / clarification for Autumn 2020:
- STR and FEGS: an STR and FEGS must be provided for each year of training declared (three required over three years). Previous checklists stipulated that an STR and FEGS should be provided for each year of training but did not specify the number. If an ACP cannot provide three FEGS/STRs, the final FEGS and STR must explain why there is no training record for the previous years.
- For ACPs wishing to credential in both adults and children, there must be sufficient evidence relating to the care of children. There should be evidence in all competences of consideration of children with this presentation and approximately 25% of all mandated adult assessments must have an additional assessment in a child.
- PP16 and PP17 must be different cases. This was also clarified in the Spring 2020 checklists.
- C3AP2a and C3AP2b require one for upper limb and one for lower limb. This has always been the requirement, but this is further clarified in the Autumn 2020 checklists.
- There must be three MSF summary reports – one MSF per year. Previous checklists indicated that one MSF was required per year but did not specifically state three were required.
Please note that a new pre-screening process and an updated academic declaration form have been introduced:
- Academic Component Declaration Form: this now requires the ACP to indicate which module of their level 7 Advanced Practice degree met each RCEM academic learning outcome. Failure to complete this new form will mean the portfolio is not considered. Previous versions of this form will not be accepted.
- Pre-screening: Due to the volume of portfolios to be reviewed, a pre-screening process has been introduced. This process, undertaken by the College staff, will identify portfolios where there is evidence clearly missing according to the screening checklist.
Having confirmed the evidence is missing, the Credentialing Panel will reject the application and the ACP will have to resubmit (for a full fee and against the guidance and checklist valid at the time) within a future credentialing window. A small administrative charge will be retained from the application fee.
Credentialing applicants should pay particular attention to the following elements of their portfolios of evidence:
- Supervisor signing off the portfolio must have attended the RCEM ACP Supervisor Training (please see above)
- Correct academic declaration is completed with the learning outcomes mapped
- The correct checklist (see above to download) is used, and the complete checklist is uploaded
- There is clear evidence in the CV of three years of complete practice as a tACP at the time of submission (minimum 30 hours per week pro-rata in EM)
- Checklist has only one item listed per competence (or two if adult and child)
- Each item in curriculum should have max 7 items (excluding e-learning) - more may be accepted for Common Competences (within reason)
- Common competences are signed off at appropriate level – i.e. the majority at level 2 with only a few at level 4
- Mandatory courses are in date
- FEGS and STR are present for each year of training - three required over three years. If an ACP cannot provide three FEGS/STRs, the final FEGS and STR must explain why there is no training record for the previous years.
- There is an appropriate balance of mini-CEX and CBD in consultant assessments – approx. 50:50
- Scanned documents should be PDF format
- MSF: this should be the summary report only - not individual forms
- All documents have any patient identifiable information removed, including hospital numbers
- Examination of the joint must be a different assessment to the manipulation assessment
- If adult and child application – there must be evidence of experience in children in the patient log/CV and some additional evidence of paediatric cases within the adult competences that are not replicated in the children’s curriculum
- You do not need to email the checklist as well as upload; however,the checklist should be uploaded as a Word document, rather than a PDF
- All applicants must have prescribing competences
- Presentations from our recent Emergency Care ACP Conference:
- To register your interest for the Emergency Care ACP credentialing process, please complete the online registration form available from here. EC ACPs who register must also become a member of the College (category Associate Member (ACP)).
- Please see the tab above for FAQs on the Emergency Care ACP. This will be updated as questions are raised throughout the implementation of the curriculum and credentialing process.
- Have a question? Please write to firstname.lastname@example.org
For information on access to the RCEM e-portfolio adapted for Emergency Care ACPs/Associate Membership (ACP), please see the initial application form.
The College has an eLearning resource, RCEMLearning
, content of which has been mapped to the curriculum. For information about accessing the RCEMLearning
site, please contact RCEMLearning@rcem.ac.uk