- Credential terminology
- Credential characteristics
- Governance and decision-making
- Credential development
- Credential delivery
What does ‘credential’ mean?
In the context of the Centre for Advancing Practice, ‘credential’ means a standardised unit of learning in a particular area of practice that meets a specific, high-priority workforce development need not currently met at scale by other education provision. It is therefore used as a noun.
Credentials support the advanced practice and broader workforce transformation agendas by facilitating workforce development and deployment to increase responsiveness to population/patient care and service delivery needs.
Individuals listed on the Centre’s directory of practitioners have their successful completion of credentials annotated on their directory record.
What does ‘credential’ not mean?
It is important to be clear how ‘credential’ is not used by the Centre. In particular, it is not used as a verb (as in ‘to credential’), while neither a unit of learning nor an individual practitioner is ‘credentialed’. This is because the Centre is neither awarding credentials to individual practitioners, nor credentialing individual practitioners.
The Centre’s specific use of the term credential fits with HEE’s role and focus to assure the quality of advanced practice education and training in England. Other organisations use terms relating to credentials in different ways. This includes to credential individuals, including as part of individuals’ CPD, or regulating credentials as part of a profession’s specialty training.
In line with the Centre’s specific use of the term ‘credential’, the lack of endorsement of other provision as credentials is not a reflection of its quality or value. It is not HEE’s plan that all education provision relating to advanced practice should be developed or recognised as credentials. Rather, credentials – as structured, standardised units of learning – are just one way in which workforce skill mix can be accelerated to respond to high-priority patient and service needs.
How is credential recognition described?
Different terms are used to distinguish different types of credential recognition in Centre activity. These are as follows:
- ‘Endorsement’ or ‘endorsed’ denotes that a credential, as a unit of learning, is recognised by HEE via the Centre for Advancing Practice.
- ‘Approval’ or ‘approved’ denotes that a provider (e.g. a university) is recognised as having met the criteria to deliver a specific endorsed credential.
- ‘Annotation’ denotes that a practitioner on the Centre directory has successfully completed an endorsed credential delivered by an approved provider.
Other units of learning may be developed and delivered that are not put forward for Centre endorsement as a credential, or for which Centre endorsement is not conferred. However, they may be recognised as credentials by other organisations.
What is the Centre’s credential approval and assurance process?
The term ‘approval and assurance process’ describes all stages, processes and requirements of the Centre’s approach to credential recognition. The process is designed to ensure that the Centre’s focus is on meeting high-priority workforce development needs, upholding quality, and maintaining probity, transparency and consistency.
The process covers the following:
- Calls for submitting credential proposals.
- Considering credential proposals against the gateway and prioritisation criteria to determine which should be progressed for supported development as full credential specifications.
- Supporting the development of selected credential proposals for full development as a credential specification.
- Considering fully-developed credential specifications against the endorsement criteria and conferring endorsement on those that fully meet the criteria.
- Launching endorsed credentials for delivery, including by listing on the Centre’s education provision directory.
- Considering and approving providers to deliver endorsed credentials.
- Recording practitioners’ successful completion of endorsed credentials on the Centre’s practitioner directory.
- Annual reporting requirements and the periodic review of endorsed credentials and their delivery, including with a view to renewing endorsement and approval.
- Evaluation of the value and impact of endorsed credentials.
What are other key terms in the Centre’s credential approach?
The credential approval and assurance process is underpinned by a full glossary of terms; see Appendix E. The glossary explains the intended meaning of key terms and how key components of the framework and its stages and requirements are described.
What can be a credential?
Prospective credentials need to address all the following:
- A high-priority workforce development need (e.g. in terms of supporting a new model of care, implementation of technological advances or changes to skill mix and workforce deployment, or addressing an identified risk to safe, effective patient care).
- A workforce development need that reflects the demands of advanced-level practice, as expressed in HEE’s multi-professional advanced clinical practice capability framework; see Advanced Practice Framework .
- An area of workforce development need that exists at scale.
A workforce development that is not currently met by established education provision.
What does a credential define?
A credential specification defines a distinctive, structured and standardised unit of learning in a particular area of practice. As such, it needs to set out the following:
- The specific capabilities required to perform the professional entrustable activity/ies in the particular area of practice.
- The indicative learning content, volume and intended learning outcomes to develop these capabilities.
- How the learning outcomes should be assessed to demonstrate fulfilment of the specific capabilities, ensuring due consistency, reliability, validity and fairness in the assessment process.
How the intended learning outcomes and their assessment reflect the key attributes of advanced-level practice capabilities, particularly in terms of managing high levels of complexity, uncertainty, unpredictability and risk.
How do credentials relate to advanced practice?
Credentials align strongly with the advanced practice agenda. Both support workforce transformation by addressing workforce development needs so that existing or emerging patient care and service delivery needs can be met in sustainable ways.
Credentials contribute to advanced practice workforce development by addressing the following:
- High-priority workforce development needs to meet patient care and service delivery needs.
- Developing advanced practice capability in a particular area of practice, with an emphasis on the capabilities required to manage complexity, uncertainty, unpredictability and risk in that area.
Standardising structured units of learning for delivery by multiple providers to meet workforce development needs effectively, efficiently and at scale.
How do credentials relate to workforce development needs?
The key characteristic of credentials are that they each address a distinctive, high-priority workforce development need that exists at scale and is not met currently by existing education provision. Depending on the workforce need that they are designed to address, credentials can form the following:
- A complete route to advanced practice recognition in a particular area of practice – that is either fully captured in a route within an advanced practice Master’s programme or that is a combination of a generic advanced practice Master’s programme, with additional components relating to its area of focus.
- A component of individual practitioners’ pathway of learning towards advanced practice status (either as a unit of learning, or module, within an advanced practice Master’s degree, or as part of a practitioner’s evidence through the portfolio route to recognition).
- An independent unit of learning that, while not fulfilling advanced practice recognition requirements in isolation, can contribute to this (e.g. through a practitioner adding it to their evidence in pursing the portfolio route).
- A component of advanced practitioners’ CPD, including if they move roles and/or respond to changing needs in service delivery, practice and models of care.
The on-going need for and focus of endorsed credentials has to be kept under active review, recognising that workforce development needs evolve in line with changes in population and patient needs, models of care and service delivery. This forms a key focus within the Centre’s quality assurance and enhancement arrangements.
While credentials are designed to support workforce development and deployment to meet patient care and service delivery needs, they are not intended to define new professional or occupational roles.
Do credentials have to be at a particular academic level?
In line with the attributes and demands of advanced-level practice, credentials should usually be at level 7 (and potentially at level 8). This fits with credentials’ focus on developing workforce capacity and capability to take responsibility for the following:
- Managing complexity, uncertainty, unpredictability and risk as an independent practitioner.
- Entrustable professional activity/ties that are central to meeting population/patient care needs in the particular area of practice/service delivery.
- Delivering and developing services, with a strong focus on quality improvement.
- Engaging in evidence-based practice, technological advances and changes in population/patient need.
- Supporting others’ learning and development.
If a credential is not at level 7 (or above), the following needs to be clear:
- Why it should exist as a credential (e.g. to meet a particular workforce development or deployment need, or a requirement relating to this)
- How it relates to advanced-level practice (e.g. by holding recognition as an advanced-level practitioner being a pre-requisite to undertaking the credential, and the reason for this).
- Expectations of how it is applied within advanced-level practice (including the demands of practice that it relates to fulfilling).
The Centre’s approach to credentials is focused on advanced-level practice (and advancing practice more broadly). This fits with its remit. However, there is the potential to consider the potential value of the credential model to support workforce development and deployment at other levels of practice.
How do credentials relate to Centre programme accreditation?
Universities are strongly encouraged to integrate endorsed credentials into their advanced practice provision to meet priority workforce development needs.
The Centre’s processes for accrediting programmes and approving the delivery of endorsed credentials are closely aligned. This is to ensure efficiencies in how HEIs can engage with the Centre’s quality assurance and enhancement requirements across programme accreditation and approved credential delivery.
Can only HEIs deliver credentials?
No. Credentials can be delivered by education providers other than HEIs providing that they can demonstrate fulfilment of the Centre’s criteria for approval. This means that they need to be able to demonstrate that they have the capability and capacity to deliver a credential fully in line with the endorsed credential specification.
Particular areas of focus are that a prospective provider has the expertise, resources and quality assurance mechanisms to ensure the delivery of high-quality learning and assessment (with an appropriate clinical focus) in line with the specific credential learning outcomes, curriculum framework and syllabus.
Providers other than HEIs could include employers, HEE training hubs and faculties and could include different organisations working in partnership with one another (e.g. an HEI working with local employers) providing that the nature of the arrangements and the quality assurance of these is clear.
Does a credential have to be a certain size?
No. The Centre’s criteria for what can be developed and endorsed as a credential are intentionally broad. They are focused on addressing workforce development priorities that can be met through a standardised unit of learning, with any one credential needing to meet the defined workforce development need in a full, but proportionate way.
The Centre does not define the minimum or maximum size of credentials in terms of the amount of learning effort involved (e.g. as an expression of an indicative number of hours). The size of each credential needs to be defined by the notional volume of learning involved in developing the defined capabilities to perform the entrustable professional activity in the particular area of practice. This means the following:
- A very small unit of learning can form a credential, if its scope and volume can meet the defined workforce development need safely and effectively.
- A credential can comprise a full Master’s degree that meets the Centre’s requirements for programme accreditation (against the ACP capabilities), plus additional components that are specific to the area of practice that forms its focus.
- A credential can comprise a series of components of learning that combined meet the workforce development need in a particular area of practice; this might be a mix of uni- and professional components that all have to be completed successfully and which are defined as pre- or co-requisites.
- Any one credential must avoid duplicating the content of another, with pre- and/or co-requisites defined to link components of learning to avoid this.
What can and can’t form the focus of a credential?
Credentials recognised through the Centre’s process cannot relate to a specific task, competence or technical proficiency or address these elements in isolation from all that contributes to safe, effective service delivery and patient care in advanced-level practice. Rather, they need to relate to the capabilities required to perform a professional entrustable activity or activities in a specific area of practice.
Credentials must do one or both of the following:
- Develop and require the demonstration of key characteristics of advanced level practice within the area of focus, with a particular focus on managing complexity, uncertainty, unpredictability and risk, underpinned by engagement in evidence-based practice.
- Specify as a pre-requisite that the target group is only individuals who already hold advanced-level practice capabilities in a relevant area of practice, such that they are able and required to apply this capability to how they engage with the focus of the credential.
Does approved credential delivery have to be credit-rated?
No. However, HEE expects endorsed credentials mostly to be delivered by universities, with credentials usually integrated into institutions’ accredited advanced practice provision. In this context, credentials, as learning provision, will usually be conferred a credit-rating (usually at level 7).
The notional volume of effort involved in completing a credential will inform the credit-rating awarded. However, HEE recognises that credit is for individual HEIs to confer at their discretion, in line with their institutional policies and based on the specific ways in which they deliver the credential as a unit of learning. There may therefore be some variation in the credit conferred on credentials by individual institutions.
Do credentials have to have a multi-professional target group?
No. However, it is expected that most credentials will be relevant to more than one profession, with uni-professional credentials being the exception, rather than the norm. For a credential to be uni-professional, it needs to be demonstrated that it reflects a high-priority workforce development need, that exists at scale and is not already addressed by other provision and which can currently only safely be met by one profession. If the case, the potential for the credential to be safely developed to relate to other professions in the longer-term would be kept under active review as part of the Centre’s quality assurance and enhancement (QAE) processes.
For all credentials, the following needs to be demonstrated:
- Its development has been informed by an appropriate breadth of expertise, including from a public/patient involvement (PPI) perspective and all professional groups that have a relevant perspective on its requirements as a unit of learning; this includes professions that sit outside the target group when they have an important perspective on what needs to be included in the unit of learning and what needs to form key focuses in its intended learning outcomes and assessment to ensure safe, effective workforce development.
- The approach, content and delivery must promote and require inter-professional collaboration to meet population/patient care needs in safe, effective ways (in whatever ways are relevant to this in the particular area of practice).
- It avoids unnecessary duplication with other credentials (e.g. if it is a uni-professional credential, it needs to link with other available credentials that cover relevant areas of capability, rather than repeating content).
The potential to broaden all credentials’ target group to meet patient care and service delivery needs safely and effectively is considered as an integral part of the Centre’s periodic review process. This forms a key part of ensuring that all credentials remain current, relevant and fit for purpose, taking account of changing population/patient needs, models of care, service delivery environments and individual professions’ scope of practice
How should multi-professional needs be met in a single credential?
Credential specifications need to explain the professions (the defined ‘target group’) for which the unit of learning is relevant. The target group should be determined by how the defined workforce development needs can be met safely and effectively, building on the scope of practice and capabilities of each profession.
Credentials must have an inclusive target group, enabling all professions that can safely and effectively contribute to meeting service delivery and patient care needs to access and undertake them, and with inclusive approaches taken to how learning is developed and assessed.
At the same time, it must be ensured that the target group is not so diverse that it risks safe, effective learning being supported and assessed, or risks individual practitioners being admitted without a reasonable, fair prospect of completing it successfully.
If a credential has a focus that means that some professions and practitioners would be at risk of entering the unit of learning with significant gaps in their knowledge, skills and understanding, appropriate pre-requisites should be defined to standardise the point of entry.
All the above sits with putting patient safety first and expediting effective workforce development.
For which professions are credentials intended?
The Centre’s current focus is on credentials to develop the workforce within regulated non-medical professions. However, credentials also be developed that are inclusive of medicine, where workforce development needs are shared.
Over time, consideration will also be given to extending the inclusivity of arrangements to professions that are not currently subject to statutory regulation.
Do credentials have to relate to a particular area of clinical practice?
Not necessarily. While credentials will, for the most part, relate to a particular area of clinical practice for which there is a defined, high-priority workforce development need, proposals for credentials in more generic areas of practice can also be considered. Such proposals need to set out how a credential in the area of focus would do the following:
- Address a priority workforce development need that relates to one or more of the pillars of advanced practice and is materially relevant to enhancing service delivery and patient care in defined, sustainable ways (i.e. by expanding workforce capacity to lead and develop services to enhance their efficacy, effectiveness and efficiency).
- Meet a new or emerging workforce development need that exists at scale.
Address a need that is not currently met at scale through existing education provision.
How can credentials be used, once endorsed?
Endorsed credentials are intended to be used by education providers to support their curriculum design and delivery and to enable standardised learning provision in areas that form high-priority, at-scale areas of workforce development. To deliver an endorsed credential as an approved provider, education providers need to seek and secure approval from the Centre.
Approved providers need to confirm practitioners’ successful completion of credentials through appropriate data-sharing agreements. The Centre will then annotate its Directory of Practitioners to indicate individuals’ acquisition of specific credentials. However, it will not maintain a directory of all practitioners who successfully complete credentials.
If an education provider delivers a Centre-endorsed credential without securing Centre approval, practitioners who complete it successfully will not be able to secure annotation of this on their Centre directory record as a matter of course. However, the potential to be able to give recognition drawing upon the Centre’s portfolio route to practitioner recognition will be considered.
How is the currency of endorsed credentials kept under review?
The Centre’s quality assurance and enhancement processes have a strong focus on whether individual endorsed credentials continue to respond to the high-priority workforce development need for which each was designed, whether the workforce development need continues to exist at scale, and whether the credential in its endorsed format continues to develop and assess high-quality, up-to-date, relevant learning.
The Centre’s quality assurance and enhancement (QAE) processes have a particular focus on the following:
- Whether a credential reflects the latest research and evidence, technological advances and models of care, and how it needs to be updated to do this.
- Whether a credential continues to support workforce deployment, flexibility and mobility, and how it may need to be updated to do this in light of changing needs.
Whether the continued need for a credential has fallen away, for positive reasons; e.g. in the context of wider education developments that mean its learning and development focuses have been integrated within pre- and/or post-registration education for the relevant professions.
How do credentials relate to existing education provision?
Existing education provision in a particular area of practice (e.g. a module or modules within an advanced practice Master’s degree) can form the starting-point for developing a credential proposal and for developing this into a full credential specification. However, the gateway and endorsement criteria still need to be fully met.
The providers of an original module or modules must be willing to do the following:
- Work with others with appropriate expertise to develop the full credential specification, including to develop a structured unit of learning that has the potential to be delivered by multiple education providers to meet workforce development needs at scale.
- Make the credential specification available as open-source material for use by other education providers, rather than something for which they would hold intellectual property rights.
Should all education provision conform to the credential approach?
No. Credentials are not intended to replace previous approaches to education provision relating to advanced practice workforce development. Likewise, there is no expectation that all education provision has or needs to be developed to fulfil the requirements attached to Centre endorsement as a credential.
Endorsed credentials are just one approach to meeting high-priority workforce development needs; i.e.
- That exist at scale.
- Are not met by existing provision.
For which standardised, structured units of learning form a logical, valid approach.
How do credentials relate to existing capability, competence and curriculum frameworks?
Existing competence, capability and curriculum frameworks can form the starting-point for the development of a credential proposal and specification. However, they will need to demonstrate fulfilment of the gateway and endorsement criteria. The developers of such frameworks also need to be willing for them to used as the basis for developing open-source material (credential specifications) over which they do not hold intellectual property rights.
For area-specific capability resources for which the HEE has already provided support, or for which HEE is currently supporting their development, specific activity is being undertaken to apply the Centre’s endorsement criteria to them. This activity is being progressed to balance taking a pragmatic approach with ensuring proportionate rigour.
HEE is working with individual development groups to enact bespoke arrangements for considering existing material for endorsement. This process will take as read that the gateway criteria have been met and focus on how the material, as a full credential specification, meets the endorsement criteria.
As part of launching full implementation of the Centre credential arrangements, HEE will define the point from which all prospective credentials will need to go through the full approval and assurance process to determine which proposals should receive HEE support for development as full credential specifications.
Likewise, HEE will define how resources endorsed as credentials through the Centre’s pilot activity will become subject to the quality review and evaluation of impact stages of the approval and assurance process.
How should credentials be used in advanced practice provision?
Credentials are designed to support the progression and recognition of advancing practice to meet high-priority workforce development needs at scale. However, they only form one type of intervention through which advanced practice workforce development and deployment needs are met.
Credentials are designed to do the following:
- Support, inform and expedite education providers’ curriculum design and delivery in areas where workforce development need is high (i.e. the need is high-priority, exists at scale, and is not met by existing provision).
Standardise the design and delivery of education provision in areas of high workforce development need without inhibiting education providers’ use of their own expertise to provide high-quality learning opportunities (both their expertise in the subject area and in learning, teaching and assessment).
How should credentials be used in Centre- accredited programmes?
Over time, HEIs of programmes accredited by the Centre and HEIs that are preparing programmes for Centre accreditation will be expected to use available endorsed credentials where the specifications for the latter align with institutions’ programmes, pathways and modules. However, it is recognised that it will take time for this alignment to be achieved, including to fit with HEIs’ timeframes for making modifications to their provision within the context of their institutional validation and quality assurance processes.
HEIs that decide not to use relevant endorsed credentials in programmes for which they seek Centre accreditation will need to explain their reason for this. However, institutions’ decision not to use endorsed credentials does not mean that their programmes cannot be considered for Centre accreditation. This respects that institutions may valuably be seeking to meet particular or different advanced practice workforce development needs through their programme design and delivery and that endorsed credentials will only ever meet particular workforce development requirements.
How do credentials for medicine and other professions fit together?
The Centre is working with other parts of HEE to explore whether and how a co-ordinated approach can be taken to developing and recognising credentials to meet high-priority workforce development needs across medicine and the other healthcare professions. This includes with a view to progressing the following:
- All credential proposals (outside those progressed through the GMC-regulated credential route for the medical profession) being considered against the same gateway and prioritisation criteria, whether they relate just to medicine, a multi-professional target group that includes medicine, or a target group that includes other healthcare professions (on a multi- or uni-professional basis).
- All credential proposals accepted for development being progressed through the same process for supported, funded development.
- All fully developed draft credential specifications being considered against the same endorsement criteria.
- All endorsed credentials being subject to the same monitoring and periodic review processes.
Key to progressing the above is ensuring that there is appropriate expertise brought to each stage of the scrutiny and review process and that governance and decision-making processes appropriately align.
How do credentials fit with arrangements for professional regulation?
Any potential future relationship between Centre-endorsed credentials and the statutory regulation of healthcare professions will continue to be kept under review, including through discussion between HEE and the regulators and as the government’s regulatory reform agenda progresses.
The following is important to note:
- All registered practitioners contributing to population/patient care and service delivery at advanced practice level are responsible for their scope of practice and professional decisions and actions in the same way as all other registrants; this includes in being accountable to their statutory regulator for meeting all current requirements.
- The focus of the Centre’s approach is on endorsing structured, standardised units of learning that can contribute to addressing high-priority workforce development needs, not on affirming the competence or capability of individual practitioners.
- Regulators’ consideration of whether they should recognise individual registrants’ achievement of endorsed credentials (e.g. by annotating the register to this effect) has to be from the perspective of whether this would be in the public interest and contribute to upholding patient safety.
The GMC is currently piloting arrangements for regulated credentials for medical practitioners in areas of identified high-priority need.
Will Centre-endorsed credentials have currency across the UK?
The remit of HEE and its Centre for Advancing Practice is to progress and shape workforce development in England in line with healthcare policy in England only. However, the potential value of credentials to address workforce development needs and support workforce deployment across the UK is recognised.
Exploratory discussions with partner bodies in each home country on the feasibility and potential value of arrangements to support and enable a UK-wide approach are on-going. These recognise the imperative of any arrangements for such an approach addressing shared workforce development priorities and ensuring collaboration and partnership-working.
What are the governance arrangements for credentials?
The Centre’s governance processes for credentials are designed to ensure rigour, consistency and transparency. This includes in how decisions are made about potential credentials’ supported development, credential specifications’ endorsement, and their delivery and on-going review. The rigour and robustness of these arrangements is recognised to be key to how credentials (both as a concept and as individual structured and standardised units of learning) gain and maintain currency and credibility with all stakeholders (including patients and the public, policy-makers, employers, professions and education providers).
The Centre’s governance and decision-making arrangements relate to the following:
- Whether a credential proposal is deemed a high-priority workforce development need for which a standardised unit of learning can valuably be created and for which funded support should be provided.
- Whether draft credential specification fully meets the requirements for endorsement and is ready for launch for delivery.
- Whether an education provider’s proposal to deliver an endorsed credential meets the requirements for approval.
- Annotation of the Centre practitioner directory of individuals’ successful completion of endorsed credentials.
- Quality assurance and enhancement arrangements to ensure each endorsed credential remains current, relevant and fit for purpose.
Evaluation of the value and impact of credentials, individually and collectively, for meeting workforce development and deployment needs.
How are decisions made about the endorsement of credentials?
Decisions about credentials’ development, endorsement and delivery are made through processes that are designed to ensure the following:
- A robust, evidence-based and data-driven approach to decision-making at each stage of the process, including in how credential proposals are considered through a competitive process to determine their relative priority and the value of their being progressed and developed.
- Independent, transparent decision-making at each stage of the process.
- The management of potential conflicts of interest.
- The appropriate resolution of different points of view.
- The appropriate handling, management and processing of confidential and sensitive information.
- The proper handling of complaints and appeals.
Arrangements are managed through the following:
- Regular priority-setting exercises to determine the areas in which credentials can most appropriately be developed and made available.
- The publication and application of criteria at each stage.
- The supply of templates and guidance to support the submission and review of information at each stage.
- Standardised arrangements for supporting the development of credentials.
- The publication of clear timeframes for the management of submissions at each stage of the process.
- Screening processes at each stage to ensure that no submission is progressed that has information gaps (with the potential for these to be rectified).
- Peer review processes for submissions at each stage to ensure that material is subject to appropriate expert scrutiny.
- Moderation processes at each stage to ensure that any differences of view through the peer review processes are identified and appropriately considered and resolved.
- Oversight processes to ensure that recommendations are made consistently and equitably.
- Sign-off of recommendations at each stage.
A complaint and appeals process for use by parties who reasonably believe that their submission was subject to a procedural irregularity.
How are credential decisions overseen?
HEE’s Multi-professional Credential Assurance Group oversees decisions made on individual credentials and the value and impact of credentials’ collective implementation.
How will decisions be made on which credentials should be supported for development in the future?
The Centre intends to enact regular arrangements through which priority topics are set for HEE-supported credentials should be developed and for organisations put forward applications for forming a credential development group for which HEE support will be provided. The precise nature of arrangements are currently being worked on, with a view to ensuring that these form a clear, transparent process that HEE can sustain on an on-going basis.
Proposals selected for supported development as a full credential specification will need to relate a high-priority workforce development need that exists at scale, is not met through existing education provision, and for which a standardised unit of learning can usefully be developed.
What does ‘supported development’ mean?
A proposal selected for supported development will be judged to have the following attributes and potential:
- Relate to a high-priority workforce development need that needs to be met at scale.
- Not be a workforce development need currently met by existing education provision.
- Can valuably be addressed through the development and delivery of a structured, standardised unit of learning.
- Do all the above in ways that align with HEE-set priorities for workforce development to deliver the NHS Long-term Plan and therefore represent an area in which supported development will meet policy objectives.
The lead representative for the proposal is informed of the outcome of the submission at the earliest opportunity. Arrangements for the following are then progressed:
- The formulation of an agreement with the credential development group (represented by the lead representative) to support the development of the proposal as a full credential specification.
- The agreement of detail within in the agreement, including on issues relating to the support to be made available (including funding), the timeframe for support and the expected submission of the credential specification for consideration for endorsement, requirements relating to progress-reporting, and intellectual property issues relating to the credential specification and underpinning resources.
The signing of the agreement that sets out the funding and other support to be made available to the development group.
What expectations are attached to supported development?
Support for a credential’s specification development is provided in the full expectation that the output of the exercise will lead to the credential being endorsed, such that is then published and launched as an endorsed credential for delivery. However, this is not a given. It is subject to the full credential specification being developed in a timely manner against the endorsement criteria and through engagement with the support provided. The output needs to be a full specification that is deemed – through a rigorous, robust process of independent peer review, oversight and sign-off - to meet the endorsement criteria in full.
What happens if a specification is not on track to meet the endorsement criteria?
If it becomes clear during the supported development process that a prospective credential risks not meeting the endorsement criteria, consideration will be given to the following:
- The mitigation measures that the development group itself should undertake (e.g. through securing additional input and expertise).
- Reasonable additional support that the Centre can provide within its available resources and without compromising support for other credentials’ development.
- Whether any other mitigation measures can reasonably be taken or put in place (e.g. agreement of an extended timeframe for the credential specification’s development, either with or without continued direct support).
- Whether the development of the credential specification needs to be managed differently (e.g. through a reconfigured development group).
If issues with a credential specification only become clear at the point at which it is considered for endorsement, consideration will be given to the extent of the shortfalls in the credential specification and whether and how these can reasonably be rectified. Depending on the nature, significance and reasons for the shortfalls, it may be reasonable to provide a package of continued, time-limited support for these to be addressed.
What should be inferred from a proposal not being supported for development?
A credential proposal not being selected for supported development does not mean that it is not deemed a valid area for advanced practice workforce development. The process to consider credential proposals is competitive.
The HEE resource available to support the development of full credential specifications is limited. It therefore has to be used to support the development of credentials that are deemed to be the highest priority. This means that a prospective credential can respond to a high-priority, at scale patient need and service demand and that there is a value in supporting strengthened workforce development and deployment in this area by developing a structured, standardised unit of learning. However, this is very different from saying that the selected areas for supported development as a full credential specification are the only ones that have value or relate to areas of need.
At the same time, there are some specific reasons why a proposal may not be deemed to be of sufficient priority for development as a credential. These include the following:
- It is already addressed sufficiently by existing education provision.
- It is substantially covered by a credential specification that either already exists or is already being supported for development.
It relates to a workforce development need that is not deemed to exist at sufficient scale.
What feedback is provided on an unsuccessful proposal?
Feedback is provided on unsuccessful proposals. Depending on the quality, nature and context of the proposal, feedback may include advice on the following:
- How the expertise of the development group might appropriately be deployed in other ways (e.g. by feeding into the development of another credential specification).
- How the proposal may benefit from a review of its scope and focus to strengthen how it addresses workforce development priorities (e.g. by expanding the multi-professional target group to whom it relates, or more strongly addressing emergent workforce
- development and deployment needs arising from new models of care and/or technological advances in service delivery).
The appropriateness of the proposal being resubmitted at a future point (e.g. if it narrowly missed being selected for supported development in the context of other proposals and the competitive process).
When are credentials ready for delivery?
Credentials are ready for delivery once their full specification has been endorsed and they are listed on the Centre directory of education provision. The time between endorsement being confirmed and credentials appearing on the Centre’s directory is as short as possible.
Providers wishing to secure approval to deliver endorsed credentials need to submit a delivery plan for approval, using the Centre template for this purpose and following the Centre guidance on the submission process.
Providers can deliver credentials as an approved provider once their application to achieve this status has been signed off.
Which bodies can deliver endorsed credentials?
To deliver credentials as an approved education provider, organisations have to submit evidence that they have the resources required to deliver them safely and effectively and fully in line with the credential specification. Evidence submissions are considered against the Centre’s approved provider criteria.
It is expected that credentials will usually be delivered and overseen by HEIs, at least in the first instance. This is to ensure that their delivery is underpinned by expertise in learning, teaching and assessment, including in relation to level 7/8 learning and robust quality assurance processes.
However, a range of other organisations (potentially employers, professional bodies, multi-professional networks, HEE training hubs, deaneries and faculties, etc.) may be able to demonstrate that they have the human and physical resources to do so. Each needs to demonstrate that they have the expertise and infrastructure to support and deliver high-quality learning and assessment consistently and at the requisite level.
How do organisations seek approval to deliver a credential?
Education providers need to seek approval to deliver a credential. The Centre processes supports them to submit the required information. These include an online template for completion and detailed guidance.
To be approved, prospective providers need to provide evidence of the following:
- The human and physical resources (including the requisite expertise in the particular area of practice and in learning, teaching and assessment) to deliver the particular credential, as defined in the credential specification, in a sustainable way.
- Appropriate links with practice to provide safe, effective supervised learning opportunities at the appropriate level and scale (in the relevant environment, specialty and/or population/patient group for the credential).
- The expertise (in terms of the subject matter, learning, teaching and assessment, and understanding of advanced practice requirements) to develop and assess learning in line with the credential specification.
The resources to engage with the quality assurance requirements attached to approval as a provider on an on-going basis.
How are applications considered to deliver a credential?
The process for conferring approval to deliver an endorsed credential is designed to be robust but proportionate, enabling the delivery of endorsed credentials as structured, standardised units of learning, at pace and scale. Submissions to seek approval to deliver a credential are taken through the following process:
- Organisations submit an application for approval, using the Centre’s online template to provide the required information.
- The Centre undertakes initial screening to check each submission includes the required information to be considered formally, with any information gaps highlighted to the prospective provider so that they can be addressed prior to resubmission.
- Applications are considered through a peer review process that enables scrutiny by a small team of individuals who have an appropriate balance of expertise to consider and recommend whether they should be approved (i.e. in terms of knowledge and understanding of the area of focus of the credential; experience and understanding of the resource requirements for delivering workforce development provision that relates to advanced practice capabilities; and expertise in curriculum design/delivery/evaluation and the assessment of learning at level 7/8).
- Recommendations are moderated by a credential delivery approval panel, including to address any discrepancies in peer reviewers’ feedback and to ensure the fairness and consistency in the recommendation made.
- The recommendation is signed off by the Centre’s Education Assurance Group.
The organisation is listed on the Centre directory of education providers for the credential in question.
How can organisations be considered to deliver multiple credentials?
The approach to provider approval is designed to balance rigour and maintaining high educational standards with being proportionate and enabling credentials to be delivered to meet workforce development needs at pace and scale. The following efficiencies are built into the approval process:
- If an HEI already holds Centre accreditation for their advanced practice provision, cross-reference is made to the information already supplied for this purpose (e.g. relating to human and physical resources and practice links that are directly relevant to developing and assessing learning in the credential’s area of focus).
If an education provider (HEI, or potentially another organisation) has already secured Centre approval to deliver another credential, cross-reference is made to information supplied for this purpose (again, relating to resources and practice links directly relevant to developing and assessing learning in the credential’s area of focus).
What are the on-going requirements of approved credential providers?
Education providers approved to deliver credentials have to comply with the Centre’s quality assurance and enhancement (QAE) requirements to retain their approval as a provider. The requirements include the following:
- Annual reporting.
- Submission of data on take-up and progression rates.
- Periodic review, such that approval can be considered for renewal.
The Centre processes and requirements are designed to be proportionate and to include a focus on quality enhancement, not just quality monitoring. This includes to seek providers’ feedback on the following:
- Quality enhancement themes that are integrated into annual reporting.
- Evidence of how multi-source stakeholder feedback has been sought and considered, including with a focus on public and patient involvement (PPI) and equality, diversity and inclusion (EDI) issues.
- Any urgent need for a credential specification to be modified to ensure it remains relevant, current and fit for purpose.
- How a credential specification might usefully be developed when it is next considered for periodic review.
- Lessons learned to inform other providers’ delivery of the same credential.
- Lessons learned to inform the delivery of other credentials.
As with the processes for securing approval as a provider, the Centre’s QAE arrangements have efficiencies built into them, removing the need for providers to submit the same information (on their delivery of multiple credentials) unnecessarily to meet Centre requirements.
What happens if an organisation delivers a credential without holding approval?
If an organisation delivers a Centre-endorsed credential without having first secured approval from the Centre, practitioners who complete the unit of learning successfully cannot have this recorded on their directory entry. Data on delivery of the credential will also not be captured in the Centre’s evaluation of the value and impact of credentials.
Organisations need to make clear to prospective participants (and their employers) if they are using a credential specification without securing approval and the implications of this.
At the same time, credential specifications are intended as open-source material to inform and support workforce development in high-priority areas. If education providers draw upon credential specifications in their design and delivery of learning and development opportunities this is welcomed and is usefully explained and acknowledged.
How can practitioners going through the Centre portfolio route use credentials?
As the Centre’s full approach is progressed to its different strands of activity, it is planned that endorsed credential specifications can be used by practitioners going through the portfolio route to Centre recognition.
Practitioners who successfully complete a Centre-endorsed credential through a Centre-approved provider will simply be able to provide confirmation of this in their portfolio evidence. The scope to consider evidence of how portfolio route candidates have independently met the learning outcomes of a credential specification is being explored.