1. Do clinicians who have done an ACP Masters degree have to do the roadmap to work as an AP in primary care?
“If you have undertaken an ACP MSc, it is likely that you will have met the capabilities for stage 1 and stage 3. You should map the learning outcomes of your MSc to the knowledge, skills and attributes to ensure this is the case. Your outstanding requirement for roadmap verification is therefore the e-learning modules and stage 2. (NB. If your MSc involved a placement in primary care, you may also have met stage 2).”
2. What has replaced the April 1 2022 completion date?
- Stage 1 should be completed with a portfolio of evidence and verified before employment in Primary Care (unless the trainee FCP is an experienced paramedic already employed in primary care). The KSA should be completed prior to employment as a FCP or AP in Primary Care to assure patient safety. For clinician already working in primary care this can be completed retrospectively.
- Stage 2 is completed with a portfolio of evidence and verified in Primary Care. This is the recognition process of the application of the KSA in Stage 1 to clinical practice in Primary Care. Best practice is that this should be completed within 6 months for a full time member of staff but this can be longer provided a completion date is agreed with the employer.
3. What is a First Contact Clinician?
- A diagnostic clinician in primary care working at masters level with undiagnosed and undifferentiated diagnoses managing complexity and uncertainty at the first point of contact who has a minimum of 5 years post graduate experience
Stage 1 = a verified portfolio of evidence of working academically at masters level against the knowledge skills and attributes document plus the 2 sets of e-learning modules
Stage 2 = a verified portfolio of evidence demonstrating the application of their stage 1 academic masters level knowledge into practice using the Work Based Placement Assessment Toolkit in the primary care clinical setting.
- First contact practice sits in the transition between Enhanced and Advanced practice
4. What is Advanced Practice Clinician?
- A clinician with a verified portfolio of evidence at a Masters level of practice across all four pillars of practice (Leadership, Clinical, Education and Research) who has a minimum of 5 years post graduate experience.
- All four pillars of practice are integral and influence every intervention
- They are multi-professional, cross organisational and cross boundary clinicians
- They provide multi-professional supervison
5. How does a first contact and advanced practice clinician differ?
First Contact Practitioner
- Manages undifferentiated undiagnosed conditions.
- Able to identify red flags and underlying serious pathology and take appropriate action.
- Works within practice, across PCN, multi-organisational, cross professions and across care pathways and systems including health, social care, and the the voluntary sectors.
- High level complex decision making to inform the diagnosis, investigation, management, and on referral within scope of practice.
- Actively takes a personalised care approach to enable shared decision making with the presenting person.
- Contributes to audit and research projects.
- Contributes to education and supervision within their scope of practice for the multi-professional team.
- Facilitates interprofessional learning in area of expertise.
- Promotes and develops area of expertise across care pathways.
- Working toward Advanced Clinical Practice (level 7 across all 4 pillars).
Advanced Clinical Practitioner
- Manages undifferentiated undiagnosed conditions.
- Able to identify red flags and underlying serious pathology and take appropriate action.
- Works within practice, across PCN, CCG and ICS, multi organisational, cross professionals and across care pathways and systems including health, social care, and the voluntary sectors.
- High-level of complex decision making to inform diagnosis, investigation complete management of episodes of care within a broad scope of practice.
- Flexible skill set to adapt to and meet needs of the PCN Population and support public health
- Manages medical complexity.
- Actively takes a personalised care and population-centered care approach to enable shared decision making with the presenting person.
- Actively engages in care from a Population care viewpoint.
- Leads audit and research projects.
- Leading audit within areas of capability.
- Provides multi-professional AP clinical and CPD supervision across all four pillars with relevant training.
- Leads education in their area of expertise.
- Enables, facilitates, and supports change across care pathways and traditional boundaries
- Working toward level 8.
6. What does Masters level practice look like?
- In-depth knowledge & understanding – informed by current research
- Critical awareness of current issues/developments
- Complex clinical reasoning
- Critical thinking
- Research understanding – ability to review and carry out
A range of generic abilities and skills that include the ability to:
- Use initiative and take responsibility
- Solve problems in creative and innovative ways
- Make decisions in challenging situations
- Continue to learn independently and to develop professionally
- Communicate effectively, with colleagues and a wider audience, in a variety of media.
7. What is the best workforce model for First Contact Roles?
Because there is now a standard of practice for these roles that prove capability, it doesn’t matter how or who a clinician is employed. It is important that which ever model is used that the clinician is integrated fully across the care pathway preventing silo working.
8. What happens if I don’t do it?
- All registered clinicians are accountable for their practice. The NHS promotes a just and learning culture and healthcare professionals should engage in relevant CPD and supervisory activity to ensure that their required registrant standards in the role that they are working in are met and the scope of practice is not exceeded. This is regulated by the HCPC.
- The GP practice that you work in may be asked in a CQC inspection of evidence of clinician capability. The employer and employee should work together to ensure capability within the scope of practice that staff are working in.
9. Why have the Roadmaps been made and why do existing clinicians have to retrospectively train?
- The Roadmaps have been made to create a standard of practice and proof of capability in primary care.
- The reason for this is for patient safety and governance of these roles in primary care.
- When you introduce a standard of practice, it needs to work backward as well as forward.
10. I am already working as a band 7/band 8a/as an Advanced practitioner in secondary/community care. Will I have to do the Roadmap training?
Everybody moving into primary care should do the roadmap training to prove capability in the primary care prerequisite knowledge skills and attributes at masters level to assure patient safety.
Points to note:
- Each clinical setting works in a different way and has a different scope of practice. Academic knowledge needs to be applied into an each clinical setting to prove capability.
- There are underpinning primary care core capabilities that are additional to working elsewhere in the healthcare system
- Pay bands are not proof of capability. They are the amount of money that is taken home at the end of a month.
- Job descriptions are not a proof of capability, they are an outline of what your employer would expect you to do in your job role.
11. Can the independent sector train to be a First contact clinician or advanced practice clinician in primary care?
12 . How do I let HEE know that I have completed the taught route?
Clinician completes the ‘FCP Verification of Evidence form’, upon the successful completion of Stage 1 and Stage 2 of the Roadmap and submits details via the recognition survey link (Primary Care Clinical level 7- FCP survey).
13. How do I let HEE know that I have completed the portfolio route with my Roadmap supervisor?
Both the clinician and Roadmap supervisor complete the ‘FCP Verification of Evidence form’, upon the successful completion of Stage 1 and Stage 2 of the Roadmap and both submit details via the recognition survey links (Primary Care clinical level 7- FCP supervisor survey & FCP survey).
14. I’ve completed the FCP survey, what happens next?
Following the launch of the CQC Mythbuster: Primary Care First Contact Practitioners (FCPs) colleagues in FCP roles in Primary Care are expected to have completed Stage 1 and Stage 2 of the Roadmap. This is illustrated by presenting your completed portfolio to your employer, including the signed ‘verification of evidence form’, as you would any other evidence of learning.
HEE’s Centre for Advancing Practice are currently exploring the opportunity of issuing a digital badge for FCPs, however this is a novel concept for the NHS and is currently still under development. Once the process is available to us, HEE will contact all FCPs who have completed the survey with further information.
1. How is the Roadmap Supervision and verification course different to the Supervision courses?
Although there are a number of multi professional supervision courses to train supervisors for both clinical and CPD supervision, they do not include how to verify and sign off a portfolio of evidence at masters level both academically and in practice using the Work Based Placement Assessment toolkit.
It is a bespoke 2 day supervision course for the Roadmaps that is essential to train and maintain the pipeline of Multi-professional First contact and Advanced practice clinicians along the portfolio route in primary care.
- A GP Trainer - ES (ES’s do not need to do the 2 day course but have an optional top up session soon to be available as an e-lfh video (approx. 60 mins in duration)
- A GP
- A Clinician who has a post-registration Masters degree (Please note - A pre-registration Masters degree does not qualify).
- Are a full MACP member.
- A First Contact Practitioner who is recognised by the HEE Centre
- An Advanced Practitioner who is recognised by the HEE Centre.
Any workplace-based assessments or verification undertaken by an individual who doesn’t meet the criteria will not count as evidence in the roadmap portfolio. Misleading trainers regarding eligibility could be deemed a fitness to practice issue.
The role of a Roadmap Supervisor comes with the responsibility of undertaking workplace-based assessments (within your own scope of practice) and verifying evidence of knowledge, skills and capability in day-to-day practice. Please ensure that you base your decisions on evidence and verification, utilising the information provided on the RMSV course, supported by resources on the HEE Landing Page, and can justify your reasoning.
3. Why can’t someone with a lot of years of Supervision experience who doesn’t have a masters degree or someone with masters modules but no masters be a Roadmap supervisor?
Because the Roadmap supervisor is accountable for verifying a portfolio of evidence and signing a clinician off to be working at a masters level of practice academically and in practice, for quality assurance and governance, we need to outline and maintain a strict criteria.
4. How can I get time for supervision and to supervise?
No clinician should be working 100% clinical in primary care. Supervision is the most basic form of governance to assure patient safety and working 100% also puts a clinician at risk of burn out.
Time for supervision and to supervise needs to be negotiated locally. A recommended model would be 80% clinical, 20% non clinical. This matches apprenticeship routes.
A first contact clinician and an advanced practitioner can supervise the multi-professional team in their scope of practice which takes pressure off from GPs. It is a shared responsibility with the GPs.
All First Contact Clinicians and Advanced practitioners in primary care are encouraged to do the 2 day Roadmap supervision and verification course once on the FC or AP directory so that they can support by creating a robust supervisor infrastructure in PCNs.
5. Are there any Train the Trainer courses being run?
Five cohorts have been trained by the national team to create a pool of nationally recognised trainers to run Roadmap supervision and verification courses from the training hubs.
The reason that the train the trainer courses are not being run by anybody other than the national team is for quality assurance and governance. It will prevent private enterprises from setting up Roadmap supervision and verification courses as all supervisors will be triangulated back to the recognised trainers and if trained by any other trainer than the national trainers, the supervisor will not be recognised and the clinician will not be placed on the directory.
National trainers -
- Trained by HEE national team
- Pool of 70 for PCTH to use
- Trainers cannot train trainers
National trainers -
- Train roadmap supervisors
- Online two-day course that trains 14 supervisors per course
- PCTH contact national trainers from the pool to deliver the Roadmap supervision and verification courses
- GP Trainers (GP ES) can supervise (optional top up session available)
Governance of QA of supervision
- HEE national trainers and trained Roadmap supervisors are held on a national directory
- Roadmap Supervisors are triangulated back to the National trainer who trained them
6. When will Roadmap Supervision and verification courses be running from the training hubs?
Each region will have Supervision course dates. Please contact your local training hub for details.
7. How can I access a supervisor if I am an independent clinician or there are no supervisors in my area?
There will be a regional list of supervisors. Your training hub should be able to help you find a supervisor if doing the portfolio route.
8. Do the Universities need to have trained Roadmap supervisors?
No. Universities are used to assessing academic knowledge into practice in a clinical setting. We are going to be running some optional supervisor courses for Universities who run First Contact courses later in the year as they have expressed an interest in the Work Based Placement Assessment toolkit and would like to learn how to use it.
9. Do First Contact and Advanced Practitioners have to be Roadmap supervisors?
It is part of an advanced practitioner’s job plan to supervise the multi-professional team. As first Contact practitioners and trainee first contact practitioners are moving into primary care, the roadmap supervision and verification course is an important course to enroll on to support GPs and the pipeline.
We are encouraging all First contact clinicians to do the 2 day course once on the directory to support too.
The more clinicians doing the course, the better the PCN supervisor infrastructure.
Once a clinician is a recognised Roadmap supervisor, it is encouraged that they link up with their local HEI to support clinical placement for the taught First contact masters module and for undergraduates.
10. Why would I do the Roadmap supervision course once on the First Contact/Advanced practice directory?
- As and advanced practitioner it is part of your job plan to supervise multi-professionally and it helps maintain currency of practice.
- As a first contact practitioner working toward Advanced Practice by being a supervisor and supporting clinical placement, it signs off a number of remaining knowledge skills and attributes in the remaining domains to Advanced practice. It also proves currency of practice.
- As a first contact clinician. It keeps your practice current having students, so it will be easy to prove currency of practice each year.
11. What quality assurance and support do the supervisors have?
- There is a strict criteria of who can be a supervisor as outlined above
- All the supervisor cohorts are encouraged to form a WhatsApp or Google classroom group to create a network
- If you are a supervisor, supervison should be part of your appraisal
- There is a quality assurance document for primary care training hubs