Background on the development and purpose of the Credential in Rural and Remote Health .
The credential in Rural and Remote Health will help to address the service and patient safety need for General Practitioners as well as doctors in non-training grade positions working in these contexts to extend and enhance the skills not covered in speciality training.
Practising medicine in rural and remote areas is challenging. Compared to their urban counterparts, doctors practising in these locations may be described as ‘extended generalists’. They provide a wider range of clinical service, sustain a heavy workload and carry a high level of clinical responsibility, all in relative professional isolation.
The credential will provide a consistent approach to the training of the “extended generalist” required to provide unscheduled and urgent care in rural and remote hospitals and at the interface with the community.
In June 2019 the GMC agreed that NHS Education for Scotland would be responsible for the delivery of the Rural and Remote Health Credential. Work has been ongoing since 2020 with the General Medical Council (GMC) on the development of a curriculum involving four nation stakeholder engagement. Membership of the Rural and Remote Health Credential Expert Steering Group was drawn from across the four nations, comprising a range of organisations with an interest in the development of the credential
The curricula is based on higher level outcomes and incorporates the GMC defined Generic Professional Capabilities.
The Credential Development body within NES are continuing to work with the GMC on the delivery phase and Digital colleagues in house on E Portfolio design.
Holders of the credential in Rural and Remote Health will not have the scope of practice equivalent to doctors on the specialist register for other GMC-approved curricula. It is a generalist credential of core emergency skills capable of being delivered in a non-specialist environment, with liaison with specialists as required.
Holders of the credential in Rural and Remote Health will be able to undertake clinical roles in small hospitals in a rural and remote context that are in addition to the usual scope of practice of a General Practitioner, including:
An initial capability assessment will be undertaken to align training to learning needs. Learning needs will vary according to previous experience.
The following key criteria will apply:
Blended learning in different contexts (sites, simulation, distanced training).
The curriculum will be delivered through a variety of learning experiences and will allow learners to achieve the capabilities described through a variety of learning methods. There will be a balance of different modes of learning from experiential learning ‘on the job’ to more formal courses. The proportion of time allocated to different learning methods will vary depending on the previous experience of the learner. Training will be constructed to enable learners to experience the full range of educational and training opportunities available and there will be robust arrangements for quality assurance in place to ensure consistent implementation of the curriculum.
The credential will provide a consistent approach to the training of the ‘extended generalist’, who is often required to provide unscheduled and urgent care, both in rural and remote hospitals and directly with patients in their community. The credential will also support a more flexible career development for doctors, allowing holders of the credential to change their career direction or enhance their skills and expertise. Most importantly, it will also provide reassurance to people living in rural and remote areas of the UK that, whatever the challenges of their location, they can expect to receive good and safe care.
Exciting times lie ahead as we step nearer to the delivery stage providing doctors with the skills necessary to practice medicine in our remotest communities are officially recognised for that, and there’s a path for others who want to follow them.