Work has been ongoing since 2020 with the General Medical Council (GMC) and other stakeholders across the UK on the development of a Credential in Rural and Remote Health focusing on unscheduled and urgent care. We are delighted to announce that we are ready to welcome our first Learners on to the programme.
To provide stakeholders with information about the Credential we have created a question-and-answer section below:
It is a new process to formally recognise a doctor’s expertise in a specific area of practice. GMC credentials will bring assured training and regulatory oversight to areas where consistent clinical standards, recognised across the UK, are necessary for better patient care. They will support areas of practice where patients are at risk due to workforce gaps, limited clinical governance or other factors that cannot safely be addressed in other ways.
Yes - NES have developed the credential with the GMC and it has been approved, quality assured and recognised by the GMC however it will be delivered by NHS Education for Scotland (NES).
Eligibility for the credential encompasses a wide range of experience and different medical backgrounds.
The entry point for this credential will most commonly be:
While the focus of this credential is at the interface between General Practice and Rural and Remote small hospitals, it is recognised that some smaller hospitals may be staffed in part by doctors on the specialist register, and that their scope of practice may differ from their specialty postgraduate training. The credential may therefore also be suitable for these doctors.
Aligned with “Excellence by Design”, the Rural and Remote Health credential curriculum is outcomes-based. Progression will therefore depend on capability rather than time. Attainment of the competencies may accordingly be achieved at different times depending on clinical placements as well as pre-credential experience and training. For example, doctors embarking on the credential may already have acquired breadth and depth of experience and competencies in rural and remote contexts. Recognising the heterogeneity of credential entrants, it is estimated that the curriculum may take up to 2 years to complete.
There are two routes for securing an award of a Credential in Rural and Remote Health (Unscheduled and Urgent Care):
In order to ensure that consistent standards are applied for doctors gaining the credential via either the training or recognition route:
The overall outcome of training in this credential is to provide the competencies required to recognise, stabilise and manage an acutely unwell patient, for up to 24 hours if evacuation is necessary, as well as the management of appropriate inpatient cases. Those following the credential are expected to achieve the knowledge, skills and behaviours required to:
Resuscitate, stabilise, and treat acutely unwell patients, liaising with specialist and primary care teams as necessary in a rural and remote context
Recognise, investigate, initiate and continue the management of common acute health problems presenting to rural and remote small hospitals, drawing upon the expertise of specialists and other professions as necessary
Provide inpatient care to an appropriate cohort of cases.
Doctors who can demonstrate they meet the outcomes of a GMC (General Medical Council) credential can be awarded the credential by providing evidence instead of completing the credential training pathway. The doctor would have to apply via the recognition route.
Each learner will be allocated a GMC recognised educational supervisor (ES) at the start of the credential programme, who will be familiar with rural and remote healthcare and the credential curriculum. The ES will oversee the learner’s educational development throughout their credential programme. The ES and credential learner should meet at the start of each training year and maintain regular contact throughout the credential programme. Four-monthly reviews with the ES will be mandatory.
Yes, the educational supervisor role will be voluntary. It is anticipated that the first Doctors who successfully complete the Recognition route will become Educational Supervisors.
At the end of each year of training, the UK Rural and Remote Credential Panel will review the learner’s progress in a similar way that a doctor in training’s progress is reviewed via the ARCP process (see Gold Guide).
The Credential Panel must assure itself that the ES has made the appropriate entrustment decisions for each CiP and procedural skill and that decisions are evidence based and defensible. It is up to the learner to ensure that the documentary evidence that is submitted is complete.
The purpose of the Credential Panel is to review the evidence and to assess competence and acquisition of required capabilities that inform a judgement of meeting credential specific requirements. This is captured as an outcome.