The RCGP Framework for GPs with Extended Roles (GPwER) defines what a GPwER is and provides a generic set of principles to underpin the governance of General Practitioners, regardless of the setting in which they work.

The process of GPwER accreditation is about the individual and not the service. It is the responsibility of commissioning organisation to make sure that the service and premises meet the required standards, and ultimately decide whether a GP is competent to deliver an extended role. For more information refer to the RCGP Guidelines for Dermatology and Skin Surgery.

For DES/LES (and other) models of skin surgery please refer to the relevant FAQ.

Successful candidates will be provided with one of the following certificates:

• • Group 1 – GPwER in General Dermatology (the diagnosis and management of inflammatory skin disease, the diagnosis of skin lesions, and the non-surgical management of pre-cancerous lesions and low-risk basal cell carcinoma)
  • Group 2 – Skin lesion management (the diagnosis and management of skin lesions, including low-risk BCC, using both surgical and non-surgical techniques)
  • Group 3 – Combines groups 1 and 2

The management of suspected melanoma, squamous cell carcinoma, and high-risk basal cell carcinoma sit outside of the remit of GPwER work, and should be managed only in consultant-led clinics.

• • Successful candidates are expected to work at least one session a month with their clinical guide (consultant or RCGP accredited GPwER)
  • Under the new RCGP framework, accredited GPwERs no longer require reaccreditation; the RCGP now advises that they participate in an annual speciality performance review carried out by their clinical guide, which should be fed into the whole scope annual appraisal document (to be discussed at their annual medical appraisal)

The evidence that a GPwER is keeping the requisite knowledge and skills up to date and maintaining their competencies should be reviewed through the doctor’s annual whole scope of practice appraisal. This replaces the former process of re-accreditation for GPwSIs.

It is recommended that GPwERs participate in an annual speciality performance review that satisfies the following criteria:

• It is best practice to include a clear description of the governance arrangements for the service being provided as a GPwER and reflective note on how the individual would respond to patient safety issues or concerns
• Documentation demonstrating that the required competencies in the specialty specific framework for the GPwER role have been maintained, or improved, with evidence and reflection on:

• • Continuing Professional Development (CPD)
  • Quality Improvement Activity (QIA)
  • Significant Events
  • Patient feedback
  • Colleague feedback
  • Complaints and compliments
  • Specialty specific personal development plans

Where possible the annual specialty performance review should be carried out by a clinical guide (a specialist working in the relevant extended role area, for example the main clinical supervisor involved in accreditation), who should also provide a structured reference. Once complete, the relevant documents should be uploaded to the GPwER’s appraisal portfolio for review as part of the whole scope annual appraisal.

The Responsible Officer will need to be assured that the governance arrangements are robust enough to provide timely information about any concerns about the GPwER at any point in the revalidation cycle, and an assurance that there are no outstanding concerns in the period preceding the revalidation recommendation.