GPwER FAQs

In addition to the speciality criteria the candidate must meet the following requirements:

• provide evidence of Certificate of Completion of Training (CCT) or equivalent in general practice
• to be actively working in General Practice and be registered on a performers list (or equivalent)
• undertake an annual medical (whole scope of practice) appraisal
• provide evidence of GMC registration
• to have undertaken at least 40 core (undifferentiated) general practice sessions in the 12 months prior to application (please contact the team if you wish to apply for accreditation but are unable to meet this requirement)

Please also refer to the GPwER Terms and Conditions, section 2.

National Accreditation of a GPwER in Dermatology and Skin Surgery is deemed as best practice and is supported by the Royal College of General Practitioners, the British Association of Dermatologists (BAD), the Primary Care Dermatology Society, NHS England, and patient groups, with interest from the GMC in the context of their developing credentialing proposals. There are many benefits to GPwER accreditation to the individual GPwER, which include:

• It enables GPs to demonstrate competence against a national standard, including some GPwSIs who have not had the opportunity to accredit against national guidelines.
• The accreditation is portable, meaning that a GP should not need to re-accredit if they move to a different geographical area.
• In accordance with the RCGP’s generic GPwER framework, GPwERs accredited through the BAD’s accreditation process only have to go through the process once, avoiding the need for re-accreditation.
• GPwERs accredited through the BAD’s process can act as clinical supervisors and train/mentor other GPs wanting to become a GPwER.
• It is likely that GPwERs accredited through the new process will be better recognised by defence unions.

You may only use AI large language models to improve your written English in your portfolio application form. You may not use AI to produce evidence of your:

• clinical skills
• case-based discussions, including content in the learning diary
• patient surveys
• skin surgery audit and collection log, where applicable
• clinical supervisor report
• low volume of work submission, where applicable

Any use of AI that results in fabricated, misleading, or non-verifiable content is considered a breach of professional integrity and may result in rejection of the submission, or further review in line with accreditation governance procedures. You are required to make a declaration about your use of AI. Further information is detailed on the AI Guidance & Declaration for GPwER Candidates which can be found within the list of forms for each group.

 

There are significant differences between a GP providing a commissioned skin surgery / minor surgery service (such as under a DES or LES contract) and a GPwER:

GPs providing surgical services – manage benign skin lesions and small low-risk BCC beneath the clavicle. They are first and foremost surgical services. GPs would be expected to have an understanding of lesion recognition appropriate to their surgical remit but they have not undertaken specialist training and competency based assessment in skin lesion recognition and management. In essence, skin surgery services such as DES or LES only cover clinical remits that are within the normal scope of General Practice; as such the RCGP does not consider that such roles warrant extended role accreditation. It remains good practice to make certain that the premises used are fit for purpose, and that the GP has their surgical competencies assessed (for example using a Direct Observation of Practical Procedure assessment tool) and periodically reviews their quality of their care.

GPwERs – work as an integrated team with commissioned secondary care services. GPwERs have undertaken formal specialist training and assessment in the diagnosis (clinical and dermoscopic) of skin lesions, enabling the GPwER to be commissioned to provide skin lesion clinics (excluding 2-week waits). Groups 2 and 3 GPwER can also provide surgical services with a wider remit, which may include certain BCC on the head and neck (refer to Annex C in Guidance and competences to support the accreditation of GPs with Extended Roles (GPwERs) in Dermatology (including Skin Surgery) 2024). The remit described is broad and so formal accreditation is required.

Most Group 2 GPwERs manage basal cell carcinomas as part of their clinical remit, but this is not mandatory. A few Group 2 GPwERs diagnose skin lesions but surgically only manage the benign lesions.

The BAD and RCGP’s position is that a GPwER is first and foremost a GP with a UK licence to practise, and practising in a primary care role. Such GPs bring important additional skills in practising holistically and dealing with complexity and uncertainty to extended roles. Therefore, for the purposes of accreditation, the candidate is required to demonstrate they have undertaken at least 40 core (undifferentiated) GP sessions in the 12 months leading up to accreditation. The figure of 40 sessions has been chosen because it is recognised by the RCGP, BMA and NHS England as a threshold for a low volume of work. It is recognised there are exceptional circumstances and therefore if a GP wishes to apply for accreditation but can’t meet this requirement, they are encouraged to contact the GPwER office to discuss their particular circumstances.

If a candidate has undertaken fewer than 40 core (undifferentiated) GP sessions in the 12 months leading up to accreditation, they are required to complete a Low Volume of Work Form and send it to education@bad.org.uk.

The form will be reviewed by the GPwER Co‑Chairs, after which the BAD will notify the candidate of the outcome. This decision will determine whether the candidate may proceed with accreditation or defer until they have completed the required number of sessions.

Yes, you can use evidence from your Foundation Year 2 or, if applicable, any relevant specialty training undertaken prior to GP Specialty Training within the five years prior to accreditation.

Most of your evidence submitted for assessment must relate to events that occurred no more than five years prior to the date of your original portfolio submission. Certain aspects of training such as clinical experience can be accepted as evidence within a period of five years prior to the date of your original portfolio submission. In exceptional circumstances longer time scales may be permitted, for example if you undertook a postgraduate qualification in dermatology as a previously accredited GPwSI and you are going through the transition route of accreditation. However, assessors will expect to see CPD or reflection in your learning diary that demonstrates you have kept up to date.

 

We suggest that in the first instance you approach your nearby dermatology services (hospital and/or community) to ask if they are willing to take you on and support your dermatology training. You can also contact your Integrated Care Board, or equivalent in devolved countries, to find out if there are any existing GPwER services in your locality, or plans to develop such services.

A senior clinical supervisor can be any of the following:

• A consultant dermatologist
• An RCGP or BAD accredited GPwER (depending on when the accreditation was achieved, the BAD has taken over the delivery of the accreditation service from RCGP)
• Another consultant working in the same scope of practice, for example a consultant plastic surgeon for Group 2 GPwERs

Senior Clinical Supervisors and Clinical Supervisors must be active and listed on the GMC register.

There is more information about clinical supervisors here.

It is advantageous (especially for Groups 1 and 3 GPwERs) but not essential if you can clearly demonstrate other ways in which you have gained relevant knowledge in your extended scope of practice. The BAD does not advise on which Diploma to choose.

In addition to those available in the UK we confirm that those available in Eire are also acceptable. There are also a number of helpful learning resources including our British College of Dermatology Education Hub,   RCGP Dermatology Educational Library, the Primary Care Dermatology Society website and this website.

No, there is no grandfathering of GPwSI. All candidates will need to demonstrate the required standard of competence, as defined by the RCGP in collaboration with the BAD and PCDS, through the submission of a portfolio of supporting information. However, the process for candidates who can demonstrate previous accreditation by a reputable body using the 2007 and 2011 guidance is very much simplified, for example candidates are required to provide a supporting statement from an appropriate clinical colleague, rather than repeat clinical assessments such as DOPS and mini-CEX.

Please refer to the Guidance and competences to support the accreditation of GPs with Extended Roles (GPwERs) in Dermatology (including Skin Surgery) 2024) for more information.

Candidates may have gained experience in private practice and work in the private sector alongside their NHS work, but the accreditation is not for candidates solely working privately. This is because candidates should have an appropriate clinical supervisor, see https://www.bad.org.uk/education-training/gps/guidance-for-gpwer-clinical-supervisors/  for more information, and work in a service that is integrated with secondary care. Evidence for accreditation should only be from NHS settings.

The original Dermatology and Skin Surgery accreditation trial (due to external funding conditions) was restricted to GPs on the NHS England performers list.

The RCGP’s Generic Framework to Support the Governance of GPs with Extended Roles and associated specialty frameworks are intended to be applicable to the four countries of the UK, and the British Association of Dermatologists is committed to making its dermatology accreditation process available to all UK-based GPs, regardless of the country in which they are based or the sector in which they work. Evidence for accreditation must have been collected in a GMC registered environment.

There is no set time or required number of specialist clinics that a GP needs to partake in as part of the accreditation process. The outcome is based on competencies, and other attributes of the GPs performance that enables the GP to demonstrate that they are capable of practising autonomously in a specialist area of medicine.

For the purposes of accreditation, candidates are required to reflect on responses from 25 candidates. Further information can be found on the Patient Survey Guidance document on the Which forms to use section of this page.

Yes, to meet the standard for accreditation you are required to have integration with secondary care and to have regular senior clinical supervision which cannot be fully remote. Section 6 of the Portfolio of evidence form has key questions which cover:

• integration with relevant secondary care colleagues/other senior colleagues
• combined clinics with your clinical supervisor/clinical guide
• consultant contact for advice about challenging cases
• referral pathways, including any triage
• prescription of systemic retinoids e.g. isotretinoin or alitretinoin within a consultant approved framework
• secondary care meetings, e.g. educational or complex case clinics
• attendance at skin cancer MDT meetings for group 2 or 3 candidate undertaking skin cancer surgery at least four times a year

There is no re-accreditation programme however you should demonstrate continued competence in all your roles through the annual medical appraisal.

Since December 2018 it has been an eligibility requirement for accreditation that candidates undertake at least 40 sessions of (undifferentiated) general practice per year unless there are exceptional circumstances. Following accreditation, it is important to maintain your generalist skills, including regular sessions in general practice, as agreed with your responsible officer.

More detailed information is supplied to successful candidates on accreditation.