For Care Of The Adult Surgical Patient

SurgicalAdvanced Clinical Practitioner (SACP)Curriculum and Assessment Frameworkfor Care of the AdultSurgical PatientEndorsed by:

Surgical Advanced Clinical Practitioner (SACP) Curriculum and Assessment ulum Aims.8Intended Audience.8Current Extended Surgical Team (EST) .9Scope of Practice of the SACP.10Outside of Scope of Practice of the Surgical ACP.10Patient Safety.11Curriculum Design .11Structure.11Capabilities in Practice (CiPs).13CiP Descriptors.13An Example of a CiP.14The Syllabus.15Syllabus Sections.16Learning from Accredited Courses.16Professional Behaviours .17Core Presentations and Critical Conditions.18Curriculum Delivery.18Programme of Learning.18What has to be Learnt to Complete the Curriculum?.18Core Entry Criteria.18Recruiting.19Academic Requirements .20Clinical Requirements.20Environment .21Clinical Progression.21Programme of Assessment.22Purpose of Assessment.22Assessment and Supervision.23Educational Supervisor (ES).23The Role of the Educational Supervisor.24Clinical Supervisor (CS).24Assessors.25The Role of the Assessor.25Multiple Clinician Reports (MCR).25TSACP Self-Assessment.28Delivery of Assessment.28Assessment of Syllabus and CiPs.30Assessment Method.31Feedback.31Learning.32Workplace Based Learning.32Learning Environment.34Supervised Learning Events (SLEs).35Educational and Development Tools.35Formal Teaching and Learning Opportunities.35Unselected and Specialty-Specific Takes.36Post-take Consultant Ward-rounds.36Personal Ward Rounds.36Ward Rounds by Senior Clinicians.36Multi-Disciplinary Team Meetings.36Simulation.37Self-Directed Learning.37Reflective Practice.38Trainee Responsibility.38Learning Partnership Agreement.38Pathway to Completion of Training.38Completion of Training (CoT).38Recording Progress in the Portfolio.41Governance and Accountability.42Appraisal.42Continuing Professional Development andRevalidation.42Review of Capability.43Prior to Completion of Training.43Accountability.43Equality and Diversity.44Appendix 1 – Critical Skills.45Appendix 2 – Specialty Capabilities – Surgery.46Appendix 3 – Exemplar Descriptors for CiPs.62Appendix 4 – Critical Progression Points.68Appendix 5 – Syllabus.69Appendix 5a – Core Professional and BehaviourCapabilities.71Appendix 5b – Core Clinical Capabilities.76Appendix 5c – Core Presentations/Conditions andExpected Level of Achievement.105Appendix 5d – Core Critical Conditions in Surgery.110Appendix 6 – Core Clinical and Procedural Skills.111Appendix 7 – Learning Outcomes from MandatoryCourses.112Appendix 8 – Portfolio Guidance and Evidence .113Appendix 9 – Review of Progression to Completionof Training Decision Aid.114Appendix 10 – Assessment Forms.117Appendix 11 – Supervised Learning Events (SLE).135Appendix 12 – Learning Partnership Agreement(Learning Contract). An 1392

Surgical Advanced Clinical Practitioner (SACP) Curriculum and Assessment FrameworkAcknowledgementsThe Surgical Advanced Clinical Practitioner (SACP) Curriculum has been developed by a working partywith representatives from Health Education England (HEE), the Royal College of Surgeons (England) andRoyal College of Surgeons Edinburgh and specialists in advanced clinical practice.HEE and the Surgical Royal Colleges acknowledge the contribution of the following individuals: Mrs Clare Sutherland, Chair SACP CurriculumDevelopment Group and HEE Associate Dean Mr Jon Lund, Surgical Director IntercollegiateSurgical Curriculum Programme (ISCP), JointCommittee on Surgical Training Mrs Jenny Abraham, Surgical Care Practitionerand Association for Perioperative Practice(AfPP) representative Miss Sara Dalby, Surgical Care Practitioner Mrs Jacqueline Finn, Project Manager HEE Mrs Annabella Gloster, Senior Lecturer,University of Salford and Associationof Advanced Practice Educators (AAPE)representative Julie Honsberger, Head of Training ProgrammeManagement, HEE Mrs Karen Jarvis, Trust Lead AdvancedPractitioner, Hull University Teaching HospitalsNHS Trust Dr. Ruth Pearce, Associate Professor, Universityof Nottingham and AAPE representative Professor Rob Crouch OBE, Consultant Nurseand Emergency Care ACP Curriculum Lead Mr Michael Donnellon, Chair Educationand Standards Committee, The College ofOperating Department Practitioners Mr Ian Eardley, Consultant Urological Surgeon Dr Judy Gillow MBE, Senior Nurse Advisor,Health Education EnglandWe also acknowledge significant support from: Professor Geeta Menon, ConsultantOphthalmic Surgeon and Postgraduate Dean,Health Education England Mrs Beverley Harden, National Allied HealthProfessional Lead, Health Education England Mr John Brecknell, Core Surgical TrainingAdvisory Committee (Chair), Joint Committeeon Surgical Training (JCST) Mr David Wilkinson MBE, Consultant VascularSurgeon Dr Sally Gosling, Assistant Director, CharteredSociety of Physiotherapy Mr Oliver Phipps, Consultant Nurse and RCNANP Forum Chair Professor Peter Harris, Patient and Publicrepresentative Mr William Allum, Consultant Upper GIsurgeon and Improving Surgical TrainingCouncil Lead, Royal College of Surgeons ofEngland Mr Nathan Jones, Regional Lead ofAssessments and Revalidation, HEE Sahima Hussain, NHS Employers Mr Adam Peckham-Cooper, Association ofSurgeons in Training Mr Charles Auld, Council Member and Lead ofthe Faculty of Perioperative Care, Royal Collegeof Surgeons of Edinburgh3

Surgical Advanced Clinical Practitioner (SACP) Curriculum and Assessment FrameworkIntroduction‘Over the next 10 years, health and care will change significantly (NHS People Plan, 2020).’The development of this curriculum has been driven by the evolving requirements of the healthcareworkforce and the need to change and adapt to continue to deliver high quality care that is safe,effective and focused on the surgical experience.Delivering high-quality care will require workforce transformation and support through education,training and development of the people the NHS employs. The NHS Constitution for England (2015)demonstrates a commitment to innovation and the development of new roles. New roles and ways ofworking are one of many solutions to improve the current and future health and care of the population.The development of advanced clinical practice reflects this commitment as an innovative NHS and privatesector workforce solution to enhance capacity and deliver improved outcomes for surgical patients.“Demand for health and care services is growing as a result of a growing and ageing population and theever-increasing possibilities of medical science. To meet that demand and deliver the vision set out in theNHS Long Term Plan, we will need more people working in the NHS over the next 10 years across mostdisciplines and in some new ones yet to be fully defined – with a rich diversity of roles and jobs across allsettings (NHS People Plan, 2020).”The principle driver for the implementation of advanced clinical practice is to enable practitioners topractice to their full capability and to optimise their contribution to meeting population, individuals,families and carers needs through different models of service delivery and multidisciplinary working.The development of the Surgical Advanced Clinical Practitioner (SACP) is driven by workforcetransformation to maintain surgical services in line with changes within the surgical workforceand the need to maintain safe and high-quality patient care.Throughout this document the term trainee is synonymous with trainee SACP.4

Surgical Advanced Clinical Practitioner (SACP) Curriculum and Assessment FrameworkBackgroundDefinition of Advanced Level Clinical PracticeAdvanced Clinical Practitioners (ACPs) enhance capacity and capability within multi-professional teamsby supporting existing established roles and developing new ways of working. They help to improveclinical continuity, enhance the multidisciplinary team and provide patient focussed safe, accessible andhigh-quality care. In collaboration with professional and regulatory partners, Health Education England(HEE) developed the following definition of advanced level clinical practice:“Advanced clinical practice is delivered by experienced, registered health and carepractitioners. It is a level of practice characterised by a high degree of autonomyand complex decision making. This is underpinned by a masters level award orequivalent that encompasses the four pillars of clinical practice, leadership andmanagement, education and research, with demonstration of core capabilitiesand area specific clinical competence.Advanced clinical practice embodies the ability to manage clinical care inpartnership with individuals, families and carers. It includes the analysis andsynthesis of complex problems across a range of settings, enabling innovativesolutions to enhance people’s experience and improve outcomes”(HEE, 2017)5

Surgical Advanced Clinical Practitioner (SACP) Curriculum and Assessment FrameworkCurriculumPurposeThe purpose of this curriculum is to establish the standard required to work as an SACP and provideguidance for practitioners to develop into competent practitioners capable of delivering excellentoutcomes for patients in the UK. The curriculum provides a guide to the education and incrementaldevelopment of SACPs in both academic and clinical settings, to ensure practitioners achieve comparablestandards of surgical care through high quality education and training. The clinical capabilities requiredin practice have been mapped to the four pillars of advanced practice as well as consideration of boththe Core surgical curricula (GMC, 2017) as well as the General surgical curriculum planned for use from2021 where knowledge and skill is required to be comparative from a patient safety perspective.The recently published NHS People Plan (2020) discusses new ways of working and delivering caredifferently and this is clearly visible throughout surgery where a change in surgical workforce andincreased integration of the extended surgical team (EST) has led to opportunities of alternative careerpathways for the multiprofessional team as well as improving the training experience of surgicaltrainees. The Royal College of Surgeons (RCS) have produced several excellent documents includingSurgical Care Team Guidance Framework RCS Surgical Care Team Guidance and A question ofbalance – the extended surgical team (2016) both of which provide detail on the benefits of utilisingthe multiprofessional team in the care of surgical patients.In 2015 HEE commissioned The Royal College of Surgeons (RCS) to lead a programme of ImprovingSurgical Training (IST). This has been a major programme of work with the understanding that for itto be successful the EST will need to be further developed. There has been acknowledgement thata curriculum that clearly defines a standard for a practitioner who has breadth of knowledge acrossa range of both medical and surgical conditions and who can support workforce transformation willultimately also facilitate the IST program.The SACP curriculum articulates how the surgical patient is at the heart of the SACP’s practice with thefour pillars of advanced practice linking together to support high quality, safe and effective care that isfocused on patient experience. This link is illustrated in Figure 1.6