Practitioners with Extended Roles Policy
Version: V2
Ratified by:
Quality Reference Group
Date ratified: 30/06/2026
Job Title of author: Medical Advisor
Reviewed by Committee or Expert Group
Quality Reference Group
Equality Impact Assessed by: Medical Advisor
Related procedural documents
CPOL44 Medical Appraisal Policy Review date: 30/06/2029
It is the responsibility of users to ensure that you are using the most up to date document template – i.e. obtained via the intranet
In developing/reviewing this policy Provide Community has had regard to the principles of the NHS Constitution.
Version Control Sheet
Version Date
Author Status Comment
V1 February2023 Medical Advisor New
V2 May2026 Medical Advisor review Provide Wellbeing and CIC variants combined into one policy – no other changes required at this review
1. Introduction
Provide currently employ a small number of medical staff who have primary qualifications in primary care but offer specialist services as part of an extended role. The guidance for these General Practitioners with extended roles (GPwER) has changed with the latest guidance from 2021 https://www.rcgp.org.uk/getmedia/8725a327-5eaf-4a4d-b8f7-c8efa8668764/RCGPGuide-to-GP-clinical-extended-roles-June-21-v21.pdf
This policy reflects that guidance.
2. Purpose
Provide as an employing organisation needs to have assurance that the practitioners it employs are suitably qualified and remain updated for their extended role.
3. Definitions
General practitioners with extended role GPwER: medical staff who have primary qualifications in primary care but offer specialist services as part of an extended role These currently include dermatology, minor surgery, and sexual health but potentially other specialities could be included. This excludes those doctors employed who are on the specialist register, consultants, and associate specialists.
4. Duties
Departmental managers will have a responsibility to request an opinion from the organisational Responsible Officer or Chief Medical Officer prior to employing GPwER and include yearly assurance as part of the employment contract.
The Provide Responsible Officer will maintain a register of employed GPwER, advise on suitability of candidates for employment and request a yearly update to ensure compliance with ongoing professional development. This will be included in an update to the appropriate governance group.
GPwER will be contractually obliged to provide sufficient assurance that they include their specialist role as part of annual appraisal. There is an expectation that they will include appropriate continuing professional development (CPD) in their specialist role.
5. Consultation and Communication
GPwER will be made aware of our policy and the annual request for appraisal information by the Provide responsible officer.
6. Monitoring
Prior to employment the manager will request an opinion from the Responsible Officer or Chief Medical Officer regarding primary qualifications and experience of the candidate for an extended role. Such qualifications may include primary qualifications in a speciality, experience in another NHS provider or one of the specific GPwER accreditations for dermatology. If in doubt external opinion may be sort from a suitably qualified specialist.
The organisation will need to be assured that in addition to any primary qualifications in their specialist role all our employed GPwER are maintaining an annual appraisal that includes sufficient CPD in their specialist area, this may include for example training, patient case reviews, audits, surgical logs and mentoring or peer group discussions.
To ensure compliance, the Provide Responsible Officer will request a yearly update of appraisal outputs and an individual declaration of compliance.
Compliance with monitoring will be included in GPwER contractual obligations. The guidance around appraisal in extended roles is included in the following: https://www.england.nhs.uk/professional-standards/medical-revalidation/ro/infodocs/roan-information-sheets/reviewing-all-roles-in-scope-of-work/
7. References
https://www.england.nhs.uk/professional-standards/medical-revalidation/ro/infodocs/roan-information-sheets/reviewing-all-roles-in-scope-of-work/
https://www.rcgp.org.uk/getmedia/8725a327-5eaf-4a4d-b8f7-c8efa8668764/RCGPGuide-to-GP-clinical-extended-roles-June-21-v21.pdf
https://www.england.nhs.uk/professional-standards/
EQUALITY IMPACT ASSESSMENT TEMPLATE
Stage 1: ‘Screening’
The Equality Impact Assessment needs to be completed so that any decisions made are compliant with the aims of the Public Sector Equality Duty – and that any adverse impact for any protected characteristics are identified and resolved.
Policy Title
CPOL73PractitionerwithExtendedRolesPolicy
Provide a brief summary (bullet points) of the aims of the Policy
Provide as an employing organisation needs to have assurance that the practitioners it employs are suitably qualified and remain updated for their extended role.
EQIA Assessor Name and Job Title
Medical Advisor
Date of Assessment
April 2026
This stage establishes whether a proposed initiative will have an impact from an equality perspective on any particular group of people or community or whether it is “equality neutral” (i.e. have no effect either positive or negative)
Q1. Will this policy affect one of the following groups more or Less favourably than another?
Details
Group
Age
Consider impact and detail across age ranges on old and younger people. This can include safeguarding, consent and child welfare
Disability
Consider and detail impact on attitudinal, physical, and social barriers.
Sex
Consider and detail impact on men and women (potential to link to carers)
Gender reassignment (including transgender)
Consider and detail impact on transgender and transsexual people. This can include issues such as privacy of data and harassment.
Pregnancy and maternity
Consider and detail impact on working arrangements, part-time working, infant caring responsibilities.
Race
Consider and detail impact on different ethnic groups, nationalities, Roma
If more or less, explain impact and any valid legal and/or justifiable exception. Include the source of any evidence
gypsies, Irish travellers, language and communication barriers.
Religion or belief
Consider and detail impact on people with different religions, beliefs or no belief.
Sexual orientation
Consider and detail impact on heterosexual people as well as lesbian, gay and bi-sexual people
Carers
Consider and detail impact on part-time working, shift-patterns, general caring responsibilities
Other identified groups
Consider and detail on different socioeconomic groups, area inequality, income, resident status (migrants) and other groups experiencing disadvantage and barriers to access.
Is the impact of the initiative – whether positive or negativesignificant enough to warrant a more detailed Stage 2 assessment?
Yes X No
Guidelines: Things to consider
Equality impact assessments at Provide take account of relevant equality legislation and include age, (i.e. young and old,); race and ethnicity, gender, disability, religion and faith, and sexual orientation.
The initiative may have a positive, negative or neutral impact, i.e. have no particular effect on the group/community.
Where a negative (i.e. adverse) impact is identified, it may be appropriate to make a more detailed EIA (see Stage 2), or, as important, take early action to redress this – e.g. by abandoning or modifying the initiative. NB: If the initiative contravenes equality legislation, it must be abandoned or modified.
Where an initiative has a positive impact on groups/community relations, the EIA should make this explicit, to enable the outcomes to be monitored over its lifespan.
Where there is a positive impact on particular groups does this mean there could be an adverse impact on others, and if so can this be justified? - e.g. are there other existing or planned initiatives which redress this?
It may not be possible to provide detailed answers to some of these questions at the start of the initiative. The EIA may identify a lack of relevant data, and that data-gathering is a specific action required to inform the initiative as it develops, and also to form part of a continuing evaluation and review process.
It is envisaged that it will be relatively rare for full impact assessments to be carried out at Provide. Usually, where there are particular problems identified in the screening stage, it is envisaged that the approach will be amended at this stage, and/or setting up a monitoring/evaluation system to review a policy’s impact over time.
EQUALITY IMPACT ASSESSMENT TEMPLATE
Stage 2
To be used where the ‘screening phase has identified a substantial problem/concern)
This stage examines the initiative in more detail in order to obtain further information where required about its potential adverse or positive impact from an equality perspective. It will help inform whether any action needs to be taken and may form part of a continuing assessment framework as the initiative develops.
Policy/ Project Title
EIA Assessor Name and Job Title Date of Assessment
EIA Review by Chief Officer name and Job Title Date Of Review
Outcome of Chief Officer Review
Q1. What data/information is there on the target beneficiary groups/communities?
Are any of these groups under- or over-represented? Yes No
Do they have access to the same resources? Yes No
What are your sources of data and are there any gaps?
Q2. Is there a potential for this initiative to have a positive impact, such as tackling discrimination, promoting equality of opportunity and good community relations? Yes No
If yes, how? Which are the main groups it will have an impact on?
Q3. Will the initiative have an adverse impact on any particular group or community/community relations? Yes
No
If yes, in what way? Will the impact be different for different groups – e.g. men and women?
No
Q4. Has there been consultation/is consultation planned with stakeholders/ beneficiaries/ staff who will be affected by the initiative? Yes
Summarise (bullet points) any important issues arising from the consultation
Q5. Given your answers to the previous questions, how will your plans be revised to reduce/eliminate negative impact or enhance positive impact?
Are there specific factors which need to be taken into account? Yes No
Q6. How will the initiative continue to be monitored and evaluated, including its impact on particular groups/ improving community relations? Where appropriate, identify any additional data that will be required
Guidelines: Things to consider
An initiative may have a positive impact on some sectors of the community but leave others excluded or feeling they are excluded. Consideration should be given to how this can be tackled or minimised.
It is important to ensure that relevant groups/communities are identified who should be consulted. This may require taking positive action to engage with those groups who are traditionally less likely to respond to consultations and could form a specific part of the initiative.
The consultation process should form a meaningful part of the initiative as it develops and help inform any future action.
If the EIA shows an adverse impact, is this because it contravenes any equality legislation? If so, the initiative must be modified or abandoned. There may be another way to meet the objective(s) of the initiative.