Advanced Critical Care Practitioners are part of the multidisciplinary ICU team
Advanced Critical Care Practitioners (ACCPs) are clinical professionals responsible for patients' care during their critical care admission. They are highly experienced and educated practitioners who have developed their skills and theoretical knowledge to a very high standard. They are empowered to make high-level clinical decisions to ensure that patients receive timely, personal, and effective care.
What are ACCPs?
The ACCP role is a way of working for health professionals, which crosses professional boundaries. ACCPs are currently developed from experienced nurses, physiotherapists, paramedics or other related health care professionals. In the future it is envisaged that ACCPs may also be drawn from other emerging healthcare roles.
- Undertake comprehensive clinical assessment of a patient’s condition
- Request and perform diagnostic tests
- Initiate and manage a clinical treatment plan
- Provide accurate and effective clinical handovers
- Undertake invasive interventions within the scope of practice
- Provide professional leadership and support within a multi-professional team
- Work autonomously in recognised situations
- Demonstrate comprehensive knowledge across a range of subject areas relevant to the field of critical care
- Critically analyse, evaluate and synthesise different sources of information for the purpose of assessing and managing the care of a critically ill patient
- Apply the principles of diagnosis and clinical reasoning that underlie clinical judgement and decision making
- Apply theory to practice through a clinical decision-making model
- Apply the principles of therapeutics and safe prescribing
- Understand the professional accountability and legal frameworks for advanced practice
- Function at an advanced level of practice as part of the multidisciplinary team as determined by the competency framework
- Apply the principles of evidence-based practice to the management of the critically ill patient
- Understand and perform clinical audit
ACCPs must complete a programme leading to an appropriate Postgraduate Diploma/Masters degree with a Higher Education Institution. Teaching within hospitals is overseen by a Local Clinical Lead (LCL) who holds an honorary appointment with the HEI and is responsible to the HEI for the delivery of the clinical components of training. The Department of Health National Education and Competence Framework for ACCPs can be found in the related downloads section below.
The ACCP Advisory Group have produced an information leaflet for patients and relatives. You can download and print a copy here.
Core Capabilities Framework
The National Education and Competence Framework for Advanced Critical Care Practitioners was published by the Department of Health in 2008. The framework built on the work of the Changing Workforce Programme development sites that tested the role in clinical practice, the National Practitioner Programme Critical Care Board, the Education and Competence Advisory Party, higher education institutions (HEIs) and clinical colleagues, drawn from a range of backgrounds, with a specific interest in critical care development.
FICM was founded in 2010 and the first edition of the FICM ACCP curriculum published in 2015.
ACCPs, MAPs and the Centre for Advancing Practice
FICM's ACCP Sub-Committee were involved in the early discussions with the Health Education England (HEE) Medical Associate Professionals (MAPs) Oversight Board.
In December 2021, FICM polled the ACCP community (fully trained, registered, and ACCPs in training, as well as the wider community via the National Association of ACCPs) around the future direction for the role. 77% of respondents clearly supported the feeling that active involvement in the MAP agenda had become increasingly less applicable for ACCPs. This tallied with the view of the FICM ACCP Sub-Committee and the MAP Oversight Board.
As such, HEE (now NHSE) and the Faculty agreed in April 2022 that the role of ACCPs would cease to fall under the scope of the MAPs programme and is instread formally aligned with the Centre for Advancing Practice.
ACCPs continue to hold registration with their base profession (e.g. NMC), not the GMC, and are qualified non-medical prescribers.
Any UK registered professional can train as an ACCP. The majority of registered ACCPs are nurses but other Allied Health Professionals (AHPs) such physiotherapists and Paramedics have also successfully trained as ACCPs. It is also envisaged that in future, Operating Department Practitioners (ODPs), Physicians Associates (PAs) and Anaesthesia Associates (AAs), when their regulating bodies allow independent prescribing, would be able to complete ACCP training and achieve FICM ACCP Member status.
From 2022 onwards it will be possible for HEIs to undertake an accreditation process with FICM. Once awarded FICM accreditation successful HEIs will be listed on the Faculty Website and in Critical Eye. Applicants undertaking training at an accredited HEI will be allowed to register as FICM ACCP members on successful completion of the course and satisfactory completion of their clinical competencies.
As the curriculum mandates a parallel of academic and clinical practice training of ACCPs will occur in existing UK training centres approved for Stage 1 and 2 ICM level training or for those sites with clear and documented approval from the regions ICM RA, following the process outlined under training centre amendment on this page. If a trainee ACCP undertakes training on a site without this approval in place, those trainees would not be eligible for any official Faculty recognition of that training, nor to apply for FICM Advanced Critical Care Practitioner Membership upon completion of their ACCP training programme. Any non-ICM training approved unit seeking to run ACCP training must make this prospectively clear to any applicants for their programme.
We know that the term ACCP has been wrongly used to include any practitioner position regardless of the length, depth and quality of training. Ensure that the training programme you are undertaking complies with the tenets laid out within the FICM curriculum. Be proactive and ask the local trainers whether the training programme and unit adheres to the FICM curriculum and whether it will leave you eligible upon completion to apply for FICM ACCP Membership. If you have any concerns please contact us for advice.
Yes. Training programmes that adhere to the FICM ACCP Curriculum should be designated as ‘Advanced Critical Care Practitioner training in line with the FICM Curriculum.’ It should be noted in the material that those who complete the full training programme would be eligible for Advanced Critical Care Practitioner Membership of the Faculty.
Training is two years, full time.
In 2021 the Faculty launched a HEI Accreditation programme. Details of HEIs ACCP Training Programmes can be found here.
Yes in conjunction with the HEI the APEL process where appropriate to the ACCP programme can be used.
There is no formal route for this; currently the ACCP role is very clearly defined by the curriculum, benchmarking against overseas practice given the wide variation would require local ICU / HEI review and UK module and clinical competencies completion. Application for FICM Advanced Critical Care Practitioner Membership would be only possible based on successful matching of these.
If you are a unit accepting stage 1 & 2 trainees for ICM training, or a unit with the support and sign off of your ICM Regional Advisor, training ACCPs would involve:
- Engagement with a local HEI to run an ACCP PGDip course (MSc in future).
- Engagement of key stakeholders in our organisation to assess the possibility of the ACCP role being a viable workforce solution for your unit.
- Plan the end point of training - most, if not all, ACCPs take a position on the medical rota. Be clear how this will work including supervision requirements.
- Business case development - early involvement of your divisional managers and repeated "marketing" of the planned ACCP role in your strategic, financial and workforce planning. Getting the Medical and Nursing Directors on board early is key.
The ACCP sub committee has produce the following document as a quick check guide of things to consider when employing ACCPs in a critical care unit
At present ACCPs need to retain their base professional registration with their regulatory bodies, this may alter in the future but currently there is no way to register the ACCP role separately.
You are bound by the revalidation rules from your base professional registering body. See advice on the toolkits section on how this may be achieved.
Pending formal regulation, trained Advanced Critical Care Practitioners (ACCPs) are expected to adhere to the code of conduct of their registering body. In addition, please see this document for ACCPs
Working in a UK Trust you will have NHS indemnity, it is your responsibility to ensure you have appropriate Standard Operating Procedures ratified by your Governance structure - these should be very explicit around the issue of supervision.
Many ACCPs choose to take out additional personal cover via the MDDUS to provide additional insurance. You do not need to have this but as many of us do choose to have it for the additional security and independent legal advice with your interests as the focus.
Want to know more?
Read the ACCP curriculum.