General Practitioners with Extended Roles

GPs with Extended Roles (GPwERs) undertake roles that are beyond the scope of GP training and the MRCGP and require additional training. The term GPwER includes those previously referred to as GPs with Special Interests (GPwSIs).

Framework to support the governance of GPwERs

The RCGP has developed a framework in partnership with NHS England, which describes a new approach to the accreditation of GPwERs and is aligned to the appraisal and revalidation process. The framework is intended to be useful to several groups, including GPs, employers, speciality-specific groups and commissioners. It will regularly be reviewed by the RCGP.

Please note this document is currently being updated to reflect that the RCGP is no longer an accreditation provider.   However, other aspects of the framework remain relevant.  We would encourage GPs seeking to pursue a clinical extended role to follow the general principles of the generic framework in relation to the demonstration of initial and ongoing competence, and speak to relevant providers and service commissioners to establish capability and service requirements.  If you are an RCGP member, you may wish to use our Mentoring Platform to connect with others with an interest or experience in your chosen extended role area.

RCGP accreditation of GPwERs

The RCGP has been trialling a national process of GPwER accreditation for GPs with extended scopes of practice in Dermatology and Skin Surgery. The College worked with the British Association of Dermatologists and the Primary Care Dermatology Society to create the dermatology specialty-specific (GPwSI) framework.

The RCGP, British Association of Dermatologists and the Primary Care Dermatology Society have agreed a process for the continued delivery of national GPwER accreditation in dermatology.  Preparations are underway for its re-launch and further information will be available on these pages soon.

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If you have questions about the GPwER frameworks, contact


What is a GP with an Extended Role (GPwER)?

A GPwER is a GP who undertakes, in addition to their core general practice, a role that is beyond the scope of GP training and the MRCGP, and requires further training. The extended role is typically undertaken within a contract or setting that distinguishes it from standard general practice and/or it is an activity offered for a fee outside of care to the registered practice population (teaching, training, research, occupational medicals, medico-legal reports, cosmetic procedures, etc).

Is a GP with Specialist Interest (GPwSI) the same as a GPwER?

GPwER includes those previously known as GPwSI.

I am a trainee GP and want to become a GPwER. What do I do now?

The RCGP recognises that having an extended role is a career aspiration for many new GPs. Although we would encourage you to focus on the core GP curriculum while in training, your deanery/educational supervisor can be a source of guidance around having an extended role and you may wish to engage with others who have a similar interest.  

What is the current GPwER guidance?

The current guidance is the newly published RCGP framework to support the governance of General Practitioners with Extended Roles (the 'generic framework'). However, we would encourage you to speak to commissioners and providers, to see if there is any local guidance you need to follow.

Is there specialty specific GPwER guidance?

Previously, 17 speciality specific (GPwSI) frameworks were available on the RCGP website. We have made the decision to take these offline because they are in need of review. However, we have published a framework for Dermatology and Skin Surgery (based largely on the 2011 GPwSI guidance), which has been updated with the British Association of Dermatologists and the Primary Care Dermatology Society. We also anticipate the development of new specialty-specific frameworks in due course, based on the new generic framework.  

How do I become accredited as a GPwER?

Since the dissolution of Primary Care Trusts in 2013 there has been no consistent process in England for the accreditation of GPwERs/GPwSIs.The RCGP is trialling GPwER accreditation in Dermatology and Skin Surgery, and subject to the outcome of the trial we will seek to phase in accreditation in a limited number of other priority areas. For now, we advise GPs to follow the generic framework and contact providers and commissioners to understand local requirements.

How do I renew my accreditation as a GPwER?

As the generic framework explains, GPwERs will now demonstrate continued competence through the annual (full scope of practice) medical appraisal, with a structured input from their extended scope of practice.

Is GPwER accreditation mandatory?

The generic framework explains that accreditation is best practice, but not all specialities will need accreditation in their extended roles and the RCGP will develop a system for deciding which speciality frameworks should be accredited. Whether or not the GP is accredited in an extended role, to remain revalidated a GP must be able to demonstrate competence in all aspects of their work, keep their professional knowledge and skills up to date and regularly take part in activities that maintain and develop their performance.

Will I be required to accredit to do 'core' general practice?

No. Additional accreditation should not be a requirement for any aspect of practice that is within the scope of GP training and MRCGP, or for GPs with a particular interest or area of expertise, unless the GP practises beyond the scope of 'usual' general practice or in an area that requires an additional specific skill-set that could affect patient safety.

Will a GPwER take all referrals relating to a particular area?

No. The GPwER role description should support the development and maintenance of relevant skills in GPs and other primary care health professionals referring to the service, but not deskill colleagues or lower their threshold for referral.

Who pays for my accreditation?

It depends on local circumstances. Accreditation may be paid for by the doctor seeking accreditation, or, in some cases employers may pay for the accreditation if it is in line with their key areas of health need.


I am based outside of England. Are there different requirements for devolved nations?

The generic framework has been created in collaboration with NHS England. However, it is intended to be useful for GPs in the other countries of the UK too.  We would advise GPs to check whether any local arrangements are in place.

I want to develop a framework, can I?

Subject to the success of the Dermatology and Skin Surgery accreditation trial, the RCGP will work with specialty colleagues to develop frameworks in a small number of priority areas, based on the generic framework. If you would like to develop a framework, the RCGP would be happy to have a preliminary conversation with you.

I am developing a GPwER service in a specific field. What criteria should a GPwER meet?

We suggest you refer to the generic framework and any relevant regulatory guidance.  

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