Purpose of this framework
This framework provides guidance for GPs who identify with providing or an ambition to fulfil a role beyond that expected of every GP.
The RCGP defines a GP as follows:
A GP is a doctor who is a consultant in general practice. GPs have distinct expertise and experience in providing whole person medical care whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. GPs work at the heart of their communities, striving to provide comprehensive and equitable care for everyone, taking into account their health care needs, stage of life and background. GPs work in, connect with and lead multidisciplinary teams that care for people and their families, respecting the context in which they live, aiming to ensure all of their physical and mental health needs are met.
The RCGP defines a GP with Extended Role (GPwER) as a GP with a UK licence to practise, who is maintaining a primary care medical role, but undertaking an activity that is beyond the scope of general practice and requires further training. The GPwER is not simply a ‘mini-secondary care specialist’ who has taken a different route to specialty practice. Extended roles are typically undertaken within a contract or setting that distinguishes them from standard general practice and involve an activity offered for a fee outside the care provided to the registered practice population. GPwERs often receive referrals for assessment and treatment from outside their immediate practice and undertake work that attracts an additional or separate medical indemnity fee.
It is recognised that several variations of this role are likely to exist, each designed around local health population needs. Therefore, this framework neither establishes a rigid uniform model nor serves as a curriculum or set of competencies for a certification, rather it guides the areas for professional development, competence and good practice that is practical and universally operational for a GPwER CAMH. This framework offers guidance on the evidence which may be helpful in demonstrating competence in this role as part of the GP annual appraisal.
Acknowledgements
We would like to thank the lead author Dr Emma Nash for her work in support of the development of this framework.
We would also like to acknowledge the contributions of the task and finish group:
Sarah Temple, Faraz Mughal, Stephanie Lamb, Amina Al-Yassine, Emma Park, Louise Randall, Ruth Thompson, Catherine Daly, Karen Nicolson, Diane Biondini, Kate Szymankiewicz, Julie Waine.
Declarations of interests by authors
Emma Nash:
- Shareholder – Fareham and Portchester PCN
- RCGP roles: eLearning Development Fellow and Clinical Lead, GP SelfTest
- Commissioned articles/presentations for Pulse and Medscape (Guidelines in Practice)
- Founder, Primary Care Mental Health Association
Faraz Mughal:
- Honorary Secretary of RCGP Adolescent Health Group
- NIHR Doctoral Fellow, Keele University which funded role as Lead author of BMJ and BJGP publications around improving care for young people after self-harm
Stephanie Lamb:
- Chair of the Adolescent Health Special Interest Group
- Founder and Clinical Director of the Well Centre, Adolescent Health Hub in South London and undertakes occasional speaking engagements on adolescent health
Sarah Temple:
- Director of EHCAP Ltd. The company owns the intellectual property for a trauma informed coaching approach that has been accredited for training health coaches, health and wellbeing coaches and other health, care and education professionals.
- Author of resources referenced in framework (Mindful Emotion Coaching)
Framework review
Date the framework was approved: April 2025
Date for next review: April 2027