APS Statement from AACE, BASICs and the Faculty of Pre-Hospital Care

Approved Practice Settings (APS) guidance relating to Pre-Hospital doctors working with NHS ambulance trusts:

This guidance is written to support ambulance trusts with regards to any doctors that are working on behalf of the trust that are clinically practising, responding to incidents and managing patient care – [View PDF version here].

All medical graduates new to full registration, and all doctors restoring to the register after prolonged absence from UK practice must meet the APS requirement, until their first revalidation. This means they must have a connection to a designated body to practise in the UK.

All doctors also need to have an annual appraisal, supported by evidence, which covers their work within an ambulance trust.

The Approved Practice Settings (APS) scheme requires all medical graduates who are new to full registration, and all those applying for restoration after a significant break in practice, to work with appropriate supervision and appraisal arrangements (or assessments).

A doctor will be meeting the APS requirement as long as they hold and maintain their connection to a designated body and their entire practice is subject to appropriate levels of supervision and governance. This does not mean a doctor is restricted to working only in that organisation; a doctor can work in any organisation as long as they hold and maintain a connection to a designated body and have the approval of the APS organisation.

Doctors granted full registration in an APS before 2 June 2014, who have not yet revalidated and do not have a prescribed connection, can continue to practise wholly in their current APS organisation until they revalidate.

Doctors on a UK training programme who want to practise outside their substantive employment may do so, but must ensure their educational supervisor is aware of this and comply with any reporting requirements set by their RO or training body.

British Association for Immediate Care Schemes (BASICS) are not Approved Practice Settings. Where an Ambulance Trust tasks a BASICS scheme whose membership comprises doctors required to be in an APS, it is incumbent on the Ambulance Trust to register as an APS or ensure that the APS to which those doctors are already registered approve the prehospital practice undertaken by those doctors.

Approved Practice Settings are UK organisations that have systems in place to:

  • provide doctors with appropriate supervision and regular appraisal
  • identify and act upon concerns about a doctor’s fitness to practise
  • support the provision of relevant training and continuing professional development for doctors
  • provide regulatory assurance.

Some ambulance trusts are Approved Practice Settings. An ambulance trust may apply to become an APS by following the application process as detailed on the GMC website.

Further information can be found on the GMC website.

[February 2016]