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Enhanced clinical practitioner

Key information

  1. Status: Approved for delivery
  2. Reference: ST0895
  3. Version: 1.1
  4. Level: 6
  5. Degree: non-degree qualification
  6. Typical duration to gateway: 18 months (this does not include EPA period)
  7. Maximum funding: £7000
  8. Route: Health and science
  9. Date updated: 25/05/2023
  10. Approved for delivery: 27 May 2021
  11. EQA provider: Ofqual
  12. Example progression routes:
  13. Review:

    This apprenticeship standard will be reviewed after three years

Print apprenticeship summary

Apprenticeship summary

Overview of the role

Provide a high standard of health care using judgment, skills, and knowledge.

Occupation summary

This occupation is found in the health and care sector. Enhanced Clinical Practitioners are qualified health and social care professionals who are working at an enhanced level of practice with specific knowledge and skills in a field of expertise. They manage a discrete aspect of a patient’s care within their current level of practice, which will be particular to a specific context, be it a client group, a skill set or an organisational context. This is in contrast to Advanced Clinical Practitioners who have developed their knowledge and skills to an advanced level of practice and would manage the whole episode of a patient’s clinical care, from the time they first present, through to the end of the episode.

Enhanced Clinical Practitioners work as part of a multi-disciplinary clinical team across a wide range of settings, including hospitals, community clinics, individual’s homes and in dental and general practices. Specific examples of settings in which Enhanced Clinical Practitioners work include critical care units providing complex interventions to critically ill patients, GP premises providing specialist services for patients in the community and Children and Families Services units within a local council providing therapeutic interventions to children, young people and their families.

The broad purpose of the occupation is to provide a high standard of complex, enhanced care for patients, using enhanced levels of clinical judgement, skills and knowledge. Enhanced Clinical Practitioners will consult with patients, their family, carers and the multi-professional team to undertake assessments of patient need and devise and evaluate complex care plans related to their field of expertise, for example renal care, critical care, child psychotherapy, diabetes. They critically evaluate and analyse clinical problems using their expertise and clinical knowledge, seeking out and applying relevant evidence, enhanced clinical assessments, diagnostics, interventions, and equipment to make clinical decisions.

Enhanced Clinical Practitioners deliver complex clinical care in the context of continual change, challenging environments, different models of care delivery, innovation and rapidly evolving technologies using critical analysis and their underpinning knowledge to manage complex interventions. They teach and advise patients and their families/carers on how to manage their condition or support the multi-disciplinary team to do so. They participate in clinical audits and research projects and implement changes as required, including the development and updating of practice protocols/guidelines and procedures. They will work within national and local protocols where these exist. They continuously update their knowledge and enhance their clinical practice and provide support, mentoring and supervision of others. They recognise and work within the boundaries of their practice, knowing when and who to refer patients to. They may delegate work to other members of the multidisciplinary team and take accountability for the delegated activity.

In their daily work, an employee in this occupation interacts with:

  • Patients, service users and carers in settings such as hospitals, clinics, dental practices, general practices, patient/client homes, care homes, community clinics
  • Other health and social care professionals for example, doctors, members of the dental team, registered nurses, care workers, social workers, allied health professionals, pharmacists, healthcare scientists, advanced clinical practitioners, consultant clinical practitioners and clinical academics
  • Students and other learners
  • Service leaders and managers
  • Stakeholder groups and third sector organisations
  • Representatives from pharmaceutical and equipment companies

 An employee in this occupation will be responsible for: 

  • Maintaining and continuously updating their existing knowledge, skills and expertise to inform their enhanced clinical judgement             
  • Critically evaluating and analysing complex clinical interventions to make evidence-based decisions on how to manage the delivery of complex clinical care for a defined population, which may include individuals from diverse cultural, social and belief systems. They often manage a caseload, sometimes providing interventions as part of a dedicated clinical pathway.
  • Caring for people with complex care needs using their existing knowledge and expertise, enhanced clinical assessments, diagnostics, interventions and equipment. They must have the confidence and ability to think critically, and to apply a depth of knowledge and highly developed skills to provide enhanced evidence-based care
  • Working as part of a wider health and care team whilst being able to work alone when seeing people in their own homes in the community or in a clinical facility. They provide complex clinical care in the context of continual change, challenging environments, different models of care delivery, an older and more diverse population, vulnerable children and young people, mental health needs and innovation and rapidly evolving technologies
  • Engaging and involving patients, families and carers in co-production of strategies to manage their own health and wellbeing
  • Negotiating boundaries and playing an important proactive clinical leadership role in multidisciplinary teams to support the integration of health and social care services
  • Managing their own personal health and well-being, providing support and supervision for others and recognising the boundaries of their practice in order to respond to the impact and demands of their practice
  • Delegating work to other members of the multidisciplinary team and taking accountability for that delegated activity

Typical job titles include:

Dietitian (gastroenterology) Educational audiologist Enhanced dental technician Mental health enhanced liaison practitioner Physiologist (paediatric respiratory) Registered nurse (critical care)

Duties

  • Duty 1 Be an accountable professional acting in the best interests of people, putting them first and providing complex clinical care that is evidence-based, person-centred, safe and compassionate.
  • Duty 2 Use existing knowledge and expertise and enhanced levels of clinical judgement to independently undertake complex and holistic assessments.
  • Duty 3 Act independently to plan, deliver, monitor and evaluate complex care using enhanced clinical assessments, diagnostics, and interventions.
  • Duty 4 Act as an expert resource within their own organisation and for external agencies.
  • Duty 5 Develop, deliver and evaluate education and training opportunities for others within own scope of practice.
  • Duty 6 Communicate effectively in challenging environments and situations with patients, their families/carers and the multi-disciplinary team.
  • Duty 7 Promote and encourage innovative clinical practice to support a culture of excellence within the wider health and care team.
  • Duty 8 Lead and manage unpredictable and unplanned clinical situations.
  • Duty 9 Participate in resource management, strategic service development, planning and service improvement.
  • Duty 10 Lead, monitor, develop and appraise staff and learners.

Apprenticeship summary

ST0895, enhanced clinical practitioner level 6

This is a summary of the key things that you – the apprentice and your employer need to know about your end-point assessment (EPA). You and your employer should read the EPA plan for the full details. It has information on assessment method requirements, roles and responsibilities, and re-sits and re-takes.

What is an end-point assessment and why it happens

An EPA is an assessment at the end of your apprenticeship. It will assess you against the knowledge, skills, and behaviours (KSBs) in the occupational standard. Your training will cover the KSBs. The EPA is your opportunity to show an independent assessor how well you can carry out the occupation you have been trained for.

Your employer will choose an end-point assessment organisation (EPAO) to deliver the EPA. Your employer and training provider should tell you what to expect and how to prepare for your EPA.

The length of the training for this apprenticeship is typically 18 months. The EPA period is typically 0 months.

The overall grades available for this apprenticeship are:

  • fail
  • pass
  • distinction

When you pass the EPA, you will be awarded your apprenticeship certificate.

EPA gateway

The EPA gateway is when the EPAO checks and confirms that you have met any requirements required before you start the EPA. You will only enter the gateway when your employer says you are ready.

The gateway requirements for your EPA are:

  • achieved English and mathematics qualifications in line with the apprenticeship funding rules


Assessment methods



The EPAO will confirm where and when each assessment method will take place.

Who to contact for help or more information

You should speak to your employer if you have a query that relates to your job.

You should speak to your training provider if you have any questions about your training or EPA before it starts.

You should receive detailed information and support from the EPAO before the EPA starts. You should speak to them if you have any questions about your EPA once it has started.


Reasonable adjustments

If you have a disability, a physical or mental health condition or other special considerations, you may be able to have a reasonable adjustment that takes this into account. You should speak to your employer, training provider and EPAO and ask them what support you can get. The EPAO will decide if an adjustment is appropriate.

Print occupational standard

Details of the occupational standard

Occupation summary

This occupation is found in the health and care sector. Enhanced Clinical Practitioners are qualified health and social care professionals who are working at an enhanced level of practice with specific knowledge and skills in a field of expertise. They manage a discrete aspect of a patient’s care within their current level of practice, which will be particular to a specific context, be it a client group, a skill set or an organisational context. This is in contrast to Advanced Clinical Practitioners who have developed their knowledge and skills to an advanced level of practice and would manage the whole episode of a patient’s clinical care, from the time they first present, through to the end of the episode.

Enhanced Clinical Practitioners work as part of a multi-disciplinary clinical team across a wide range of settings, including hospitals, community clinics, individual’s homes and in dental and general practices. Specific examples of settings in which Enhanced Clinical Practitioners work include critical care units providing complex interventions to critically ill patients, GP premises providing specialist services for patients in the community and Children and Families Services units within a local council providing therapeutic interventions to children, young people and their families.

The broad purpose of the occupation is to provide a high standard of complex, enhanced care for patients, using enhanced levels of clinical judgement, skills and knowledge. Enhanced Clinical Practitioners will consult with patients, their family, carers and the multi-professional team to undertake assessments of patient need and devise and evaluate complex care plans related to their field of expertise, for example renal care, critical care, child psychotherapy, diabetes. They critically evaluate and analyse clinical problems using their expertise and clinical knowledge, seeking out and applying relevant evidence, enhanced clinical assessments, diagnostics, interventions, and equipment to make clinical decisions.

Enhanced Clinical Practitioners deliver complex clinical care in the context of continual change, challenging environments, different models of care delivery, innovation and rapidly evolving technologies using critical analysis and their underpinning knowledge to manage complex interventions. They teach and advise patients and their families/carers on how to manage their condition or support the multi-disciplinary team to do so. They participate in clinical audits and research projects and implement changes as required, including the development and updating of practice protocols/guidelines and procedures. They will work within national and local protocols where these exist. They continuously update their knowledge and enhance their clinical practice and provide support, mentoring and supervision of others. They recognise and work within the boundaries of their practice, knowing when and who to refer patients to. They may delegate work to other members of the multidisciplinary team and take accountability for the delegated activity.

In their daily work, an employee in this occupation interacts with:

  • Patients, service users and carers in settings such as hospitals, clinics, dental practices, general practices, patient/client homes, care homes, community clinics
  • Other health and social care professionals for example, doctors, members of the dental team, registered nurses, care workers, social workers, allied health professionals, pharmacists, healthcare scientists, advanced clinical practitioners, consultant clinical practitioners and clinical academics
  • Students and other learners
  • Service leaders and managers
  • Stakeholder groups and third sector organisations
  • Representatives from pharmaceutical and equipment companies

 An employee in this occupation will be responsible for: 

  • Maintaining and continuously updating their existing knowledge, skills and expertise to inform their enhanced clinical judgement             
  • Critically evaluating and analysing complex clinical interventions to make evidence-based decisions on how to manage the delivery of complex clinical care for a defined population, which may include individuals from diverse cultural, social and belief systems. They often manage a caseload, sometimes providing interventions as part of a dedicated clinical pathway.
  • Caring for people with complex care needs using their existing knowledge and expertise, enhanced clinical assessments, diagnostics, interventions and equipment. They must have the confidence and ability to think critically, and to apply a depth of knowledge and highly developed skills to provide enhanced evidence-based care
  • Working as part of a wider health and care team whilst being able to work alone when seeing people in their own homes in the community or in a clinical facility. They provide complex clinical care in the context of continual change, challenging environments, different models of care delivery, an older and more diverse population, vulnerable children and young people, mental health needs and innovation and rapidly evolving technologies
  • Engaging and involving patients, families and carers in co-production of strategies to manage their own health and wellbeing
  • Negotiating boundaries and playing an important proactive clinical leadership role in multidisciplinary teams to support the integration of health and social care services
  • Managing their own personal health and well-being, providing support and supervision for others and recognising the boundaries of their practice in order to respond to the impact and demands of their practice
  • Delegating work to other members of the multidisciplinary team and taking accountability for that delegated activity

Typical job titles include:

Dietitian (gastroenterology) Educational audiologist Enhanced dental technician Mental health enhanced liaison practitioner Physiologist (paediatric respiratory) Registered nurse (critical care)

Entry requirements

Enhanced Clinical Practitioners must be registered with either one of the statutory healthcare regulators, Social Work England or with one of the following accredited voluntary registers: The Academy for Healthcare Science, Register of Clinical Technologists or Registration Council for Clinical Physiologists. They must undertake revalidation processes or audit of their continuing professional development where these apply. Apprentice Educational Audiologists must hold student membership with The Academy for Healthcare Science on entry, and hold full registration with The Academy for Healthcare Science at the gateway to end-point.

Occupation duties

Duty KSBs

Duty 1 Be an accountable professional acting in the best interests of people, putting them first and providing complex clinical care that is evidence-based, person-centred, safe and compassionate.

K1 K2 K3

S1 S2 S3

B1 B2 B3

Duty 2 Use existing knowledge and expertise and enhanced levels of clinical judgement to independently undertake complex and holistic assessments.

K4 K5 K6

S4 S5 S6

B1 B2 B3

Duty 3 Act independently to plan, deliver, monitor and evaluate complex care using enhanced clinical assessments, diagnostics, and interventions.

K7 K8 K10 K11

S7 S8 S9 S10 S11

B1 B2 B3

Duty 4 Act as an expert resource within their own organisation and for external agencies.

K9 K12 K13

S12 S13

B1 B2 B3

Duty 5 Develop, deliver and evaluate education and training opportunities for others within own scope of practice.

K14 K15 K16

S14 S15 S16

B1 B2 B3

Duty 6 Communicate effectively in challenging environments and situations with patients, their families/carers and the multi-disciplinary team.

K17 K18 K19 K27

S17 S18 S19 S27

B1 B2 B3

Duty 7 Promote and encourage innovative clinical practice to support a culture of excellence within the wider health and care team.

K20 K21 K22

S20 S21 S22

B1 B2 B3

Duty 8 Lead and manage unpredictable and unplanned clinical situations.

K24 K25 K26

S24 S25 S26

B1 B2 B3

Duty 9 Participate in resource management, strategic service development, planning and service improvement.

K28 K29 K30

S28 S29 S30

B1 B2 B3

Duty 10 Lead, monitor, develop and appraise staff and learners.

K23 K31 K32

S23 S31 S32

B1 B2 B3


KSBs

Knowledge

K1: Tools and techniques used to systematically search, select and present evidence. Back to Duty

K2: Techniques to critically appraise evidence such as local and national quality standards and frameworks and ways to relate this to own practice. Back to Duty

K3: Requirements of their on-going professional registration and code of conduct in relation to their scope of practice such as when and how to escalate or refer in line with defined scope of practice. Back to Duty

K4: How to appraise the relevance of available tools and techniques to the clinical situation and own scope of practice. Back to Duty

K5: Legislation, clinical frameworks, contemporaneous evidence-based practice guidelines, outcomes from clinical audit and algorithms to support decision making. Back to Duty

K6: Anatomy and physiology and pathophysiology to support complex holistic patient assessment including the underlying psychological, social and long-term impact of illness. Back to Duty

K7: Tools and techniques to critically evaluate clinical information to inform decision making and care management planning. Back to Duty

K8: Underpinning anatomy and complex applied physiology, disease, toxicities, treatments and interventions which guide the selection of specialist diagnostics. Back to Duty

K9: Methods to support complex intervention decision making aligned to national and international guidelines. Back to Duty

K10: Principles and theories of co-production, health coaching, peer support and self-management used to build knowledge, skills and confidence to enable patient self-management. Back to Duty

K11: Diverse sources of information and evidence to underpin decision making and techniques to interpret and assimilate a diverse range of information and evidence. Back to Duty

K12: Principles and theories of coaching used in supporting others in complex clinical decision making and care delivery. Back to Duty

K13: Principles and theories of leadership and role modelling. Back to Duty

K14: Tools and procedures for conducting a training needs analysis. Back to Duty

K15: Teaching, learning and assessment theories, techniques, innovations and models relevant to the educational activity including ways to facilitate a positive learning environment. Back to Duty

K16: Models, tools and frameworks for receiving and providing constructive feedback. Back to Duty

K17: Principles of different communication strategies and theories, communication modes (written, digital, verbal, non-verbal) and clinical communication tools. Back to Duty

K18: Models and theories for negotiating and mediating, such as de-escalation and diffusing strategies. Back to Duty

K19: Communication strategies and tools used to share complex information with different audiences and individuals. Back to Duty

K20: Principles of change management and co-production to support clinical innovation in the workplace. Back to Duty

K21: Local and national approaches and planning processes to support quality improvement. Back to Duty

K22: Service evaluation, research and audit techniques to support quality improvement processes within area of enhanced clinical practice. Back to Duty

K23: The role and impact of reflection in improving clinical practice and best-practice methods for clinical supervision. Back to Duty

K24: Signs and pathophysiology of deterioration or distress in mental, physical, cognitive and behavioural health in own scope of practice. Back to Duty

K25: Protocols and systems used to plan, prioritise and direct resources within area of enhanced clinical practice and how to escalate to and engage others when working at the boundaries of scope of practice. Back to Duty

K26: Evidence-based strategies to manage clinical risk in enhanced clinical practice. Back to Duty

K27: Principles of psychological well-being, the importance of maintaining own and others well-being and counselling techniques used within own scope of practice. Back to Duty

K28: Employer policy and procedures for resource management and reporting. Back to Duty

K29: Strategies to plan and prioritise resources and manage immediate and longer-term service requirements. Back to Duty

K30: Local, regional, and national strategic priorities for patient populations within area of specialist practice. Back to Duty

K31: Principles of mentoring and preceptorship and how these differ from counselling, coaching and teaching. Back to Duty

K32: Local appraisal policy and systems and own responsibility in relation to appraisal of others. Back to Duty

Skills

S1: Conduct systematic literature searches to source evidence to inform enhanced clinical practice. Back to Duty

S2: Critically appraise evidence and use findings to plan and provide enhanced patient-centred clinical care. Back to Duty

S3: Provide enhanced clinical care in line with professional registration, code of conduct and defined scope of practice, being responsible and accountable for own decisions, actions and omissions. Back to Duty

S4: Select available tools, technologies and techniques needed to perform complex and holistic. Back to Duty

S5: Assimilate, synthesise and apply complex information to promote and advocate best interests of others, upholding the principles of safeguarding and evidence-based practice. Back to Duty

S6: Undertake holistic patient-centred assessments using available tools, technologies and techniques. Back to Duty

S7: Analyse the data arising from the assessment process to inform clinical decision-making. Back to Duty

S8: Identify, request and interpret specialist diagnostics within own scope of practice to inform the delivery and management of specialist care for patients and families. Back to Duty

S9: Develop, implement and evaluate an enhanced care management plan which may include interventions and referral to other members of the multidisciplinary team or other agencies. Back to Duty

S10: Prepare and support patients and families to manage their own health and care as independently as possible. Back to Duty

S11: Interpret, assimilate and draw conclusions using diverse sources of information and evidence to inform clinical reasoning. Back to Duty

S12: Direct others to sources of information and evidence, coaching and supporting them in applying information and evidence in complex clinical decision making. Back to Duty

S13: Provide leadership within scope of own role and positive role-modelling for others in the multidisciplinary team. Back to Duty

S14: Identify training and education needs of others in the workplace. Back to Duty

S15: Plan and facilitate the delivery of practice-based education, training and assessment activities. Back to Duty

S16: Evaluate the effectiveness of training and education activities. Back to Duty

S17: Use communication strategies suitable for a variety of situations including sensitive and distressing topics. Back to Duty

S18: Use strategies to manage conflict and challenge. Back to Duty

S19: Discuss complex information with patients, their families, the multi-disciplinary team and other agencies. Back to Duty

S20: Challenge ineffective systems and processes and support others to identify the need for change within their area of enhanced clinical practice. Back to Duty

S21: Contribute to quality improvement plans and strategies to support a culture of continuous quality improvement within area of enhanced clinical practice. Back to Duty

S22: Participate in quality improvement activities, such as audit, service evaluations and research projects within area of enhanced clinical practice. Back to Duty

S23: Reflect on own and others’ practice using clinical supervision processes. Back to Duty

S24: Identify and act on evidence of unexpected change or patient deterioration within own scope of practice. Back to Duty

S25: Manage self and others in unpredictable and complex environments, instigating clinical interventions where protocols may not be available. Back to Duty

S26: Identify and manage risk to patient safety and others in an unpredictable and complex environment. Back to Duty

S27: Counsel patients, family, carers and others to manage psychological well-being of self and others. Back to Duty

S28: Contribute to efficient resource management within the workplace. Back to Duty

S29: Plan, prioritise and deliver enhanced clinical care within a defined resource. Back to Duty

S30: Contribute to the drafting of business cases or project proposals. Back to Duty

S31: Provide mentorship, opportunity for peer-learning and constructive feedback to guide, support, motivate and develop others in the multidisciplinary team. Back to Duty

S32: Contribute to the appraisal of individuals in the multidisciplinary team. Back to Duty

Behaviours

B1: Treat people with dignity, respecting individual's diversity, beliefs, culture, needs, values, privacy and preferences. Back to Duty

B2: Show respect and empathy for those you work with. Back to Duty

B3: Be adaptable, reliable and consistent. Back to Duty


Qualifications

English and Maths

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment. For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL.

Print EPA plan

End-point assessment plan

1.1

Introduction and overview

This document sets out the requirements for end-point assessment (EPA) for the Enhanced clinical practitioner apprenticeship standard. It explains how EPA for this apprenticeship must operate.

It provides the EPA design requirements for end-point assessment organisations (EPAOs) for this apprenticeship standard. It will also be useful for apprentices undertaking this apprenticeship, their employers and training providers.

EPA must be conducted by an EPAO approved to deliver EPA for this apprenticeship standard. Each employer should select an approved EPAO from the Education & Skills Funding Agency’s Register of end-point assessment organisations (RoEPAO).

Full-time apprentices will typically spend 18 months on-programme (before the gateway) working towards this occupational standard. All apprentices must spend a minimum of 12 months on-programme. All apprentices must spend a minimum of 20% of on-programme time undertaking off-the-job training.

Before starting EPA, an apprentice must meet the gateway requirements. For this apprenticeship they are:

  • the employer must be content that the apprentice is working at or above the occupational standard
  • apprentices must have achieved English and mathematics at Level 2

The EPAO must confirm that all required gateway evidence has been provided and accepted as meeting the gateway requirements. The EPAO is responsible for confirming gateway eligibility. Once this has been confirmed, the EPA period starts. This EPA should then be completed within an EPA period lasting typically for 0 months.

This EPA consists of 2 discrete assessment methods.

It will be possible to achieve the following grades in each end-point assessment method:

Assessment method 1 - Professional discussion underpinned by portfolio:

Assessment method 2 - Quality improvement proposal with presentation and Q&A:

Performance in these end-point assessment methods will determine the overall apprenticeship standard grade of: Fail, Pass, Distinction

For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and mathematics minimum requirement is Entry Level 3. British Sign Language (BSL) qualifications are an alternative to English qualifications for those who have BSL as their primary language.

EPA summary table

On-programme (typically 18 months)

The apprentice must:

  • complete training to develop the knowledge, skills and behaviours (KSBs) outlined in this apprenticeship’s standard
  • complete training towards English and mathematics qualifications in line with the apprenticeship funding rules

End-point assessment gateway
The apprentice’s employer must be content that the apprentice has attained sufficient KSBs to complete the apprenticeship.

The apprentice must:

  • confirm they are ready to take the EPA
  • have achieved English and mathematics qualifications in line with the apprenticeship funding rules

The apprentice must submit the gateway evidence to their EPAO, including any organisation specific policies and procedures requested by the EPAO.

End-point assessment (typically 0 months)
The grades available for each assessment method are below

Professional discussion underpinned by portfolio:

Quality improvement proposal with presentation and Q&A:

Overall EPA and apprenticeship can be graded:

    • fail
    • pass
    • distinction

Re-sits and re-takes



  • Re-take and re-sit grade cap:
  • Re-sit timeframe: typically months
  • Re-take timeframe: typically months

Duration of end-point assessment period

The EPA is taken in the EPA period. The EPA period starts when the EPAO confirms the gateway requirements have been met and is typically 0 months.

The EPAO should confirm the gateway requirements have been met and start the EPA as quickly as possible.



EPA gateway

The apprentice’s employer must be content that the apprentice has attained sufficient KSBs to complete the apprenticeship. The employer may take advice from the apprentice's training provider, but the employer must make the decision. The apprentice will then enter the gateway.

The apprentice must meet the gateway requirements before starting their EPA.

They must:

  • confirm they are ready to take the EPA
  • have achieved English and mathematics qualifications in line with the apprenticeship funding rules

The apprentice must submit the gateway evidence to their EPAO, including any organisation specific policies and procedures requested by the EPAO.

Order of assessment methods

The assessment methods must be delivered in the following order:



Professional discussion underpinned by portfolio

Overview

Rationale

Delivery

The must be structured to give the apprentice the opportunity to demonstrate the KSBs mapped to this assessment method to the highest available grade.

An independent assessor must conduct and assess the .

The EPAO must give an apprentice 0 ' notice of the .

The must last for 0 minutes. The independent assessor can increase the time of the by up to 10%. This time is to allow the apprentice to respond to a question if necessary.

The independent assessor must ask at least 0 questions.

The independent assessor must make the grading decision.

The independent assessor must keep accurate records of the assessment. They must record:

  • the apprentice’s answers to questions
  • the KSBs demonstrated in answers to questions
  • the grade achieved 

Assessment location

The must take place in a suitable venue selected by the EPAO for example, the EPAO’s or employer’s premises.

The should take place in a quiet room, free from distractions and influence.

Question and resource development

The EPAO must develop a purpose-built assessment specification and question bank. It is recommended this is done in consultation with employers of this occupation. The EPAO should maintain the security and confidentiality of EPA materials when consulting with employers. The assessment specification and question bank must be reviewed at least once a year to ensure they remain fit-for-purpose.

The assessment specification must be relevant to the occupation and demonstrate how to assess the KSBs mapped to this assessment method. The EPAO must ensure that questions are refined and developed to a high standard. The questions must be unpredictable. A question bank of sufficient size will support this.

The EPAO must ensure that the apprentice has a different set of questions in the case of re-sits or re-takes.

The EPAO must produce the following materials to support the professional discussion underpinned by portfolio:

  • independent assessor assessment materials which include:
    • training materials
    • administration materials
    • moderation and standardisation materials
    • guidance materials
    • grading guidance
    • question bank
  • EPA guidance for the apprentice and the employer

The EPAO must ensure that the EPA materials are subject to quality assurance procedures including standardisation and moderation.

Quality improvement proposal with presentation and Q&A

Overview

A project involves the apprentice completing a significant and defined piece of work that has a real business application and benefit. The project must meet the needs of the employer’s business and be relevant to the apprentice’s occupation and apprenticeship.

This assessment method has 2 components:

Together, these components give the apprentice the opportunity to demonstrate the KSBs mapped to this assessment method. They are assessed by an independent assessor.

Rationale



Question and resource development

The EPAO must develop a purpose-built assessment specification and question bank. It is recommended this is done in consultation with employers of this occupation. The EPAO should maintain the security and confidentiality of EPA materials when consulting with employers. The assessment specification and question bank must be reviewed at least once a year to ensure they remain fit-for-purpose.

The assessment specification must be relevant to the occupation and demonstrate how to assess the KSBs mapped to this assessment method. The EPAO must ensure that questions are refined and developed to a high standard. The questions must be unpredictable. A question bank of sufficient size will support this.

The EPAO must ensure that the apprentice has a different set of questions in the case of re-sits or re-takes.

EPAO must produce the following materials to support the project:

  • independent assessor EPA materials which include:
    • training materials
    • administration materials
    • moderation and standardisation materials
    • guidance materials
    • grading guidance
    • question bank
  • EPA guidance for the apprentice and the employer

The EPAO must ensure that the EPA materials are subject to quality assurance procedures including standardisation and moderation.

Overall EPA grading

Performance in the EPA determines the overall grade of:

  • fail

  • pass

  • distinction

An independent assessor must individually grade the professional discussion underpinned by portfolio and quality improvement proposal with presentation and q&a in line with this EPA plan.

The EPAO must combine the individual assessment method grades to determine the overall EPA grade.

If the apprentice fails one assessment method or more, they will be awarded an overall fail.

To achieve an overall pass, the apprentice must achieve at least a pass in all the assessment methods.

Grades from individual assessment methods must be combined in the following way to determine the grade of the EPA overall.

Re-sits and re-takes

If the apprentice fails one assessment method or more, they can take a re-sit or a re-take at their employer’s discretion. The apprentice’s employer needs to agree that a re-sit or re-take is appropriate. A re-sit does not need further learning, whereas a re-take does. The apprentice should have a supportive action plan to prepare for a re-sit or a re-take.

The employer and the EPAO should agree the timescale for a re-sit or re-take. A re-sit is typically taken within months of the EPA outcome notification. The timescale for a re-take is dependent on how much re-training is required and is typically taken within months of the EPA outcome notification.

Failed assessment methods must be re-sat or re-taken within a 6-month period from the EPA outcome notification, otherwise the entire EPA will need to be re-sat or re-taken in full.

Re-sits and re-takes are not offered to an apprentice wishing to move from pass to a higher grade.

The apprentice will get a maximum EPA grade of for a re-sit or re-take, unless the EPAO determines there are exceptional circumstances.

Roles and responsibilities

Reasonable adjustments

The EPAO must have reasonable adjustments arrangements for the EPA.

This should include:

  • how an apprentice qualifies for reasonable adjustment
  • what reasonable adjustments may be made

Adjustments must maintain the validity, reliability and integrity of the EPA as outlined in this EPA plan.

Internal quality assurance

Internal quality assurance refers to the strategies, policies and procedures that an EPAO must have in place to ensure valid, consistent and reliable EPA decisions.

EPAOs for this EPA must adhere to the requirements within the roles and responsibilities table.

They must also appoint independent assessors who:

  • have recent relevant experience of the occupation or sector to at least occupational level gained in the last 0 years or significant experience of the occupation or sector

Value for money

Affordability of the EPA will be aided by using at least some of the following:

Professional recognition

This apprenticeship is not aligned to professional recognition.



Mapping of KSBs to assessment methods

Knowledge Assessment methods
K1

Tools and techniques used to systematically search, select and present evidence.

Back to Grading
No mapped assessment methods
K2

Techniques to critically appraise evidence such as local and national quality standards and frameworks and ways to relate this to own practice.

Back to Grading
No mapped assessment methods
K3

Requirements of their on-going professional registration and code of conduct in relation to their scope of practice such as when and how to escalate or refer in line with defined scope of practice.

Back to Grading
No mapped assessment methods
K4

How to appraise the relevance of available tools and techniques to the clinical situation and own scope of practice.

Back to Grading
No mapped assessment methods
K5

Legislation, clinical frameworks, contemporaneous evidence-based practice guidelines, outcomes from clinical audit and algorithms to support decision making.

Back to Grading
No mapped assessment methods
K6

Anatomy and physiology and pathophysiology to support complex holistic patient assessment including the underlying psychological, social and long-term impact of illness.

Back to Grading
No mapped assessment methods
K7

Tools and techniques to critically evaluate clinical information to inform decision making and care management planning.

Back to Grading
No mapped assessment methods
K8

Underpinning anatomy and complex applied physiology, disease, toxicities, treatments and interventions which guide the selection of specialist diagnostics.

Back to Grading
No mapped assessment methods
K9

Methods to support complex intervention decision making aligned to national and international guidelines.

Back to Grading
No mapped assessment methods
K10

Principles and theories of co-production, health coaching, peer support and self-management used to build knowledge, skills and confidence to enable patient self-management.

Back to Grading
No mapped assessment methods
K11

Diverse sources of information and evidence to underpin decision making and techniques to interpret and assimilate a diverse range of information and evidence.

Back to Grading
No mapped assessment methods
K12

Principles and theories of coaching used in supporting others in complex clinical decision making and care delivery.

Back to Grading
No mapped assessment methods
K13

Principles and theories of leadership and role modelling.

Back to Grading
No mapped assessment methods
K14

Tools and procedures for conducting a training needs analysis.

Back to Grading
No mapped assessment methods
K15

Teaching, learning and assessment theories, techniques, innovations and models relevant to the educational activity including ways to facilitate a positive learning environment.

Back to Grading
No mapped assessment methods
K16

Models, tools and frameworks for receiving and providing constructive feedback.

Back to Grading
No mapped assessment methods
K17

Principles of different communication strategies and theories, communication modes (written, digital, verbal, non-verbal) and clinical communication tools.

Back to Grading
No mapped assessment methods
K18

Models and theories for negotiating and mediating, such as de-escalation and diffusing strategies.

Back to Grading
No mapped assessment methods
K19

Communication strategies and tools used to share complex information with different audiences and individuals.

Back to Grading
No mapped assessment methods
K20

Principles of change management and co-production to support clinical innovation in the workplace.

Back to Grading
No mapped assessment methods
K21

Local and national approaches and planning processes to support quality improvement.

Back to Grading
No mapped assessment methods
K22

Service evaluation, research and audit techniques to support quality improvement processes within area of enhanced clinical practice.

Back to Grading
No mapped assessment methods
K23

The role and impact of reflection in improving clinical practice and best-practice methods for clinical supervision.

Back to Grading
No mapped assessment methods
K24

Signs and pathophysiology of deterioration or distress in mental, physical, cognitive and behavioural health in own scope of practice.

Back to Grading
No mapped assessment methods
K25

Protocols and systems used to plan, prioritise and direct resources within area of enhanced clinical practice and how to escalate to and engage others when working at the boundaries of scope of practice.

Back to Grading
No mapped assessment methods
K26

Evidence-based strategies to manage clinical risk in enhanced clinical practice.

Back to Grading
No mapped assessment methods
K27

Principles of psychological well-being, the importance of maintaining own and others well-being and counselling techniques used within own scope of practice.

Back to Grading
No mapped assessment methods
K28

Employer policy and procedures for resource management and reporting.

Back to Grading
No mapped assessment methods
K29

Strategies to plan and prioritise resources and manage immediate and longer-term service requirements.

Back to Grading
No mapped assessment methods
K30

Local, regional, and national strategic priorities for patient populations within area of specialist practice.

Back to Grading
No mapped assessment methods
K31

Principles of mentoring and preceptorship and how these differ from counselling, coaching and teaching.

Back to Grading
No mapped assessment methods
K32

Local appraisal policy and systems and own responsibility in relation to appraisal of others.

Back to Grading
No mapped assessment methods
Skill Assessment methods
S1

Conduct systematic literature searches to source evidence to inform enhanced clinical practice.

Back to Grading
No mapped assessment methods
S2

Critically appraise evidence and use findings to plan and provide enhanced patient-centred clinical care.

Back to Grading
No mapped assessment methods
S3

Provide enhanced clinical care in line with professional registration, code of conduct and defined scope of practice, being responsible and accountable for own decisions, actions and omissions.

Back to Grading
No mapped assessment methods
S4

Select available tools, technologies and techniques needed to perform complex and holistic.

Back to Grading
No mapped assessment methods
S5

Assimilate, synthesise and apply complex information to promote and advocate best interests of others, upholding the principles of safeguarding and evidence-based practice.

Back to Grading
No mapped assessment methods
S6

Undertake holistic patient-centred assessments using available tools, technologies and techniques.

Back to Grading
No mapped assessment methods
S7

Analyse the data arising from the assessment process to inform clinical decision-making.

Back to Grading
No mapped assessment methods
S8

Identify, request and interpret specialist diagnostics within own scope of practice to inform the delivery and management of specialist care for patients and families.

Back to Grading
No mapped assessment methods
S9

Develop, implement and evaluate an enhanced care management plan which may include interventions and referral to other members of the multidisciplinary team or other agencies.

Back to Grading
No mapped assessment methods
S10

Prepare and support patients and families to manage their own health and care as independently as possible.

Back to Grading
No mapped assessment methods
S11

Interpret, assimilate and draw conclusions using diverse sources of information and evidence to inform clinical reasoning.

Back to Grading
No mapped assessment methods
S12

Direct others to sources of information and evidence, coaching and supporting them in applying information and evidence in complex clinical decision making.

Back to Grading
No mapped assessment methods
S13

Provide leadership within scope of own role and positive role-modelling for others in the multidisciplinary team.

Back to Grading
No mapped assessment methods
S14

Identify training and education needs of others in the workplace.

Back to Grading
No mapped assessment methods
S15

Plan and facilitate the delivery of practice-based education, training and assessment activities.

Back to Grading
No mapped assessment methods
S16

Evaluate the effectiveness of training and education activities.

Back to Grading
No mapped assessment methods
S17

Use communication strategies suitable for a variety of situations including sensitive and distressing topics.

Back to Grading
No mapped assessment methods
S18

Use strategies to manage conflict and challenge.

Back to Grading
No mapped assessment methods
S19

Discuss complex information with patients, their families, the multi-disciplinary team and other agencies.

Back to Grading
No mapped assessment methods
S20

Challenge ineffective systems and processes and support others to identify the need for change within their area of enhanced clinical practice.

Back to Grading
No mapped assessment methods
S21

Contribute to quality improvement plans and strategies to support a culture of continuous quality improvement within area of enhanced clinical practice.

Back to Grading
No mapped assessment methods
S22

Participate in quality improvement activities, such as audit, service evaluations and research projects within area of enhanced clinical practice.

Back to Grading
No mapped assessment methods
S23

Reflect on own and others’ practice using clinical supervision processes.

Back to Grading
No mapped assessment methods
S24

Identify and act on evidence of unexpected change or patient deterioration within own scope of practice.

Back to Grading
No mapped assessment methods
S25

Manage self and others in unpredictable and complex environments, instigating clinical interventions where protocols may not be available.

Back to Grading
No mapped assessment methods
S26

Identify and manage risk to patient safety and others in an unpredictable and complex environment.

Back to Grading
No mapped assessment methods
S27

Counsel patients, family, carers and others to manage psychological well-being of self and others.

Back to Grading
No mapped assessment methods
S28

Contribute to efficient resource management within the workplace.

Back to Grading
No mapped assessment methods
S29

Plan, prioritise and deliver enhanced clinical care within a defined resource.

Back to Grading
No mapped assessment methods
S30

Contribute to the drafting of business cases or project proposals.

Back to Grading
No mapped assessment methods
S31

Provide mentorship, opportunity for peer-learning and constructive feedback to guide, support, motivate and develop others in the multidisciplinary team.

Back to Grading
No mapped assessment methods
S32

Contribute to the appraisal of individuals in the multidisciplinary team.

Back to Grading
No mapped assessment methods
Behaviour Assessment methods
B1

Treat people with dignity, respecting individual's diversity, beliefs, culture, needs, values, privacy and preferences.

Back to Grading
No mapped assessment methods
B2

Show respect and empathy for those you work with.

Back to Grading
No mapped assessment methods
B3

Be adaptable, reliable and consistent.

Back to Grading
No mapped assessment methods

Mapping of KSBs to grade themes

Professional discussion underpinned by portfolio - Discussion

KSBS GROUPED BY THEME Knowledge Skills Behaviour

Quality improvement proposal with presentation and Q&A - Project

KSBS GROUPED BY THEME Knowledge Skills Behaviour

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Contact us about this apprenticeship

Employers involved in creating the standard: Central Manchester NHS Foundation Trust East Cheshire NHS Trust Great Ormond Street Hospital for Children NHS Imperial College Healthcare NHS Trust NHS Blood and Transplant Northumbria Healthcare NHS Foundation Trust Nottingham University Hospitals NHS Trust P J Care Royal Cornwall Hospitals NHS Trust Solent NHS Trust The Christie NHS Foundation Trust The James Cook University Hospital University Hospitals of North Midlands Yorkshire Ambulance Service NHS Trust

Version log

Version Change detail Earliest start date Latest start date Latest end date
1.1 Standard revised 25/05/2023 Not set Not set
1.0 Approved for delivery 27/05/2021 24/05/2023 Not set

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