GPwER Definition and Recognition Process

What is a GPwER?

A General Practitioner with Extended Role (GPwER) is a fully qualified GP who undertakes additional clinical work beyond the normal scope of general practice training. A GPwER continues their core generalist practice while devoting part of their time to a specialist area such as cardiology, diabetes, dermatology, or women’s health.
By acquiring further training and skills, GPwERs help bridge primary and secondary care, managing specific conditions in the community and improving patient access to specialist-level care.

Official Framework and Accreditation

The Royal College of General Practitioners (RCGP), in partnership with NHS England, has developed a national GPwER framework that guides how GPs demonstrate competence in extended roles. This framework aligns with the GMC’s requirements for scope of practice and the NHS appraisal and revalidation process.
Notably, RCGP defines a GPwER as “a GP who undertakes a role beyond the scope of GP training and the MRCGP, requiring further training”.

The framework outlines generic governance principles for all GPwER roles. Importantly, the RCGP does not itself “credential” or license GPwERs centrally (except via specific collaborations, e.g. dermatology with the BAD). Instead, accreditation is determined locally by employers/commissioners (usually your NHS Integrated Care Board, or ICB). In practice, this means a GP must build evidence of their extended competencies and have them recognised by the relevant local health organisation that will engage them in that role.

Becoming a GPwER – Training and Portfolio

To achieve GPwER status, a doctor must first meet baseline criteria:

  • Full GP qualification (CCT and GMC GP Register)

  • Ongoing general practice work (the RCGP recommends at least 40 GP sessions/year in standard practice).

  • Specific training in the chosen speciality, such as a formal postgraduate course (for example, a university-accredited PGCert or diploma) in that field

  • Clinical experience and portfolio of evidence

The doctor should seek out a clinical supervisor/mentor (often a consultant or experienced GPwER in the speciality) and undertake a period of supervised practice to gain hands-on skills. During this time, the GP accumulates a portfolio of evidence demonstrating their competence in the extended role.
According to RCGP guidance, the portfolio of evidence should include: 

  • Proof of relevant knowledge and skills (e.g. postgraduate course/exam certificates)

  • Log of clinical experience in the speciality (with supervision details)

  • Case reports or audits

  • Structured feedback from specialists and patients about the GP’s performance in that role

  • A supporting reference from the clinical supervisor is also expected


Local Accreditation and Governance

Once the GP is confident in meeting the competencies (often by following a speciality-specific GPwER curriculum if available), they can seek formal recognition.
This typically involves a local accreditation process. NHS England advises that accreditation should be a collaboration between primary and secondary care, often with an assessment panel or process led by the regional commissioners.

Ultimately, the decision rests with the employing/commissioning body (such as the ICB) to ensure the GP is competent and that the service setup is appropriate.  In practical terms, a GP might apply to their ICB’s GPwER accreditation program (if one exists for the speciality) or present their portfolio to the medical director of the local service. It’s advisable for aspiring GPwERs to check with their ICB or local NHS England team early on about any specific accreditation steps or panels for their speciality.

Maintenance of Competence

Once approved, a GPwER does not need annual re-certification in the way GPwSIs once did. Instead, maintaining the role is folded into the normal GMC appraisal and revalidation cycle. Each year at appraisal, the GPwER must demonstrate they are keeping up to date and safe in that extended scope. This is achieved by incorporating the extended role into the scope of practice and providing evidence of ongoing CPD (continuing professional development), quality improvement activities, case reviews, significant event reflections, and feedback specifically related to that role.

Using a PGCert Course towards GPwER Status

It’s important to clarify that completing a postgraduate certificate does not, on its own, confer GPwER status.

The PGCert serves as a significant credential indicating the GP has mastered the relevant guidelines and evidence base.
However, to be recognised as a GPwER, the GP must apply that knowledge in practice and document it. 

They will need to supplement the certificate with clinical experience, such as working in specialist clinics, attending multidisciplinary team meetings, and managing relevant cases in their GP surgery. Reflection on these experiences, plus feedback from consultants, will then be added to their portfolio of evidence. Finally, the GP would present the combined evidence – including the PGCert as proof of high-level theoretical training – to the appropriate accrediting body (local ICB). 

In summary, the GPwER framework set by RCGP/NHSE provides a clear route: Train → Evidence → Appraise/Accredit → Practice & Maintain.