Curriculum for Training for Advanced Critical Care Practitioners (v1.1 2015) - Part I

Curriculum for Training for Advanced Critical Care Practitioners (v1.1 2015) - Part II

Curriculum for Training for Advanced Critical Care Practitioners (v1.1 2015) - Part III

Amendment to FICM ACCP 2015 Curriculum

The FICM Board have recently reviewed and approved a change to the FICM ACCP 2015 curriculum concerning the training centres approved for ACCP training. The details behind the change request and the particulars for training sites moving forward are outlined below. 

Rationale for Change:

The current document’s wording restricts training of ACCPs to training centres approved for a minimum of Stage 1 and 2 ICM level training. Although during the first five years of ACCP training, this was deemed prudent in order to ensure a consistently high standard of training and monitoring, this approach is now limiting the wider rollout of ACCP training, and the absolutely vital embedding of the role in smaller units as part of a sustainable critical care workforce solution.

Existing requirements [FICM ACCP 2015]

4.6 Training environments
There is no central FICM process for formal endorsement of ACCP training; the training of ACCPs will occur in existing UK training centres approved for, at a minimum, Stage 1 and 2 ICM level training. The FICM considers that units who do not train these levels of ICM CCT trainee would be unable to deliver the level of training required by the ACCP curriculum; as such, the Faculty would not consider it appropriate for FICM ACCP Membership to be awarded to any ACCPs trained in units who do not receive these levels of ICM CCT
trainee. Whilst non-training units may be able to partner with a Higher Educational Institution (HEI) and offer ACCP training to interested nurse and AHP colleagues, those trainees would not be eligible for any official Faculty recognition of that training, nor to apply for FICM ACCP Membership upon completion of their ACCP training programme. Any non-ICM training approved unit seeking to run ACCP training must make this prospectively clear to any applicants for their programme.

The training environment should provide appropriate training and supervision with an adequate exposure to a wide spectrum of critical illness. If necessary, rotations to other hospitals should be arranged. Departments in which training occurs must comply with the regulations and recommendations of the relevant national Departments of Health, the GMC, NMC, HPC and the FICM.

Proposed Change: 

Training Unit approval pathway: 

• The FICM Regional Advisor (RA) must approve training for ACCPs in the relevant unit. 
• The RA should forward successful and unsuccessful applications to the FICM ACCP Sub-Committee for ongoing oversight and acknowledgement.

The RA should use this form to assess the unit’s suitability and once completed, share a copy of this with FICM (contact@ficm.ac.uk)

To be approved as an ACCP Training Unit, the following aspects of organisation, environment and ethos towards training are required, and should be verified during the application process:

• Compliance with the regulations and recommendations of the relevant national Departments of Health, NMC, HPC and the FICM.
• Nominated ICM Consultant Lead for ACCPs with oversight to support trainers and ACCP trainees to engage in current training requirements. There should be formal links with an appropriate HEI providing the academic elements.  
• Named Educational Supervisor for each trainee ACCP to mentor progress and provide pastoral support. Depending on the size of Unit and numbers of Trainee ACCPs, this may be the Consultant Lead.
• The unit would be expected to be recognised for at least core level ICM training (by FICM and Statutory Education Bodies (SEBs)).
• A Unit with sufficient clinical activity to deliver the ACCP training syllabus and meet the curriculum requirements. 
• Where this is not possible in a single ICU, alliance with a larger allied teaching hospital/DGH or tertiary centre, in a hub and spoke model, is proposed. The duration of attachments and supervisory structure may need to be addressed on an individual basis.
• FFICM consultants should staff the unit as per GPICS standards. Where this may not be possible, out of hours cover for small and rural units arrangements for appropriate consultant support as detailed in the GPICS V2 chapter on smaller remote and rural units should be in place. 
• The recognised national standards, ethos and enthusiasm of the unit to embrace training is of paramount importance.
• Sufficient training opportunities for all trainees (ACCPs and doctors in training) allocated to the unit at any one time must be maintained.
• Sufficient clinical supervision such that every ACCP in training can be responsible to a nominated consultant at all times. The consultant must be available to advise and assist them as appropriate.
• Consistent positive feedback from the GMC National Training Survey, and local training feedback surveys. Where poor feedback is received, the RA with the support of the FICM ACCP Sub-Committee will review ongoing eligibility as a training unit for ACCPs.

ADDITIONAL CONSIDERATIONS: It is recognised that some units are critical care units i.e. a flexible mix of ICU and HDU patients. In these situations, the average Level 3 occupancy should be related to bed numbers. Similarly, many units have adjacent ICU and HDU facilities, covered by the same medical staff. Here a similar calculation could be applied. Geographically separate units, for example separated by several floors or considerable horizontal distance of more than a few yards, should not be normally regarded as one unit. 

guidance_training_units_icm_19_0.pdf (ficm.ac.uk)

This amendment to the ACCP 2015 Curriculum will take immediate effect and will appear in full in the new ACCP curriculum to be launched in 2022.