Optional Skills Framework

The Faculty has worked closely with appropriate partner organisations to develop Optional Skills Framework Modules (OSFs) for ACCPs to undertake applicable to local patient need and ACCP development.

These documents outline FICM approved modules which may be put in place locally if there is benefit to patient care/service need.

Local need

These modules are optional and will not be applicable or appropriate for all Qualified ACCPs. The requirement to undertake these optional modules will be driven by local service need within your trust/ health board.

The responsibility for ensuring local procedures for risk, governance, evaluation and reporting in relation to use of OSFs remain with the trusts/ health boards.

Local implementation

It is recommended that the following points are considered before any OSFs are implemented locally for ACCPs:

  • They should be discussed by the ICU clinical team and agreed as appropriate for the patient/service need and the ACCP cohort.
  • Use of an OSF for ACCPs is reviewed by the ICU governance group ensuring compliance with regulators, delivers safe, quality and effective care and that legislation and all standards are met.
  • Risks to the patient, service and the ACCP are assessed and reviewed as part of the ICU governance process.
  • Any adverse event or concerns should be reported and investigated using the trust/health board incident reporting system.
  • ACCPs must keep a log of activity in relation to the OSF and discuss at yearly appraisals.
  • ACCPs are recommended to advise their professional indemnity insurers of context and use of OSFs.


The trained ACCP undertaking an OSF must have the support of a nominated consultant supervisor. The supervisor is responsible for:

  • Assisting with creating knowledge, skills and competency opportunities relating to the OSF
  • Assessment and support throughout the completion of the OSF 
  • Supporting maintenance of the skill reported and audited via PDR. 

More modules coming soon watch this space!

Optional Skills Framework modules

Diagnosing Death for Donation after Circulatory Death (DCD) Optional Skills Framework

The growth of the ACCP role, combined with the 100% increase in donor numbers over the last 10 years, means that for some units the ability for ACCPs to diagnose death in the context of DCD is vital for service provision and ensuring every donation opportunity can be facilitated.

To enable Advanced Critical Care Practitioners (ACCPs) to diagnose circulatory death in the context of DCD organ donation the following competency document has been developed.

The local Clinical Lead for Organ Donation (CLOD) and ICU Clinical Lead must agree and ensure local governance arrangements are in place with activity reviewed and reported to the CLOD.

The aims of this Advanced Critical Care Practitioner (ACCP) DCD competency are to:

  • Enable ACCP training to a nationally agreed standard by FICM and NHSBT for the diagnosis of death in the context of DCD organ donation.
  • To describe the core theoretical knowledge, practical skills and professional judgment required of an ACCP in the diagnosis of death in the context of DCD organ donation.
  • The competences identify knowledge, common and specialist elements, which are deemed essential to the role, while allowing for flexibility within local settings to meet service needs.
  • Each individual practitioner will take professional responsibility for their autonomous practice including acknowledgement of their limitations and when to ‘refer the patient on’ to medical colleagues or other appropriate professionals.

Diagnosing Death for Donation after Circulatory Death (DCD) for Advanced Critical Care Practitioners

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