Approved practice settings
What are approved practice settings?
Approved practice settings (APS) are organisations we approve as suitable for doctors new to full registration or returning to the medical register with a licence to practise after prolonged absence from UK practice.
These organisations have systems for:
- the effective management of doctors
- identifying and acting upon concerns about doctors' fitness to practise
- supporting the provision of relevant training or continuing professional development
- providing regulatory assurance.
Approved practice settings provide public protection by requiring doctors new, or returning, to full registration in the UK to work in a system with appropriate supervision and appraisal arrangements or assessments.
Do I have to work in an approved practice setting?
From 3 December 2012, all UK and International Medical Graduate doctors granted full registration for the first time, and all doctors returning to full registration after a prolonged period out of UK practice, are restricted to practising only in an APS. We automatically remove this restriction from a doctor’s registration when they revalidate for the first time after joining, or returning to, the register.
Doctors who joined the register, or restored to the register before 3 December 2012 are only required to complete 12 months’ practice in an APS before the restriction is lifted. They can wait until their first revalidation for us to automatically remove reference to this restriction from their registration status, or ask us to remove it any time after 12 months’ practice in an APS.
If you are unsure whether you need to work in an APS, you can use our APS online tool to find out.
Organisations with current approved practice setting status
View the organisations which are currently approved practice settings.
Please note that all Primary Care organisations (Primary Care Trusts in England, Area Health Boards in Scotland, Local Health Boards in Wales and Health and Social Services Boards or Health and Social Care Trusts in Northern Ireland) are automatically granted APS status, but only for the purpose of undertaking managed training; that is Foundation Programme training, or training as a GP Registrar. They are therefore not included in our online list of APS.
Organisations which employ doctors new to full registration or returning to the medical register with a licence to practise after prolonged absence from UK practice, need to make sure we have approved them as suitable practice settings.
If you have any queries about an organisation's APS status, or wish to apply for APS status on behalf of your organisation, please contact aps@gmc-uk.org.
Approved practice settings: the criteria
There are a number of requirements that must be met by organisations seeking approved practice setting status.
We will first of all seek to be satisfied that the organisation is:
- a. A practice setting with designated body status, or
- b. A practice settings where the doctor is in managed training under the auspices of a designated body.
We will also wish to ensure that the organisation is regulated or quality assured by an independent body or organisation. We may need to make checks with the relevant regulatory or quality assurance body including the outcomes of any recent inspections.
The organisation seeking approved practice setting status will also need to confirm to us, by completing our application form, that it has in place systems for:
- The effective management of doctors that include:
- An annual appraisal or assessment process for individual doctors, based on the principles of Good Medical Practice
- A system of clinical governance or, if outside the NHS, a quality assurance system, that includes:
- Clear lines of responsibility and accountability for the overall quality of medical practice
- Clear policies aimed at managing risks
- Appropriate supervision arrangements for doctors, including arrangements for induction or orientation
- Identifying and acting on concerns about doctors' fitness to practise that include:
- Procedures to help the individual to improve their performance whenever possible
- Support for doctors in their duty to report any concerns about colleagues' fitness to practise (including conduct, health or performance)
- Clear procedures for reporting concerns so that early action can be taken to avoid harm to patients and remedy problems
- Acting on and learning from complaints
- Supporting the provision of relevant training or continuing professional development so that doctors have access to and participate in activities to update the knowledge and skills relevant to their professional work
- Challenging discrimination, promoting equality and respect for human rights
- Providing regulatory assurance that:
- All employed or contracted doctors hold a licence to practise and appropriate registration and are both required and enabled to abide by Good Medical Practice
- Identify and manage staff who do not comply with GMC guidance.
We will only issue the application form once we are satisfied that the organisation meets the requirements in relation to designated body status described above.