Advanced Clinical Practice in Emergency Medicine
Emergency Medicine – Advanced Clinical Practitioners (EM-ACPs) play a vital role in the delivery of emergency care across the UK. RCEM has over one thousand ACP members, and this number is rapidly increasing. EM-ACPs are represented on all major RCEM Committees.
The RCEM ACP Forum participates and contribute to all RCEM committees and activities and provides a voice for ACPs across the college. It also provides support to all ACPs in EM across the UK. Explore the ACP Forum and its representatives.
For RCEM ACP credentialing please see the Emergency Medicine ACP Credentialing page, all queries should be directed to ACP@rcem.ac.uk.
Advanced Clinical Practice and the Role of ACPs in EM
Advanced Clinical Practice
Advanced clinical practice is a defined level of practice within a range of regulated clinical professions such as nursing, paramedicine, pharmacy and occupational therapy.
It is a level of practice characterised by a high degree of autonomy and complex decision making, underpinned by a master’s level award or equivalent that encompasses the four pillars of advanced practice (clinical practice, leadership and management, education, and research), with demonstration of core capabilities and area specific clinical competence.
For regional information, read the Multi-professional Framework for Advanced Clinical Practice in England (2025) and the Professional Framework for Enhanced, Advanced and Consultant Clinical Practice in Wales (2023).
The role of ACPs in Emergency Medicine
The role of ACPs in Emergency Medicine (EM) is relatively new. Working as part of the multi-disciplinary team, EM-ACPs are able to look after patients with a wide range of pathologies from the life-threatening to the self-limiting.
- They are able to identify the critically ill and injured, providing safe and effective immediate care
- They have expertise in resuscitation and are skilled in the practical procedures needed
- They establish the diagnosis and differential diagnosis rapidly and initiate or plan for definitive care
- They work with all the in-patient and supporting specialties as well as primary care and prehospital services
- They are able to correctly identify who needs admission and who can be safely discharged.
Wellbeing and Sustainable Careers
The NHS Long Term Workforce Plan (2023) highlights how advanced clinical practice is central to helping transform service delivery and better meet local health needs by providing enhanced capacity, capability, productivity and efficiency within multi-professional teams.
As part of the plan, there will be a focus on expanding enhanced, advanced and associate roles to offer modernised careers, with a stronger emphasis on the generalist and core skills needed to care for patients with multimorbidity, frailty or mental health needs. This includes increasing the number of advanced practitioners and independent prescribers acting as senior decision-makers in appropriate settings, offering options for clinical career progressions for more experienced staff.
The wellbeing of EM-ACPs is a vital factor to be considered in the development of an effective and sustainable workforce. Working with the RCEM Sustainable Working Practices Committee, the RCEM ACP Forum has created guidance for EM-ACPs and Emergency Departments in managing their growing ACP workforce.
Position Statement on Agenda for Change banding for ACPs
A position statement for ACPs actively working in EM within the NHS to promote credentialing, which we believe standardises training and provides a clear national reference for departments.
Post-Credentialing Strategy
The strategy (Advanced Clinical Practitioner Post-Credentialing Strategy 2025) sets out a clear, supportive, and sustainable framework for the ongoing development of credentialed ACPs across the UK who continue to work in EM.
It outlines how RCEM will help support EM-ACPs’ lifelong learning, wellbeing, professional growth, and career development. sets out expectations and guidance across three key areas: Continuing Professional Development (CPD), clinical and professional development, and governance and workforce standards.
A new post-credentialing CPD ePortfolio is being developed to support ACPs document their development, record evidence, and maintain accountability in line with College standards, as well as a good practice guidance on CPD and governance.
Radiology Requesting for ACPs
Radiology requesting rights for EM-ACPs vary throughout the UK. RCEM have developed a Radiology Requesting Protocol for Extended and Advanced Clinical Practitioners in the Emergency Department which is supported by the Clinical Radiology Faculty of The Royal College of Radiologists.
The aim of this to provide timely care for patients alongside ensuring all radiological and imaging processes involving the Emergency Department meet IRMER regulations.
The Centre for Advancing Practice further supports consistent access to clinical imaging requesting for registered healthcare professionals working in advancing practice roles with guidance from the Royal College of Nursing (RCN) and NHS England’s Good practice guidance for enabling equitable access to clinical imaging referrals for registered healthcare professionals working in advancing practice roles.