6. Assessment and award of CCT

6.1. GP registrars will be subject to a national assessment programme defined by the RCGP and approved by the GMC. This includes Workplace Based Assessment (WPBA), the Applied Knowledge Test (AKT) and the Simulated Consultation Assessment (SCA) or equivalent.

6.2. GP registrar appraisal is annual and via the ARCP process. ARCP panels should take place within two calendar months of the end of the period under review.

6.3. ESR's should have been completed within the two calendar months preceding the ARCP panel date. When the ESR has been undertaken outside of this timeframe, a comment should be added to the ARCP form to confirm that there has been no change since the ESR, and the panel are reassured in making a decision based on progress and the evidence presented. 

6.4. The ARCP panel should review the full period of training since the last ARCP panel. A decision can then be made on overall progression and learning based on all the evidence presented. In doing this, a satisfactory outcome can only be issued if the full pro rata WPBA requirements for the period under review have been met.

6.5. If a post is interrupted by a period of statutory leave where the GP registrar returns to the same post at the same location with the same supervisor, the evidence for the post should be considered in its entirety when determining whether any of the post could count. 

6.6. Occasionally there is no evidence of learning, often when a post is unexpectedly cut short. Where this is the case, the Educational Supervisor should raise this with the GP registrar at their next review (whether year end or interim) and ask that they provide an explanation of the circumstances in a Learning Log and their reflections on what was learned. The Educational Supervisor can then review and comment.

6.7. When reviewing evidence of learning, particularly for short posts (usually less than two months), an ARCP panel has three options:

• If overall progress is satisfactory, and there is sufficient evidence, the period can count.
• If there is insufficient evidence and overall progress is not satisfactory, the period cannot count.
• If more information is required, an Outcome 5 could be issued.

6.8. A standard statement should be added to the comments section of the ARCP form confirming that the short post was considered and whether this period of training should count towards training or not.

6.9. A similar approach should be taken with any GP registrar who does not regularly upload evidence to their Training Portfolio and early referral to GP registrar Support Services should be considered.

6.10. Where training is fragmented by multiple absences in a condensed period, the GP registrar may not have been in training for long enough for a formal assessment to take place, the first ARCP panel on return to training must review evidence of capabilities. The ARCP form must contain a statement confirming that capabilities have been achieved despite the fragmented training.

6.11. GP registrars are expected to revalidate with the GMC immediately following the award of a CCT. Evidence collected within their Training Portfolio for WPBA will be used to assist in the appraisal and revalidation process. The evidence is equivalent to but different from that normally collected by qualified GPs undergoing annual appraisal and revalidation. Additional evidence, which falls outside the requirements of the GP Curriculum, should not normally be required for GP registrar appraisal and revalidation purposes.

6.12. When an ARCP Outcome 4 is issued, the reasons for this and the options available to the GP registrar should be clearly documented.

• The final ARCP form must clearly note which capabilities have and have not been met, specific reasons for the Outcome 4 and any information on mitigating circumstances.
• An Outcome 4 usually means it is unlikely that the GP registrar will be able to go on to have a career as a GP. This often means having to have a difficult conversation; however, this is in the best interests of the GP registrar.

6.13. Unless the named Clinical Supervisor is also the Educational Supervisor, the Clinical Supervisor should complete an assessment of the GP registrar’s performance from a clinical perspective (Clinical Supervisor Report - CSR) on completion of that placement or at other appropriate times as per the current WPBA guidance.

6.14. The GP Educational Supervisor should review and report on the educational progress of the GP registrar every six calendar months and when required for additional ARCP panels, by completing an ESR. In the final educational review, the Educational Supervisor must make a declaration whether, in their opinion, the GP registrar has acquired all the capabilities as set out in the GP Curriculum necessary to be awarded a CCT.

6.15. The portfolio of assessments, ESRs and other evidence should be reviewed by an ARCP panel of the Deanery in line with GMC and Gold Guide requirements. The panel is responsible for ensuring that all the mandatory evidence has been provided and then making a judgement about the GP registrar’s progress before recommending one of the Outcomes described in the Gold Guide.

6.16. Where causes for concern have been highlighted in a final ARCP, relating to revalidation, this should not stop the recommendation for CCT being made if all training and educational requirements for CCT have been met.

6.17. As with all GP registrars, any performance issues that may occur following the award of an Outcome 6 are dealt with via the Responsible Officer for revalidation.

6.18. The ARCP form is the historical record of training which must be true and accurate. This is the expectation of the GMC. The GP registrar must check that the details of their training are accurate and correct in the Training Portfolio and therefore also on their ARCP form before they sign it. The panel chair also has a responsibility to ensure that details on the ARCP form are correct before they sign it.

6.19. The CCT date recorded on the last ARCP form is final and cannot usually be altered after the form has been signed. Changes to a CCT date must be agreed prior to signing the ARCP form.

6.20. The RCGP Specialist Applications (GPSA) team will review all ARCP forms to ensure that all requirements for CCT have been met at the end of training. They will liaise with Deanery staff, providing support and guidance and make the recommendation for CCT to the GMC where the GP registrar has met the capabilities and requirements of the GP Curriculum, including successful completion of the tripos for MRCGP. This recommendation will be based on the information on the final ARCP form.