Acting Up

For Information on Acting up in NHS England, South East read the Guidance

Acting up Guidance


Doctors in training intending to act up as a consultant within the last twelve months of their training may be asked, by the Trust with whom they are employed or another Trust, to act up into the role of a consultant.

This can be for a maximum of three months. For Less Than Full Time doctors in training, the period of acting up may be pro rata of the three months. This will count toward the doctors in training’s Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration Combined Programme (CESR CP), if approved by the Postgraduate Dean and subject to a satisfactory Educational Supervisors report.

This is not the same as taking a Locum Consultant post. The guidance is based on GMC requirements which may differ from the Gold Guide statements around Acting Up.


Invitations for doctors in training to act up as consultants are issued in exceptional circumstances. These may include, for example:

The Consultant going on maternity leave or extended sick leave

The Trust inviting the doctors in training to act up prior to being offered a substantive Consultant appointment

Opportunities to act up are not available to all doctors in training and are only possible if the opportunity arises and the employing trust, or another trust, extends an invitation.

Invitations to act up are normally only issued within the NHS England South East area, not within a hospital covered by another NHS England office.

Duties and Responsibilities

Doctors in training

For periods Acting Up, the following conditions apply:

Doctors in training must be progressing and be in possession of a satisfactory outcome from their Annual Review of Competence Progression (ARCP) and, if applicable, be on track for meeting their Penultimate Year Assessment (PYA) targets by their CCT date

An Acting Up application form must be completed and returned to the relevant Programme Manager or Officer providing 16 weeks notice unless there is mutual agreement between both parties i.e. Trusts and Supervisors prior to the proposed start date of the acting up period

Doctors in training cannot act up during their period of grace; if they are within their period of grace they will be expected to take up the post as Locum Consultant and resign their National Training Number (NTN)

Doctors in training retain their NTN during the period of acting up. They remain in their training programme.

When in post the term acting up and not ‘locum’ must be applied

The post that doctors in training act’s up into must be within the UK

Doctors in training must have a named Clinical Supervisor in the hospital where the acting up is taking place

Doctors in training must have a named Educational supervisor but this need not be in the hospital where the acting up is taking place

It is up to the Head of School and Postgraduate Dean to make the decision on whether the acting up placement is relevant to gaining the competences, knowledge, skills and behaviours required by the curriculum

This prospective approval application has to be consistent with other GMC post approval mechanisms. That is, applications should come to the Deanery which requires College input is assured through this mechanism

An Educational Supervisor’s report will be sent to NHS England South East at the end of the acting up period

If the doctor in training is not returning to their training programme, i.e. they have been appointed to the substantive Consultant post they must give NHS England South East and their employing Trust 3 months notice of their intention

If, in exceptional circumstances, the acting up role is within a Trust outside of the NHS England South East, confirmation of the invitation will be required from the inviting Trust.

Providing all the correct details have been completed on the application form, the Programme Manager or Officer will forward it to the Postgraduate Dean for consideration and decision of approval.

During the acting up period NHS England South East expects the trainee to remain under an Educational Supervisor, including during out of hours or on-call work. During on-call work there must be a consultant available on the telephone for supervision.

NHS England South East will receive a report from the Educational Supervisor at the end of the acting up period. NHS England South East will not organise and/or provide back-fill for the trainee who is accepting the invitation to act up.

Guidance Approved by HEE Wessex Leadership Team: 11 March 2015. Reviewed against the Standard Operating Procedures: 23 August 2023. 

Next Review Date: September 2029

Applying to Act up as a Consultant

All doctors in training who wish to act up should complete and return the Acting Up as a Consultant Application Form.

Additional Requirements

Core Medical doctors in training are required to read the guidance published by the Joint Royal Colleges of Physicians Training Board before submitting their application to

Paediatric doctors in training who wish to act up will also need to apply through the ePortfolio and submit to the Head of School. Please note, sub-specialty trainees must confirm that either they have contacted their CSAC or their TPD has done so. Please see more information on the Royal College of Paediatrics and Child Health website.