Acting Up

For Information on Acting up in Health Education England- Wessex read the Guidance

Acting up Guidance


Trainees 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 (whole time equivalent) and will count toward the trainee’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 trainees 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 trainee to act up prior to being offered a substantive Consultant appointment

Opportunities to act up are not available to all trainees 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 HEE Wessex area, not within a hospital covered by another HEE office.

Duties and Responsibilities

The Trainee

For periods Acting Up, the following conditions apply:

Trainees 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 3 months 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

Trainees cannot act up during their period of grace; trainees who are within their period of grace will be expected to take up the post as Locum Consultant and resign their National Training Number (NTN)

Trainees retain their NTN during the period of acting up. They remain a trainee.

As per the Gold Guide, section 6.84, trainees cannot act up into Locum consultant posts, the Consultant post must be a substantive post

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

The post a trainee act’s up into must be within the UK

The trainee must have a named Clinical Supervisor in the hospital where the acting up is taking place

The trainee 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 HEE Wessex at the end of the acting up period

If the trainee is not returning to be a trainee, i.e. they have been appointed to the substantive Consultant post they must give HEE Wessex 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 HEE Wessex, confirmation of the invitation will be required from the inviting Trust.

HEE Wessex

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 HEE Wessex 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.

HEE Wessex will receive a report from the Educational Supervisor at the end of the acting up period. HEE Wessex 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
Next Review Date: February 2021

Applying to Act up as a Consultant

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

Additional Requirements

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

Paediatric trainees who wish to act up will also need to complete the Royal College of Paediatrics and Child Health Acting Up application form available from their college website.