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AGIP Accredited Independent Healthcare Practitioner CPD Forms

AGIP Accredited Independent Healthcare Practitioners must submit CPD every other year (by the 30th April) in order to maintain their status. Complete the relevant sections within Form 4 – Continuing Professional Development.

Due 30th April 2020

Form 4: Section 1, Record of CPD Activity (pages 2-3)

The minimum requirement for CPD is 10 hours per annum:

  • 10 hours CPD which may include up to 5 hours in-house or mandatory training and 5 hours external training/courses

Note: The AGIP symposium and the AGM fulfill 2½ hours of external CPD. Attendance at 1 full day of the BSG annual conference fulfills all 5hours of external CPD required per annum.

Form 4: Section 2, Reflective Practice (pages 4-5)

It is important for practitioners to reflect on any development activity undertaken using this form. A separate copy of the form should be submitted for each of the six (3 per year) reports required for submission.

NB: Each Reflective Practice Account must be signed and dated by the appropriate Line manager (or equivalent senior colleague) and the applicant, or they WILL NOT BE ACCEPTED.

Form 4: Section 3, Personal Development Plan (page 6)

Please give a brief list of any planned CPD for the year to come, for examples please see the list in Section 1. There is no need to list any more than five objectives.

Form 4: Section 4, Extended Scope of Practice (page 7) *Only if appropriate*

The association should be aware of the work you do as an accredited professional. Since your last submission, please submit this form only if you have extended your scope of practice into new areas. E.g. clinical skills, service development, teaching, management

Form 4: Section 5, Check List (page 8)

Please use the check list on page 8 to make sure you have completed all the above sections before submitting as incomplete submissions will be returned…

all of the above forms must be returned (on time or you could be subjected to a late submission fee) to:


Tanya Miller PhD SRCS
Principle Clinical Scientist in GI Physiology
Oxford Centre for GI Physiology, Pelvic Floor Services & Research
Block 24
The Churchill Hospital
Old Road
Oxford OX3 7LJ

Phone: 01865 235879