Important update from the Health & Care Professions Council (HCPC) for each of their 15 professions-


Expanding our Workforce- NHS England

The needs of our communities, in particular in areas where there are health inequalities, are greater than ever before. Our population is being impacted more and more by complex, long term conditions. There is a growing concern about areas of longstanding unmet health need and the social determinants of health are playing a bigger role than ever before. These new challenges are increasing the pressure on the system to deliver for those in our communities and there is more that we can do to shift our focus from treating those who are unwell to preventing ill health and tackling health inequalities.

The creation of Primary Care Networks (PCNs) builds on the core of current primary care services and enables a greater provision of proactive, personalised and more integrated health and social care.

The Additional Roles Reimbursement Scheme (ARRS) is an automatic funding stream available to Primary Care Networks (PCNs) to support recruitment which currently supports the employment of service provision.

This provides funding for 26,000 additional roles to create bespoke multi-disciplinary teams. Primary care networks assess the needs of their local population and, working with local community services, make support available to people where it is most needed.

More information on the ARRS, including financial reimbursement information can be found here-

Network Contract Directed Enhanced Service – Contract specification 2023/24 – PCN Requirements and Entitlements (



Practice Resources

The Department of Health & Social Care (DHSC) have produced posters and promotional resources that can be downloaded and used to promote a particular role(s) in your practice.

This campaign is intended to promote understanding amongst patients of what many of these roles do and how the wider team of healthcare professionals can support delivery of their care.


Further information on the different roles can be found on the BMA website.



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Clinical Pharmacist / Pharmacy Technician

Clinical pharmacists work in primary care as part of a multidisciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas. They work with and alongside the general practice team, taking responsibility for patients with chronic diseases and undertaking clinical medication reviews to proactively manage people with complex medication use, especially for the elderly, people in care homes and those with multiple conditions. NHS England

Clinical pharmacists are increasingly working as part of general practice teams. They are highly qualified experts in medicines and can help people in a range of ways. This includes carrying out structured medication reviews for patients with ongoing health problems and improving patient safety, outcomes, and value through a person-centred approach. As well as providing clinical services, the role also includes:

  • Prescription management
  • Audit and Education
  • Medicines management

Having clinical pharmacists in GP practices means that GPs can focus their skills where they are most needed, for example on diagnosing and treating patients with more complex conditions. This helps GPs to manage the demands on their time.

The Primary Care Pharmacists Association’s guide for GPs considering employing a pharmacist includes a summary of what pharmacists can do, advice on the different methods of recruitment, sample job adverts and sample job descriptions.

Practices can employ pharmacists through, for example:

  • direct employment
  • locum hire
  • contract from an ICB (Integrated Care Board), CSU (Commissioning Support Unit) or a private provider.

The  BMA has produced a template agreement which can be adapted to suit practice needs. Any practices and providers using it must take their own independent legal advice before it is signed.

Pharmacy-Technicians play an important role within general practice and complement the more clinical work of clinical pharmacist, through utilisation of their technical skillset. Their deployment within primary care settings allows the application of their acquired pharmaceutical knowledge in tasks such as audits, discharge management, prescription issuing, and where appropriate, informing patients and other members of PCN workforce. Work is often under the direction of clinical pharmacists, and this benefit is realised through the creation of a PCN pharmacy team.

Pharmacy technicians must be registered with the general pharmaceutical council (GPhC), which would follow completion of an appropriate level 3 course / funded apprenticeship programme.

Training and Development

Information taken from Primary care pharmacy education pathway : CPPE

The Centre for Pharmacy Postgraduate Education (CPPE) is commissioned by Health Education England to deliver training to pharmacy professionals working in primary care as part of the primary care Network Contract Directed Enhanced Service (DES). They have developed the Primary care pharmacy education pathway  (PCPEP) to align the education requirements of the pharmacists and pharmacy technicians with the NHS Long Term Plan and the primary care Network Contract Directed Enhanced Service.

This pathway will equip pharmacists and pharmacy technicians with the necessary knowledge, skills, and experience to work in various patient-facing roles in primary care networks as part of a multidisciplinary team. Pharmacists and pharmacy technicians will be able to access a range of different study methods to suit different learning styles, a continuous assessment process and support from supervisors and peers. The pathway is 18-months for pharmacists and 15-months for pharmacy technicians. Independent prescribing is in addition to the training pathway and will be completed following completion of the PCPEP.

CPPE regularly runs an introduction webinar for employers, clinical supervisors and interested parties outlining the PCPEP pathway. For a recording of this webinar click here. The education pathway is outlined below-

For those who work in primary care but are not eligible for the Primary care pharmacy education pathway CPPE has a wide range of learning in the portfolio. You can download an information sheet here.

Useful Links

Pharmacy Framework 2020.pdf (

Pharmacy-Technician.pdf (

Clinical-Pharmacist.pdf (

Primary care pharmacy education pathway : CPPE

Training offers for Pharmacy Technicians and pre-registration trainee pharmacy technicians | Health Education England (

Guide for GP’s.indd (

Employing clinical pharmacists in GP practices (

NHS England » Clinical pharmacists

General Pharmaceutical Council (

Clinical Pharmacists | Dorset Primary Care Training Hub (

Pharmacy –

Pharmacy – Working across Wessex (

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Registered Dietitians are qualified health professionals that assess, diagnose, and treat dietary and nutritional problems at an individual and wider public health level.

They utilise behaviour modification methods and motivational interviewing techniques as well as innovative digital practice to enable service users to make appropriate lifestyle and food choices to manage their own conditions, enabling a positive impact on clinical outcomes. Primary Care Dietitians

First Contact Dietitians  may cover one of more of the following areas of practice, depending on their knowledge, experience, and scope of practice-

  • Diabetes (which may include assessing levels of motivation to support identification of appropriateness for very-low-calorie diet programmes)
  • Weight management
  • Frailty
  • Functional bowel disorders and Coeliac disease

By making it easier for patients to access an experienced dietitian without needing to see a GP first, patients will have quicker access to diagnosis and treatment, helping them to manage their conditions more effectively and recover faster, so they can get back to normal life quickly.

Through their advanced clinical skills and acting as a true first point of contact, First Contact Dietitians can help to reduce GP workload, as well as reducing unnecessary patient referrals into secondary and community care services. Primary Care Dietitians

There are several ways to access a dietitian through DES in a PCN, these include:

  • A service level agreement with a local NHS trust dietetic department – this is likely to be the preferred option for most PCNs as training, profession-specific supervision and mentoring will already be in place, along with cover for annual leave, sickness, and maternity leave. It also prevents potential duplication of services.
  • Service contract with a freelance dietitian – working on a contractual basis
  • A dietitian employed directly by the PCN
Training and Development

The HCPC requires that dietitians participate in training, supervision (continuing professional development and clinical) and mentoring. As local NHS trust dietetic departments have a structure in place to support this, this may be the preferable option for both the PCN practice and dietitian. The BDA has produced a guide for general practice on the role of the Dietitian in Primary care, full document can be accessed here.

A Roadmap to Practice
To practice, dietitians must be registered with the Health and Care Professions Council (HCPC). To register with the HCPC, completion of an approved degree in dietetics is required This is usually a BSc (Hons) degree, although there are shortened postgraduate programmes available. A degree apprenticeship standard in dietetics has also been approved.

  • HEE Primary care FCP training must be completed as the minimum threshold for entry to primary care and be supported by appropriate governance and indemnity.
  • HEE primary care FCP training can begin 3-5 years post graduate.


Health Education England (HEE), with support from the BDA , have produced a Roadmap to Practice for first contact dietitians and advanced practitioners in primary care. It includes a set of capabilities to ensure safety and consistency for first contact dietitians and advanced practice dietitians in primary care.




Please click here for an example of a job description.

Useful Links

Dietitians-in-primary-care-a-guide-for-general-practice.pdf (

Primary Care | British Dietetic Association (BDA)

healthandcareprofessionspracticeeducationstatementandguidance.pdf (

Primary Care Dietitians

Dietitians in primary care | Health Education England (

Dietician.pdf (

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Mental Health Practitioner

From April 2021, Primary Care Networks (PCNs) could recruit Mental Health Practitioners (MHPs) through the additional role reimbursement scheme (ARRS) to support population health management.

These roles sit alongside NHS Talking Therapies for anxiety and depression, and a range of other roles within primary care that provide mental health support. Mental health practitioners provide GPs and other primary care staff with timely support and advice, helping to relieve pressure on workloads and build stronger relationships with mental health services. NHSE.

The role of a Mental Health Practitioner will include ‘seeing adult patients who have been referred by GPs and other local services and deciding on the best support for them.  

This will include providing psychological interventions around:  

  • behavioural activation and graded exposure using the ‘GOALS’ programme. 
  • problem solving 
  • improving sleep 
  • recognising and managing emotions 
  • guided self-help for bulimia and binge-eating 
  • confidence building 
  • managing medicines

This involves working ‘as part of a wider multidisciplinary team to promote good mental health and recovery from severe mental health problems’.   NHS- Health Careers

Training and Development
To enable areas to meet local needs, a mental health practitioner role can be taken on by a wide range of staff with mental health expertise (ranging from Band 4-8a). This includes, but is not limited to:

  • Peer support workers
  • Community psychiatric nurses
  • Clinical psychologists
  • Mental health social workers
  • Mental health occupational therapists
  • Mental health community connectors  NHSE

You can train for a postgraduate or graduate certificate, depending on whether or not you already have a degree qualification. You don’t need previous experience of working in mental health, but you will need to demonstrate your ability to study at degree level or above.  NHS Health Careers

Please click here for an example of a job description.

Useful Links

NHS England » Mental health practitioners

An Introduction to the Primary Care Network Mental Health Practitioner (

Mental Health Practitioner – Sussex Training Hub

Mental health and wellbeing practitioner | Health Careers

Approved Mental Health Professional – elearning for healthcare (

NHS England » Mental health practitioners

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Occupational Therapist

Occupational therapists are playing an increasing role in primary care. They enable people living with a range of health problems and chronic conditions to overcome the barriers so they can participate in everyday life and improve their health and wellbeing.

Occupational therapists assess the needs of people to do what they need and want to do (occupations). They develop plans with patients, so they can re-engage in everyday life, despite their health and social difficulties.

Through intervening early and taking a collaborative approach occupational therapists are able to address what matters to people. This can minimise crisis situations, prevent further deterioration and promote independence and social inclusion. HEE

Occupational Therapists can help GPs to support patients with a range of needs:

Frail older adults

  • Use of frailty indexes to identify people needing a proactive approach
  • Rapid crisis response to prevent hospital admission or to speed discharge.
  • Assessment and interventions to ensure people can cope at home, including support for carers.
  • Short term rehabilitation interventions and referral on to specialist services if indicated
  • Use of digital and assistive technology to ensure safety at home.

People with mental health problems

  • Risk assessment for acute distress,
  • Personalised care plans for self-management,
  • Patient activation to achieve personal goals,
  • Social prescribing, and signposting or referral onto recovery support and services.

Working age adults with employment difficulties

New resources for occupational therapists in primary care (Primary Care Bulletin: issue 264: 9th November 2023)

The Royal College of Occupational Therapists has developed a range of resources to support occupational therapists and their employers, in primary care. These include capability frameworks, sample job descriptions and case studies.

The RCOT occupational therapy in primary care network includes monthly virtual meetings and email bulletins for members. By joining the network, you will be automatically invited to the meetings and added to email list. Please read the Terms of reference  before signing up by emailing with your RCOT membership number (begins with BT).

Training and Development
A BSc degree in occupational therapy is required to work as an occupational therapist in any setting.

  • HEE Primary care FCP training must be completed as the minimum threshold for entry to primary care and be supported by appropriate governance and indemnity.
  • HEE primary care FCP training can begin 3-5 years after the completion of the postgraduate degree. HEE


This occupational therapy version of the educational pathway and framework is applicable across the life span dependent on the scope of practice, appropriate knowledge and skills that may apply to specific patient groups, and the job description that the FCP Occupational Therapist is working under. Health Education England provide regular updates about the roadmaps here.



Please click here for an example of a job description.

Useful Links

First Contact Practitioners and Advanced Practitioners in Primary Care: (Occupational Therapy) A Roadmap to PracticeFirst Contact Practitioners and Advanced Practitioners in Primary Care: (Musculoskeletal) A Roadmap to Practice (

Occupational therapy in primary care – RCOT

How PCNs can benefit from using occupational therapists – Pulse Intelligence (

Occupational Therapists in primary care | Health Education England (

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Paramedics have been an integral part of the primary care multi-professional team within general practice for many years, and their numbers have increased since 2021.

A paramedic in primary care can provide a rapid response to deteriorating patients and patients with long-term conditions, minor injuries, and minor illness. They can also support patients who require wound care, have fallen, have musculoskeletal problems, and have urinary tract or respiratory infections. Paramedics can supply a range of medicines through patient group directions, including antibiotics and analgesics. NHS England

The role of the paramedic has developed over recent years to meet the shifting needs of healthcare towards community provision, aimed at supporting patients to be treated and managed within their own home. Changing demands have required the paramedic workforce to be flexible, to develop the skills and competencies required to treat and manage increasingly complex patients, while continuing to provide excellent and safe patient care. (HEE).

Paramedics can support PCNs in responding to on the day demand by offering telephone triage or undertaking home visiting. They can also support PCNs to improve access to care by managing minor ailments and seeing patients in care homes.

Training and Development
A BSc in a training programme approved by the College of Paramedics

  • For Band 7 roles, Health Education England Primary Care FCP capability training must be completed as the minimum threshold for entry to primary care and be supported by appropriate governance and indemnity
  • Health Education England primary care FCP training can begin 3-5 years postgraduate
  • For Band 8a roles, the Health Education England FCP training must be completed, and they must be working at an advanced level of practice i.e. at master’s level (level 7) across all four pillars of advanced practice

As paramedics progress along their educational pathway, their scope of practice within the general practice teams will advance, and this can be further enhanced through the completion of additional training. This training will increase their competencies and capabilities to develop their level of practice within a variety of settings including general practice (NHSE)

Paramedics can follow the Health Education England (HEE)  Roadmaps to Practice evidencing their capability as first contact practitioners (FCPs) or advanced practitioners (APs). They provide a clear educational pathway from undergraduate to advanced practice for clinicians wishing to pursue a career in general practice, and the capability framework clearly articulates capabilities so that employers can understand what the clinicians can offer the multi-disciplinary team (MDT). NHSE


AHPs who have followed and demonstrated these capabilities will be able to see and manage more clinically complex patients and, within their scope of practice, work independently in general practice. APs will be able to supervise other relevant members of the MDT.

Figure 1taken from NHSE shows the educational pathway for an AHP, including the minimal time they can move through the pathway.

Please click here for an example of a job description.

Useful Links

First Contact Practitioners and Advanced Practitioners in Primary Care: (Paramedics) (

Paramedic Specialist in Primary and Urgent Care Core Capabilities Framework.pdf (

jd-pcn-paramedic.docx (

Advanced Practice Toolkit | Health Education England (

First Contact Practitioners and Advanced Practitioners in Primary Care: (Paramedics) A Roadmap to Practice (

Primary and Urgent Care (

Paramedics – elearning for healthcare (

Paramedics workforce | Health Education England (

B1847-Paramedics-in-general-practice-1.pdf (

Interactive Career Framework – Related Downloads (

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Physician Associate

Physician associates are healthcare professionals with a generalist medical education, who work alongside doctors providing medical care as an integral part of the multidisciplinary team. Physician associates are practitioners who can work autonomously, but always under the supervision of a fully trained and experienced doctor. They add new talent to the skill mix within teams, providing a stable, generalist section of the workforce which can help ease the workforce pressures that the NHS currently faces.

Faculty of Physician Associates

This role complements that of a GP and includes:

  • managing patient lists
  • providing health promotion and disease prevention advice for patients
  • performing physical examinations
  • diagnosing illnesses
  • seeing patients with long-term conditions
  • undertaking residential, nursing and home visits
  • taking medical histories from patients
  • analysing test results
  • making referrals and
  • developing management plans.

The responsibilities held by a PA working within general practice vary depending on their experience, and their scope of practice will develop over time at the discretion of their named supervising GP, with many experienced PAs working at a semi-autonomous level. This means that supervision may be remote, such as when PAs are providing home visits or care home reviews. Although PAs are currently unable to prescribe, they are trained in clinical therapeutics and are therefore able to prepare prescriptions for their supervising GP to sign, having devised an appropriate management plan. British Journal of General Practice

According to the CQC, PA cannot issue medication by Patient Group Direction (PGD). They can provide medicines by a Patient Specific Direction (PSD). It is likely that physician associates will gain prescribing privileges in the next few years.

The BMA explain that Physician Associates ‘are not, however, a substitute for a doctor who undergoes years of medical training that enables them to provide complex, highly skilled care to their patients. GPs play a particularly important role in diagnosing serous conditions, a task that that can only be done with an appropriate level of medical expertise and experience’. They ‘strongly recommend that GP practices only consider recruiting PAs who are registered on the Physician Associate Managed Voluntary Register.’

Training and Development
To enter the profession, all physician associates must have a:

  • relevant degree (for example bioscience or healthcare-related) and
  • postgraduate diploma which takes two years of full-time study to complete.

Physician associate courses in the UK follow a national curriculum and competence framework. All physician associates must pass a national examination of knowledge and skills. They must recertify in the knowledge component every six years. This is to ensure they keep up to date. Physician associate is the only clinical profession in the UK which has a national skills and knowledge test. CQC


Please refer to our Physician Associate (PA) Role- FAQ webpage for further information on the PA role, this also includes discussion around the current concerns surrounding the PA role and position statements from the BMA, RCGP and NHSE.

Useful Links

Faculty of Physician Associates – quality health care across the NHS (

Physician associates in general practice: what is their role? | British Journal of General Practice (

Physician associates in primary care | Health Education England (

Physician Associates in general practice – #AssociateYourself | Health Careers

Employing physician associates in GP practices (

Faculty of Physician Associates – quality health care across the NHS (

GP mythbuster 82: Physician associates in general practice – Care Quality Commission (

Physician associates (

Microsoft Word – New Roles in Primary Care Toolkit 011020.docx (

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Physiotherapist (MSK FCP)

FCP roles began with the development of the FCP Physiotherapist in 2014, in response to the shortage of General Practitioners (GPs) in Primary Care. HEE

This means that a patient presenting to a GP practice with an MSK condition can see a FCP at their first appointment, accelerating their MSK assessment, treatment plan and (if appropriate) investigations and referral, along with saving both time and resources within primary care teams. HEE

The vast majority of musculoskeletal first contact practitioners are physiotherapists with enhanced skills. They can help patients with musculoskeletal issues such as back, neck and joint pain by:

  • Assessing and diagnosing issues
  • Giving expert advice on how best to manage their conditions.

The role of the FCP physiotherapist can help

  • Management of MSK caseloads through FCP allows the individual to access a practitioner with MSK expertise without a GP referral.
  • This results in shorter treatment pathways and fewer referrals for imaging and secondary care treatment overall.
  • It means patients receive timely preventative and rehabilitation interventions.
  • At the start of the pathway, FCPs are in an excellent position to promote the benefits of improving health through smoking cessation, reducing weight, and increasing physical activity. HEE

Training and Development
  • BSc degree in Physiotherapy
  • Health & Care Professions Council (HCPC) registration
  • Can demonstrate working at Level 7 [within the ACP framework] capability in MSK related areas of practice or equivalent (such as advanced assessment diagnosis and treatment)
  • Health Education England primary care FCP training can begin 3-5 years postgraduate
  • For Band 8a roles, the Health Education England FCP training must be completed, and they must be working at an advanced level of practice i.e. at master’s level (level 7) across all four pillars of advanced practice


This is the MSK version of the educational pathway to FCP and AP in Primary Care and is relevant to all experienced professionals specialising in MSK. The framework presented is applicable across adults and children dependent on the scope of practice, appropriate knowledge and skills that may apply to specific patient groups, and the job description that the FCP is working under. HEE



Please click here for an example of a job description.

Useful Links

First Contact Practitioners and Advanced Practitioners in Primary Care: (Musculoskeletal) A Roadmap to PracticeFirst Contact Practitioners and Advanced Practitioners in Primary Care: (Musculoskeletal) A Roadmap to Practice (

Musculoskeletal (2018) – Skills for Health

Musculosketal First Contact Practitioner Services – Implementation Guide (

First Contact Practitioner (FCP) resource (

Musculoskeletal Primary Care – elearning for healthcare (

Specialist physiotherapy provider for GP practices & PCNs – Primary Care Physio

001404_fcp_guidance_england_2018.pdf (

Microsoft Word – MSK First Contact Physiotherapists sample JD.docx (

Physiotherapists | (

MSK service standards – patient version | The Chartered Society of Physiotherapy (

Guide to embedding your first contact physiotherapy service | The Chartered Society of Physiotherapy (

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Podiatrists are healthcare professionals that have been trained to diagnose and treat foot and lower limb conditions. Podiatrists provide assessment, evaluation, and foot care for a wide range of patients, which range from low risk to long-term acute conditions. Many patients fall into high-risk categories such as those with diabetes, rheumatism, cerebral palsy, peripheral arterial disease, and peripheral nerve damage. NHS England


According to the Royal College of Podiatry (rcpod), podiatrists can prevent and manage foot problems, relieve pain, treat infection and support foot irregularities, to keep people of all ages mobile and active.

Podiatrists are ideally placed to use their expertise in primary care settings by developing and embedding services that extend the ability of GPs and primary care teams to provide a focus on prevention and early intervention, and help to-

  • Minimise the impact and consequence of long term conditions
  • Prevent and delay onset of deterioration of chronic conditions
  • Maintain and maximise mobility
  • Help to reduce the number of falls
  • Enable independence leading to improved quality of life and reduced social exclusion
  • Reduce the need for secondary, surgical or pharmacological intervention
  • Reduce hospital admissions and unnecessary hospital referrals
  • Support patients living with long term conditions
  • Keep people mobile and in work
  • Reduce the burden on GPs and primary care teams. 

A summary of activities undertaken by a podiatrist can be found here and more information on the scope of podiatrists as First Contact Practitioners can be found here 

Non-medical prescribing

Working within primary care settings, podiatrists are competent to prescribe medicines independently, providing patients with direct access to the interventions they need. This is not only valuable to patients but increases capacity within primary care settings by relieving pressure on GPs and primary care teams.

Podiatrists have a unique understanding of medicines management as it is a significant component of the podiatry undergraduate curriculum. Around 5000 podiatrists have access to medicines exemptions, which is a graduate qualification, and many go on to take further qualifications in supplementary and independent prescribing. Podiatrists are established non-medical prescribers and have a history of safe, effective practice.

An audit evaluating 1000+ non-medical prescribing episodes, identified that for patients seen by an allied health professional, including podiatrists, 20 per cent avoided the need for a GP appointment and 11 per cent avoided the need for a GP home visit.1 This demonstrates the huge impact which non-medical prescribing offers.

Training and Development

According to NHSE, the most popular way into podiatry is through an approved degree course or a Master’s degree in podiatry. It usually takes two to three years full time and over four years part-time.  Once you’ve successfully completed your degree you’ll need to register with the Health and Care Professions Council (HCPC) before you can start practising.

A Road Map to Practice
Must have a BSc to work as a podiatrist in all settings.


The capability framework clearly articulates capabilities so that employers and workforce planners can understand what the clinicians can offer to the multi-professional team to enable the best care for their patient population. It also provides clear guidance of the expected supervision needed to support the roadmap to practice and outlines the bespoke supervision training that a supervisor needs to have completed.



Please click here for an example of a job description.

Useful Links

First Contact Practitioners and Advanced Practitioners in Primary Care roadmap to practice

Registration | Health and Care Professions Council (HCPC) | (

Podiatry’s role in primary care (

Podiatry Careers Podiatry Courses & Training – – Health Careers

Microsoft Word – New Roles in Primary Care Toolkit 250221 Final.docx (

Podiatrists as First Contact Practitioners (

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Skills Matrix

Multidisciplinary Framework for Skills and Costing

(Please download the document to get the full format)

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