For healthcare practitioners working in primary care in the NHS, the Performers List Regulations provide an additional layer of regulation that works alongside the CQC and the healthcare professional regulators (GMC, GDC, GOC). In England, the performers lists are managed by NHS England, and in Wales, by the Health Boards. In England, you are most likely to deal with the local area team.
Performers List Regulations
The Performers List Regulations apply to those working as an:
- NHS general practitioner
- NHS dentist
- NHS optometrist
Your specific role does not matter — whether you are a partner, a provider, a dental associate, or a trainee GP, you must be on the Performers List to undertake any work in primary care. If you are newly qualified and starting out in your career, then the first hurdle is to be admitted to the Performers List. That may involve declaring any cautions or convictions or any disciplinary investigations.
The Performers List Regulations set out the framework within which NHS England and Welsh Health Boards can investigate concerns about primary care practitioners. The regulations allow NHS England or Welsh Health Boards to take action where concerns are substantiated; however, interim action can be taken to mitigate risks whilst an investigation is undertaken into whether definitive action is required following an investigation.
The Performers List imposes requirements such as a duty to information if you are involved in an inquest where you are found to have caused or contributed to a death, if you have had your conduct brought into question, if you have accepted a police caution, or if you have been charged with an alleged offence.
Performers List investigations
Performers List investigations cover issues such as capability, probity concerns, health issues, behavioural concerns, and efficiency cases. In some cases, Practitioner Performance Assessment, or PPA as it is often known, may become involved in an advisory or assessment capacity.
Engagement with an investigation under the Performers List Regulations is likely to require a practitioner to engage with a Performers Advisory Group (PAG) or the Performers List Decision Panels (PLDP), or in Wales, you may be required to attend a Reference panel hearing to address the issues. The issues may be framed as an efficiency case. The eventual outcome of an investigation by NHS England or a Health Board can include:
- Suspension — removal from the Performers List meaning that a practitioner cannot work in primary care either in the interim or permanently;
- Conditions that limit a primary care practitioner’s ability to practice until sufficient remediation is demonstrated;
- A referral to a Regulator, the Police, the NHS Counter Fraud Service, CQC/HIW or a safeguarding referral to a Local Authority: these outcomes often arise in parallel with suspension or removal, or at an earlier point during an investigation;
- Informal monitoring of behaviour or performance; or
- An invitation to agree a remediation plan through the agreement of undertakings.
Can you work as a GP without being on the Performers List?
Some of these outcomes limit a primary care practitioner’s ability to practice and earn an income, and suspension from the Performers List can cause stress and anxiety. If you are removed from the Performers List, then you cannot undertake any work in primary care, and it may be difficult to make a successful admission to be included on the Performers List. If you have conditions imposed, then you must comply with them or face further action being taken.
A Performers List investigation can also lead to further regulatory action beyond the remit of primary care regulation — for example, a referral to the General Medical Council (GMC) or the General Dental Council (GDC).
If you are unhappy with a decision made by the PDLP or a Welsh Health Board, then there is, in some cases, such as a removal from the Performers List, a right of appeal to the First-tier Primary Health Lists.
Whatever the eventual outcome, an investigation under the Performers List Regulations can be a very stressful and worrying time for a healthcare practitioner working in primary care. Over decades, we have represented hundreds of clinicians in Performers List cases. Our legal experts have deep experience and expertise, meaning you can be confident you are in safe hands. In most cases, the sooner advice is obtained, the more time there is to prepare a case and to develop a strategic approach that will best safeguard your position before any interview or hearing. We will agree pragmatic goals with you and work with you towards achieving them. Not only do we advise on responses and case preparation, but our team includes experienced advocates who can present your case at interim and substantive hearings. This is economical and provides continuity through a very worrying time.