Purpose

This document sets out the processes which must be followed by NHS England regional teams when considering applications from primary care medical, dental, ophthalmic and ophthalmic medical practitioners to join the NHS England Performers Lists (PL).

The term ‘performer’ is used throughout this document to mean the medical, dental, ophthalmic or ophthalmic medical practitioners included on the PL for the provision of NHS primary care services. Where the Performers List Regulations (PLR) are quoted, the term ‘practitioner’ is used. The term ’applicant’ refers to a performer in the process of applying to the Performers List, prior to an inclusion decision.

When the term ‘medical director’ is used, this means either the Medical Director System Improvement and Professional Standards (MD SIPS) or a member of staff with delegated authority from the MD SIPS. Where the term ‘regional team’ is used, this means the Regional Professional Standards and Performers Lists Teams.

You should be aware that independent contractors may also be employed by a primary care provider. In this event, primary care providers will be required to comply with the human resources policies that cover recruitment and employment checks applicable to that organisation. These arrangements do not fall within the scope of this document; however, employers and NHS England should be aware of the need to ensure the sharing of information between both parties where appropriate.

Overview of the Performers Lists/statutory responsibility

NHS England is responsible for assuring itself that primary care providers deliver safe and effective care to patients. Providers contract with the NHS to deliver primary care services and one of the terms of their contract is to ensure that any general medical practitioner (GP), general dental practitioner (GDP), ophthalmic practitioner (optometrist) or ophthalmic medical practitioner (OMP) working under their contract for services is included on the relevant England PL and is not suspended from that list.

The NHS (Performers Lists) (England) Regulations 2013, as amended (the Regulations) set out the statutory framework for managing inclusion onto each of the three Performers Lists in respect of GPs, GDPs, optometrists and OMPs.  The Regulations also provide the statutory framework associated with the imposition of conditions, suspension or removal from the list. The purpose of the assessment for inclusion is to assure NHS England that the performer is not only fit to practice (included on the professional register) but fit for purpose (suitable to perform primary care services). The regulations do not require the performer to declare their scope of work beyond that of a general medical practitioner, general dental practitioner or ophthalmic practitioner, and there is no requirement for this detail to be recorded against their name on the list.

NHS England is the custodian of the England Lists, and the MD SIPS in each region has responsibility for managing performers included on the list within their own geographical area. MD SIPS are accountable to the regional medical director (RMD) who in turn are professionally accountable to the national medical director.

The Professional Standards Strategic Oversight Group (PSSOG) has responsibility for the oversight and assurance to NHS England’s Board and its membership is drawn from the national and regional medical directors. The Professional Standards Assurance Committee (PSAC) membership is drawn from the national professional standards team and the regional professional standards teams and has responsibility for developing and delivering the professional standards and performers lists workstreams. It reports to the PSSOG.

The performers list is a national list, covering England. For administration purposes, the list is subdivided into seven and administered at a regional level. Performers should usually be aligned to the NHS England region where they carry out the most work and can be transferred as required between regions.

Roles and responsibilities

The role of the medical director

The MD SIPS’ role encompasses responsibility for the management of applications for inclusion on the PL and the management of practitioners included on the PL thereafter in accordance with the PLR and NHS England policy. This responsibility covers GPs, GDPs, Optometrists and OMPs included on the PL.

Roles and responsibilities of the decision making and support structures

NHS England has established Professional Standards Groups (PSGs) and Performers Lists Decision Panels (PLDPs) that are convened at a regional level to support independent and robust decision making within each of the NHS England regions.

The remit of the Professional Standards Group (PSG) is to assess information received by NHS England in relation to applications to join the Performers Lists in the relevant geography, and to decide if any further action is indicated (as well as considering details of concerns relating to named individuals already included on a Performers List as described in the NHS England Policy on Managing the NHS Performers Lists (England)).

The PSG’s constitution is derived from a pool of trained members with prescribed quoracy and voting rights. The roles the PSG must include are fixed but the members are not. Appointment to the pool of PSG members will be made, as necessary, by the Regional Head of Professional Standards (HOPS and/or MD SIPS). The PSG will be convened as frequently as the activity dictates. There is a standing invitation to the appropriate Local Representative Committee in the geographical area. Other individuals may be asked to attend to provide expertise as necessary.

If the PSG considers that Performers List regulatory action should be considered, it may issue notice as defined in the Performers List Regulations, and the case manager will make arrangements for the application to be considered by the Performers List Decision Panel (PLDP), which has authority to decide if the actions proposed in the notice are to be effected.

The remit of the PLDP is to consider information received by NHS England in relation to a named individual applying to or included on a Performers List. PLDPs and their constitution are derived from a pool of trained members with prescribed quoracy and voting rights. The roles of the PLDP members are fixed but the members are not. Appointment of PLDP members will be made, as necessary, by the Regional HOPS and/or MD SIPS. The PLDP will be convened as frequently as the activity dictates.

The PLDP’s primary role in considering applications to join the list is to make decisions under the PLR, including inclusion with conditions, deferral or refusal.  

If action is considered necessary under the PLR, both PSG and PLDP can issue notice of regulatory action. Only PLDP has delegated authority to effect such action. Members of the PLDP must take account of any potential conflict of interest or perception of bias and NHS England officers must take this into account when convening panels to consider each case. 

Terms of reference for the PSG and the PLDP are set out in the Policy on managing the England Performers Lists.

The MD SIPS, or nominated deputy, is responsible for ensuring that each application is properly assessed against the requirements of the PLR and this policy.

The MD SIPS is responsible for ensuring that clinical governance arrangements are established to identify issues relating to fitness for purpose and/or practice. Where assessment of the application reveals information of note or identifies concerns that, in the view of the MD SIPS or nominated deputy, may warrant regulatory action the application must be considered by the PSG or PLDP. The PSG may confirm to the MD SIPS that agreement terms could be offered to the applicant, or they may refer the case on to the PLDP to decide to include (with or without agreement terms), include with conditions, refuse or defer the application. 

Roles and responsibilities of management staff

The roles, responsibilities and scheme of delegation of members of staff responsible for the management of the Performers List are set out in the Policy on Managing the England Performers Lists. 

Within the context of the present policy, the role of the Performers List Decision Panel is to:

• consider applications of note
• hear any representation from the applicant, or their chosen representatives, if requested to do so
• make decisions about inclusion of the applicant based on the information and evidence before them 
• give reasons for decisions and facts relied upon.

The Panel is confined to making decisions based on the information before it. Its remit does not extend to the oversight or continuous management of the case beyond the Panel making its decision. This responsibility is conferred on the MD SIPS or delegated officer. 

Managing applications to join the Performers Lists

MD SIPS are responsible for ensuring that all applications for inclusion onto the PL are managed in a fair, open and consistent manner. The NHS (Performers Lists) (England) Regulations 2013, as amended, set out the regulatory requirements that applicants and NHS England must comply with. In addition, NHS England has prescribed that additional checks are to be undertaken to assure commissioners and patients that performers are safe to practise. A summary of the statutory and NHS England policy requirements is set out in Table 1 below.

Performers List requirements according to applicant circumstances

Table 1 above describes the evidence required in respect of each category of applicant. Applicants will fall into one of the following 5 categories:

• Returners – the applicant has previously been included on a Performers List in England
• The applicant is currently included on a Performers List in Wales, Scotland or Northern Ireland
• The applicant is a GP registrar (Resident Doctor) in training
• The applicant is a Dental Foundation Trainee
• The applicant does not fall into one of the categories listed above

The application evidence and policy requirements for each applicant type follows, with a link to an online section for each. This policy should be read in conjunction with the Regulations.  Regional teams must assure themselves that all regulatory, policy and evidence requirements have been met when considering each application.

1. Returners – Processing an application from a practitioner seeking to return to an England Performers List

1.1 Application process

Statutory Instrument 2023 No 828 (The National Health Service (Performers Lists) (England) (Amendment) (No. 2) Regulations 2023 (legislation.gov.uk)  amends the  evidence required for applicants who have previously been included on an England Performers List and who wish to return to the list after a period of absence.  Returners do not have to provide the full range of evidence, as they will have provided this the first time they applied to the England Performers List. 

Returners do not have to provide evidence of:

• CV
• References
• Indemnity
• Certificate of graduation
• Declaration that their name is on the professional register

Returning practitioners can be included on an England Performers List via PCSE Online prior to the third-party checks outlined in Regulation 5 “Consideration of applications”. These checks must be concluded within three months of inclusion.  (Note that inclusion of returners prior to these checks being made is at NHS England’s discretion and is not mandatory in the same way as inclusion of a performer currently included on a list in a devolved nation subject to meeting the criteria in regulation 5 (A) (1)).  

1.2 Application evidence required

• Name
• Date of birth
• Address and telephone number
• Last appraisal, if available

Enhanced Disclosure and Barring Check (DBS) check or Police Check where DBS is not available: If the applicant is living in, or has previously lived in the UK, the applicant must present evidence of having applied for an enhanced DBS check, or of having signed up to the DBS update service. The evidence can be provided before inclusion or after inclusion via agreement terms. If they have resided abroad for a period of 12 months or more (whether continuous or not) in the five years prior to their application, they must provide a police check from that country. Any applicant who is unable to obtain a police check must provide a statement that sets out the actions that they have taken to obtain one. Applicants who are unable to apply for a DBS check until they have entered the UK must confirm their agreement (either as part of their Agreement Terms or as a condition on inclusion) to apply for an enhanced DBS check as soon after their arrival in the UK as practicable.

Applicants from Scotland can supply evidence of a recent Protect Scotland disclosure under the Protection of Vulnerable Groups scheme. Applicants from Northern Ireland can supply evidence of a recent enhanced Access NI check.

Evidence of the required level of English language competence: In order to be competent and fit to practice independently in England within a primary care setting, performers need to be able to demonstrate adequate command of the English language in order for NHS England to be assured that they can practise safely.

It is NHS England policy that the required level of English language competence for admission to the Performers List is the same as the IELTS/OET test standard required by the relevant regulator, i.e. the GMC, GDC or GOC. An applicant’s inclusion on the relevant register is not evidence in itself of English language competency, and NHS England has the right to under the Performers List Regulations to require applicants to produce direct evidence of meeting the regulator’s English language competence standard which is in force at the point at which an application is made to join the Performers List or to undertake such further testing as NHS England deems necessary.

The requirements of each of the regulators can be found here:

• GMC: Evidence of your knowledge of English
• GDC: English language controls
• GOC: International optometrists

In circumstances where there is a concern or query regarding an applicant’s English language proficiency and the applicant cannot demonstrate evidence of their English language proficiency through the IELTS/OET- medical only test, or references (which must evidence a minimum of 12 months full-time or equivalent professional practice as a practitioner in the relevant profession in an environment where English is the first or national language), the MD SIPS or delegate should meet with the applicant to seek assurance that the applicant can communicate effectively with those officers. If the MD SIPS or delegate is not assured of the applicant’s ability to communicate with them, the applicant will be required to undertake IELTS/OET testing, the cost of which must be borne by the applicant. 

Regional teams are reminded that under 7(4)(b) of the Regulations, NHS England must refuse to include a performer on a PL where ‘it is not satisfied that the Practitioner has sufficient knowledge of the English language necessary for the work which those included on that performers list perform’. 

Proof of Identity: The applicant must complete the PCSE Online verification process, including uploading a scan of their current passport or an alternative acceptable form of photographic identity as defined on the DBS website ID checking guidelines for standard/enhanced DBS check applications.

Dental only: Occupational Health: All applicants to the English Dental Performers List (DPL) are required to undertake an occupational health assessment to provide them with clearance to work within the NHS. The assessment should be made by an NHS Occupational Health provider or SEQOHS accredited provider.  As Exposure Prone Procedures form part of everyday work, dental applicants will need to evidence ‘additional health clearance’ to this standard.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Dental only: Evidence of recent Basic Life Support (BLS) training: Dental applicants must provide evidence of recent (within the last 12 months) hands-on Basic or Advanced Life Support training in accordance with UK Resuscitation Council guidelines: 2021 resuscitation guidelines.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Performers List Regulations Undertakings (Reg 4(3)(a-f).

Counter Fraud check, carried out by PCSE after discretionary inclusion, within 3 months.

NHS Resolution Performer and Healthcare Professional Check; carried out by PCSE after discretionary inclusion, within 3 months.

Statement of Intention to work in Primary Care in England: In accordance Regulation 7 (4) (a), the applicant must state where they intend to work and if they have an employment offer, a copy of that offer must be uploaded to PCSE Online.

GP Returners only: Employer checks: A GP applicant who has applied to the Performers List as part of the Return to Practice Programme will need to provide additional information if they are joining a placement with a bursary. This process is managed by the Workforce, Training and Education directorate and is separate to the PL application process. 

2. Processing an application from the Devolved Nations

2.1 Application process

Statutory Instrument 2023 No 525, came into effect on 31 May 2023 [The National Health Service (Performers Lists) (England) (Amendment) Regulations 2023]. The purpose of this amendment is to allow performers already included on the Performers List of Wales, Scotland or Northern Ireland to work for a period of up to three months from the date that their application to the England Performers List is received, if they meet the required criteria set out in regulation 5(A)(1).

These criteria are as follows:

• the applicant must be included on a Performers List in Wales, Scotland or Northern Ireland.
• the applicant must not be suspended from that list.
• the applicant must not have conditions on their inclusion in that list.
• the applicant must not be under notice pending a decision by the authority responsible for the list of potential suspension, imposition of conditions or removal from that list.
• the applicant must not have made a previous application to the England list which has been refused unless the refusal was overturned on appeal.

When an applicant has declared in their online application that they are already on a devolved nation’s list, PCSE will send the following information to the relevant regional team prior to undertaking routine third-party checks.

• name of applicant
• performer type
• GXC number
• contact details
• screenshots of declaration pages from application form

The regional team must:

• check any available online version of the devolved nation’s list to confirm the applicant is on the relevant equivalent list
• carry out an online NHS Resolution Performer and Healthcare Professional Check
• contact the performer and ask them to confirm they meet the criteria outlined in Regulation 5 (A) (1)

Once the MD SIPS or nominated representative has confirmed that contact has been made with the applicant and they are satisfied the applicant meets the criteria set out in 5(A)(1), the regional team must issue a letter to the applicant confirming their inclusion under Regulation 5(A) and confirm that they are permitted to work for a period of up to three months from the date that the application was received by PCSE whilst the standard application checks are made. The performer’s name will not show on the public-facing website until the full application has been considered and determined by the regional team. 

When all the standard checks have been undertaken by PCSE, the full application will be released into the regional team PCSE Online work queue and the regional team must decide whether to offer continued inclusion on the list or offer inclusion on the list with conditions. Applicants will be notified accordingly and included applicants’ names will appear on the public-facing website. Should the standard checks reveal adverse information that renders the applicant unsuitable to be included on the list, a decision to remove the performer from the list may be made.

If for any reason it is not possible to complete the standard checks and to take a definitive decision on continued inclusion, inclusion with conditions, or removal within the three-month period from the date the application was received, then at that three month point the applicant must be informed that they are no longer permitted to work pending a definitive decision. Regional teams must therefore make every effort to ensure that applications from performers included on Devolved Nation lists are considered in a timely manner. 

Online versions of Performers Lists in the devolved nations

If there is no public list available, regional teams are encouraged to take reasonable steps to gather this information by other means, for example, by contacting the devolved nation directly to ensure every effort is made to include the applicant at the earliest opportunity.  

2.2 Application evidence required

• Name
• Date of birth
• Address and telephone number
• CV
• Evidence of registration with relevant regulatory body

Structured references: The applicant must provide details of two referees who have agreed to provide clinical references for current or recent posts held. If a referee is based outside the UK, applicants must also provide evidence of the referee’s professional registration. Where the applicant is unable to provide referees that can fulfil the criterion, the applicant must provide a full explanation as to why this is the case, for example a newly qualified practitioner. If NHS England considers that it would aide its decision making, it may contact the referee about a reference provided or seek further references.

NHS England may refuse an applicant inclusion on the list in accordance with Regulation 7 (2) (c) – Decisions and grounds for refusal that states having obtained references from the referees named by the Practitioner under regulation and 4(2)(f), if it is not satisfied with those references.

Last appraisal, if available.

Evidence of appropriate indemnity (dental and ophthalmic applicants only) – this evidence must be received prior to inclusion to the list.

Enhanced Disclosure and Barring Service (DBS check) or Police Check where DBS is not available If the applicant is living in, or has previously lived in the UK, the applicant must present evidence of having applied for an enhanced DBS check, or of having signed up to the DBS update service. The evidence can be provided before inclusion or after inclusion via agreement terms. If they have resided abroad for a period of 12 months or more (whether continuous or not) in the five years prior to their application, they must provide a police check from that country.   Any applicant who is unable to obtain a police check must provide a statement that sets out the actions that they have taken to obtain one. Applicants who are unable to apply for a DBS check until they have entered the UK must confirm their agreement (either as part of their Agreement Terms or as a condition on inclusion) to apply for an enhanced DBS check as soon after their arrival in the UK as practicable.

Applicants from Scotland can supply evidence of a recent Protect Scotland disclosure under the Protection of Vulnerable Groups scheme. Applicants from Northern Ireland can supply evidence of a recent enhanced Access NI check.

Evidence of the required level of English language competence: In order to be competent and fit to practice independently in England within a primary care setting, performers need to be able to demonstrate adequate command of the English language in order for NHS England to be assured that they can practise safely.   

It is NHS England policy that the required level of English language competence for admission to the Performers List is the same as the IELTS/OET test standard required by the relevant regulator, i.e. the GMC, GDC or GOC. An applicant’s inclusion on the relevant register is not evidence in itself of English language competency, and NHS England has the right to under the Performers List Regulations to require applicants to produce direct evidence of meeting the regulator’s English language competence standard which is in force at the point at which an application is made to join the Performers List or to undertake such further testing as NHS England deems necessary.

The requirements of each of the regulators can be found here:

• GMC: Evidence of your knowledge of English
• GDC: English language controls
• GOC: International optometrists

In circumstances where there is a concern or query regarding an applicant’s English language proficiency and the applicant cannot demonstrate evidence of their English language proficiency through the IELTS/OET- medical only test, or references (which must evidence a minimum of 12 months full-time or equivalent professional practice as a practitioner in the relevant profession in an environment where English is the first or national language), the MD SIPS or delegate should meet with the applicant to seek assurance that the applicant can communicate effectively with those officers. If the MD SIPS or delegate is not assured of the applicant’s ability to communicate with them, the applicant will be required to undertake IELTS/OET testing, the cost of which must be borne by the applicant. 

Regional teams are reminded that under 7(4)(b) of the Regulations, NHS England must refuse to include a performer on a PL where ‘it is not satisfied that the Practitioner has sufficient knowledge of the English language necessary for the work which those included on that performers list perform.

Proof of Identity: The applicant must complete the PCSE Online verification process, including uploading a scan of their current passport or an alternative acceptable form of photographic identity as defined on the DBS website ID checking guidelines for standard/enhanced DBS check applications.

Evidence of qualifications.

Dental only: Occupational Health: All applicants to the English Dental Performers List (DPL) are required to undertake an occupational health assessment to provide them with clearance to work within the NHS. The assessment should be made by an NHS Occupational Health provider or SEQOHS accredited provider. As Exposure Prone Procedures form part of everyday work, dental applicants will need to evidence ‘additional health clearance’ to this standard. If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Dental only: Evidence of recent Basic Life Support (BLS) training: Dental applicants must provide evidence of recent (within the last 12 months) hands-on Basic or Advanced Life Support training in accordance with UK Resuscitation Council guidelines: 2021 resuscitation guidelines.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Performers List Regulations Undertakings (Reg 4(3)(a-f).

Counter Fraud check; carried out by PCSE after mandatory inclusion, within 3 months.

NHS Resolution Performer and Healthcare Professional Check; carried out by PCSE after mandatory inclusion, within 3 months.

Statement of Intention to work in Primary Care in England: In accordance Regulation 7 (4) (a), the applicant must state where they intend to work and if they have an employment offer, a copy of that offer must be uploaded to PCSE Online.

3. GP Registrars

3.1 Application process

Under amendments introduced by Statutory Instrument 2023 No 828 GP registrars (GPRs) on an approved postgraduate training programme may deliver primary care services without being on the PL. GPRs should apply to the PL not earlier than six months’ prior and ideally not later than three months’ prior to their expected date of Certificate of Completion of Training (CCT).

As GPRs are connected to an NHS England Responsible Officer (RO) (the Postgraduate Dean), when making their application to the join the list, a GPR is not required to provide:

• CV
• references
• evidence of their degree certificate or registration with the regulator
• indemnity
• appraisal

Nothing precludes a GPR from making their application to join the list earlier than the six months prior to their expected CCT and for their status on the list to be amended to GP performer after they achieve their CCT.

NHS England may also accept applications under this streamlined process from GPRs up to 3 months after CCT.   

GPRs in training in Scotland, Wales and Northern Ireland can also apply via this route as they are in the same training programme with the same governance structure as GPRs in England.

It is expected that any ongoing issues of note would be shared with the NHS England Tier 1 RO at the point of CCT via the Medical Practice Information Transfer (MPIT) process.

If a GPR is included on the list before the completion of training and they subsequently fail to complete training, they must withdraw from it (Regulation 26 (3) (a) (ii)). Regional teams must remove a GPR from the performers list if they fail to complete training and do not withdraw from the performers list within 28 days of being requested to do so (Regulation 28 (1)(d)).

3.2 Application evidence required

• Name
• Date of birth
• Address and telephone number

Enhanced Disclosure and Barring Check (DBS) check (or Police Check where DBS is not available If the applicant is living in, or has previously lived in the UK, the applicant must present evidence of having applied for an enhanced DBS check, or of having signed up to the DBS update service. The evidence can be provided before inclusion or after inclusion via agreement terms. If they have resided abroad for a period of 12 months or more (whether continuous or not) in the five years prior to their application, they must provide a police check from that country. Any applicant who is unable to obtain a police check must provide a statement that sets out the actions that they have taken to obtain one. Applicants who are unable to apply for a DBS check until they have entered the UK must confirm their agreement (either as part of their Agreement Terms or as a condition on inclusion) to apply for an enhanced DBS check as soon after their arrival in the UK as practicable.

Applicants from Scotland can supply evidence of a recent Protect Scotland disclosure under the Protection of Vulnerable Groups scheme. Applicants from Northern Ireland can supply evidence of a recent enhanced Access NI check.

Evidence of the required level of English language competence: In order to be competent and fit to practice independently in England within a primary care setting, performers need to be able to demonstrate adequate command of the English language in order for NHS England to be assured that they can practise safely.   

It is NHS England policy that the required level of English language competence for admission to the Performers List is the same as the IELTS/OET test standard required by the GMC. An applicant’s inclusion on the relevant register is not evidence in itself of English language competency, and NHS England has the right to under the Performers List Regulations to require applicants to produce direct evidence of meeting the regulator’s English language competence standard which is in force at the point at which an application is made to join the Performers List or to undertake such further testing as NHS England deems necessary.

The requirements of the GMC can be found here: Evidence of your knowledge of English

In circumstances where there is a concern or query regarding an applicant’s English language proficiency and the applicant cannot demonstrate evidence of their English language proficiency through the IELTS/OET- medical only test, or references (which must evidence a minimum of 12 months full-time or equivalent professional practice as a practitioner in the relevant profession in an environment where English is the first or national language), the MD SIPS or delegate should meet with the applicant to seek assurance that the applicant can communicate effectively with those officers. If the MD SIPS or delegate is not assured of the applicant’s ability to communicate with them, the applicant will be required to undertake IELTS/OET testing, the cost of which must be borne by the applicant. 

Regional teams are reminded that under 7(4)(b) of the Regulations, NHS England must refuse to include a performer on a PL where ‘it is not satisfied that the Practitioner has sufficient knowledge of the English language necessary for the work which those included on that performers list perform’. 

Proof of Identity: The applicant must complete the PCSE Online verification process, including uploading a scan of their current passport or an alternative acceptable form of photographic identity as defined on the DBS website ID checking guidelines for standard/enhanced DBS check applications.

Performers List Regulations Undertakings (Reg 4(3)(a-f).

Counter Fraud check; carried out by PCSE before application is released to the regional team.

NHS Resolution Performer and Healthcare Professional Check; carried out by PCSE before application is released to the regional team.

Statement of Intention to work in Primary Care in England: In accordance Regulation 7 (4) (a), the applicant must state where they intend to work and if they have an employment offer, a copy of that offer must be uploaded to PCSE Online.

4. Dental foundation trainees

4.1 Application process

Under amendments introduced by Statutory Instrument 2023 No 828 Dental Foundation Trainees applying to the Performers List do not need to provide:

• CV
• evidence of professional registration

Are required only to provide the name of one referee. This referee should normally be someone who can provide an official reference from the dental school where the trainee graduated. 

DFTs in training in Scotland, Wales and Northern Ireland can also apply via this route as they are in the same training programme with the same governance structure as DFTs in England.

DFTs must withdraw from the performers list if they fail to complete training (Regulation 33 (3) (a) (ii).  Regional teams must remove a DFT from the performers List if they fail to complete training and do not withdraw from the performers list (Regulation 35 (1) (b)).

4.2 Application evidence required

• Name
• Date of birth
• Address and telephone number
• One reference: The referee will normally be someone who can provide an official reference from the dental school where the trainee graduated.
• Evidence of appropriate indemnity – this evidence must be received prior to inclusion to the list.

Enhanced Disclosure and Barring Check (DBS)N check (or Police Check where DBS is not available) If the applicant is living in, or has previously lived in the UK, the applicant must present evidence of having applied for an enhanced DBS check, or of having signed up to the DBS update service. The evidence can be provided before inclusion or after inclusion via agreement terms. If they have resided abroad for a period of 12 months or more (whether continuous or not) in the five years prior to their application, they must provide a police check from that country.   Any applicant who is unable to obtain a police check must provide a statement that sets out the actions that they have taken to obtain one. Applicants who are unable to apply for a DBS check until they have entered the UK must confirm their agreement (either as part of their Agreement Terms or as a condition on inclusion) to apply for an enhanced DBS check as soon after their arrival in the UK as practicable.

Applicants from Scotland can supply evidence of a recent Protect Scotland disclosure under the Protection of Vulnerable Groups scheme. Applicants from Northern Ireland can supply evidence of a recent enhanced Access NI check.

Evidence of the required level of English language competence: In order to be competent and fit to practice independently in England within a primary care setting, performers need to be able to demonstrate adequate command of the English language in order for NHS England to be assured that they can practise safely.   

It is NHS England policy that the required level of English language competence for admission to the Performers List is the same as the IELTS test standard required by the GDC. An applicant’s inclusion on the relevant register is not evidence in itself of English language competency, and NHS England has the right to under the Performers List Regulations to require applicants to produce direct evidence of meeting the regulator’s English language competence standard which is in force at the point at which an application is made to join the Performers List or to undertake such further testing as NHS England deems necessary.

The requirements of the GDC can be found here: Necessary knowledge of English language for dental professionals

In circumstances where there is a concern or query regarding an applicant’s English language proficiency and the applicant cannot demonstrate evidence of their English language proficiency through the IELTS/OET- medical only test, or references (which must evidence a minimum of 12 months full-time or equivalent professional practice as a practitioner in the relevant profession in an environment where English is the first or national language), the MD SIPS or delegate should meet with the applicant to seek assurance that the applicant can communicate effectively with those officers. If the MD SIPS or delegate is not assured of the applicant’s ability to communicate with them, the applicant will be required to undertake IELTS/OET testing, the cost of which must be borne by the applicant.

Regional teams are reminded that under 7(4)(b) of the Regulations, NHS England must refuse to include a performer on a PL where ‘it is not satisfied that the Practitioner has sufficient knowledge of the English language necessary for the work which those included on that performers list perform’. 

Proof of identity: The applicant must complete the PCSE Online verification process, including uploading a scan of their current passport or an alternative acceptable form of photographic identity as defined on the DBS website ID checking guidelines for standard/enhanced DBS check applications.

Occupational health: All applicants to the English Dental Performers List (DPL) are required to undertake an occupational health assessment to provide them with clearance to work within the NHS. The assessment should be made by an NHS Occupational Health provider or SEQOHS accredited provider. As Exposure Prone Procedures form part of everyday work, dental applicants will need to evidence ‘additional health clearance’ to this standard.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Evidence of recent Basic Life Support (BLS) training: Dental applicants must provide evidence of recent (within the last 12 months) hands-on Basic or Advanced Life Support training in accordance with UK Resuscitation Council guidelines: 2021 Resuscitation Guidelines | Resuscitation Council UK.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Performers List Regulations Undertakings (Reg 4(3)(a-f)

Counter Fraud check; carried out by PCSE before application is released to the tegional team

NHS Resolution Performer and Healthcare Professional Check; carried out by PCSE before application is released to the regional team

Statement of Intention to work in Primary Care in England: In accordance Regulation 7 (4) (a), the applicant must state where they intend to work and if they have an employment offer, a copy of that offer must be uploaded to PCSE Online.

5. All other applicants

5.1 Application evidence required

• Name
• Date of birth
• Address and telephone number
• CV
• Evidence of registration with relevant regulatory body

Structured references: The applicant must provide details of two referees who have agreed to provide clinical references for current or recent posts held. If a referee is based outside the UK, applicants must also provide evidence of the referee’s professional registration. Where the applicant is unable to provide referees that can fulfil the criterion, the applicant must provide a full explanation as to why this is the case, for example a newly qualified practitioner. If NHS England considers that it would aid its decision making, it may contact the referee about a reference provided or seek further references.

NHS England may refuse an applicant inclusion on the list in accordance with Regulation 7 (2) (c) – Decisions and grounds for refusal that states having obtained references from the referees named by the Practitioner under regulation and 4(2)(f), it is not satisfied with those references.

Last appraisal, if available

Evidence of appropriate indemnity (dental and ophthalmic applicants only) – this evidence must be received prior to inclusion to the list.

Enhanced Disclosure and Barring Service (DBS check (or Police Check where DBS is not available) If the applicant is living in, or has previously lived in the UK, the applicant must present evidence of having applied for an enhanced DBS check, or of having signed up to the DBS update service. The evidence can be provided before inclusion or after inclusion via agreement terms. If they have resided abroad for a period of 12 months or more (whether continuous or not) in the five years prior to their application, they must provide a police check from that country. Any applicant who is unable to obtain a police check must provide a statement that sets out the actions that they have taken to obtain one. Applicants who are unable to apply for a DBS check until they have entered the UK must confirm their agreement (either as part of their Agreement Terms or as a condition on inclusion) to apply for an enhanced DBS check as soon after their arrival in the UK as practicable.

Applicants from Scotland can supply evidence of a recent Protect Scotland disclosure under the Protection of Vulnerable Groups scheme. Applicants from Northern Ireland can supply evidence of a recent enhanced Access NI check.

Evidence of the required level of English language competence: In order to be competent and fit to practice independently in England within a primary care setting, performers need to be able to demonstrate adequate command of the English language in order for NHS England to be assured that they can practise safely.   

It is NHS England policy that the required level of English language competence for admission to the Performers List is the same as the IELTS/OET test standard required by the relevant regulator, i.e. the GMC, GDC or GOC. An applicant’s inclusion on the relevant register is not evidence in itself of English language competency, and NHS England has the right to under the Performers List Regulations to require applicants to produce direct evidence of meeting the regulator’s English language competence standard which is in force at the point at which an application is made to join the Performers List or to undertake such further testing as NHS England deems necessary.

The requirements of each of the regulators can be found here:

• GMC: Evidence of your knowledge of English
• GDC: English language controls
• GOC: International optometrists

In circumstances where there is a concern or query regarding an applicant’s English language proficiency and the applicant cannot demonstrate evidence of their English language proficiency through the IELTS/OET (medical only) test, or references (which must evidence a minimum of 12 months full-time or equivalent professional practice as a practitioner in the relevant profession in an environment where English is the first or national language), the MD SIPS or delegate should meet with the applicant to seek assurance that the applicant can communicate effectively with those officers. If the MD SIPS or delegate is not assured of the applicant’s ability to communicate with them, the applicant will be required to undertake IELTS/OET testing, the cost of which must be borne by the applicant. 

Regional teams are reminded that under 7(4)(b) of the Regulations, NHS England must refuse to include a performer on a PL where ‘it is not satisfied that the Practitioner has sufficient knowledge of the English language necessary for the work which those included on that performers list perform’. 

Proof of Identity: The applicant must complete the PCSE Online verification process, including uploading a scan of their current passport or an alternative acceptable form of photographic identity as defined on the DBS website ID checking guidelines for standard/enhanced DBS check applications.

Evidence of qualification

Dental only: Occupational Health: All applicants to the English Dental Performers List (DPL) are required to undertake an occupational health assessment to provide them with clearance to work within the NHS. The assessment should be made by an NHS Occupational Health provider or SEQOHS accredited provider. As Exposure Prone Procedures form part of everyday work, dental applicants will need to evidence ‘additional health clearance’ to this standard.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Dental only: Evidence of recent Basic Life Support (BLS) training: Dental applicants must provide evidence of recent (within the last 12 months) hands-on Basic or Advanced Life Support training in accordance with UK Resuscitation Council guidelines: 2021 resuscitation guidelines.

If any applicant is unable to provide this evidence with their application, it can be provided at a later date as part of agreement terms. 

Performers List Regulations Undertakings (Reg 4(3)(a-f)

Counter Fraud check; carried out by PCSE before application is released to the regional team

NHS Resolution Performer and Healthcare Professional Check; carried out by PCSE before application is released to the regional team

Statement of Intention to work in Primary Care in England: In accordance Regulation 7 (4) (a), the applicant must state where they intend to work and if they have an employment offer, a copy of that offer must be uploaded to PCSE Online.

6. Evaluation of application to establish if any support is needed to move safely into Primary Care

The regional team in which the applicant intends to work must consider the application and the outcome of the checks previously stated in full. The Professional Standards team and a discipline-specific Clinical Adviser must review the application and all supporting documentation. This assessment must include whether or not the applicant is suitable to be included on the list and to evaluate whether the applicant requires any tailored induction or support to enable them to work safely in primary care.

Where, following an assessment of the application, NHS England considers that the applicant presents with some educational/clinical support needs, it may offer the applicant the opportunity to be included on the List with a probationary flag whilst these needs are being met. This arrangement is referred to as Agreement Terms.

The above does not apply to applicants who are already on the Performers Lists in the devolved nations, as their initial inclusion is mandatory (Regulation 5 (A)). A decision about whether the performer can remain on the list is made at a later stage.

6.1 Medical applicants

The first stage of the evaluation is to establish whether the applicant has worked previously in primary care in the UK. If they have not, they should be directed to the WTE International Induction Programme (IIP) as set out below. 

GP applicants who have previously worked in primary care in the UK are required to meet with a clinical adviser, who will engage in a structured conversation with the applicant (face-to-face or virtually) to assess whether the applicant may need an Educational/Clinical Support Plan (ECSP). If this is the case, the applicant will be referred to WTE for a decision to be made about engaging in the Return to Practice Programme (RtP) as set out below. If the clinical adviser confirms that in their opinion the applicant does not need any form of support, the application moves to the next stage – “Consideration of all information”.

The structured conversation should take into account the length of absence from NHS primary care, experience obtained prior to their absence from primary care, the reason for their absence, whether any relevant practice or CPD was undertaken during that period, evidence of keeping up to date; any other relevant factors, e.g. health needs, and any self-assessed learning needs or specific request for support. A sample risk assessment matrix which may be helpful for the structured conversation can be found in the PL Resources Repository (access via the NHS England internal SharePoint system).

GP International Induction Programme (IIP)

The NHS GP IIP provides a supported pathway for overseas-qualified GPs to be inducted safely into NHS general practice. The programme is designed for GPs who have never previously worked in NHS general practice in the UK.

The IIP must be completed before these GPs can be recommended for full inclusion on the Medical Performers List (MPL).

GP Return to Practice (RTP) Programme

The NHS GP RTP Programme provides a safe supported pathway for qualified GPs to return to NHS general practice after a period of absence.

It is designed for GPs who have previously been on the GMC GP register and NHS England’s MPL and would like to return to general practice after a career break, raising a family, working abroad or absence for another reason.

NHS England’s Medical Directors need to be assured that all doctors included on NHS England’s MPL are suitable to be included on the list. Referral to the RTP scheme will be considered for any doctor wishing to join the list where a personalised risk-based assessment (taking into account their previous experience, length of absence from general practice, whether they have been undertaking clinical work elsewhere during their absence, and other relevant factors) suggests that a period of adaptation/refresher support may be necessary. The programme is not open to GPs that currently hold non-health related GMC conditions, and is therefore not able to support GPs requiring remediation.

Applications to the list from potential candidates for the IIP or RTP

It is recognised that some flexibility is required to attract GPs to work in England without unnecessary barriers. There are therefore two points of entry for application to the list by international applicants and returners, as follows:

1. International applicants and returners can contact NHS England’s GP International Induction and Return to Practice Team to explore what they need to do in order to be included on the MPL. They will then be linked to the WTE Programme Lead for the area in which they intend to work and if appropriate, will be signposted to a range of learning materials and permitted to access a Learning Needs Assessment (LNA) (Multiple Choice Question (MCQ) test. The applicant will also be linked to the NHS England regional team and asked to make a PCSE Online application to the list.

2. International applicants and returners may also begin the process by making an application to the list via PCSE Online, and at the evaluation stage of the application process will be identified as likely to need IIP or RTP support.

If any form of Induction or Returner support is deemed necessary, an ECSP will be developed for the doctor by NHS England with input from WTE, and a set of Agreement Terms for inclusion with a probationary flag on the MPL will be drafted.

NHS England has a bank of standard requirements which can be used to populate the terms of the Agreement. Teams are not constrained to using solely the bank and they may specify any enhanced support arrangements, provided these are tailored to the needs of the applicant.

The GP applicant will also need to provide additional information if they are joining a placement with a bursary or undertaking IIP/RtP whilst directly employed by a practice. This process is managed by the Workforce, Training and Education directorate, separately to the PL application process.

If the doctor is offered inclusion with a probationary flag and accepts the Agreement Terms, they will be admitted to the list with a probationary flag, which is visible on the public-facing Performers List, whilst they complete the IIP or RTP and fulfil the requirements of the Agreement Terms. In addition, all GPs that have undergone IIP or RTP will be advised to have their first GP appraisal within six months of entry to the PL.

During the programme the regional team, working with their local WTE colleagues, will ensure that there is an appropriate approved learning environment for any placement or clinical supervision in an employing practice.

Should any concerns be raised during the period of the programme, the MD SIPS of the home region where the doctor is working will be responsible for ensuring the satisfactory resolution of the concerns raised. 

For further details relating to these programmes, see GP International Induction Programme and GP Return to Practice Scheme.

6.3 Dental applicants

The first stage of the evaluation is to establish whether the applicant has worked previously in NHS primary dental services in the UK.

Applicants who have not previously provided NHS primary dental services in the UK or are not exempt from undertaking foundation training must have a structured conversation with a dental clinical adviser (face-to-face or virtually) to assess whether the applicant is up to date to perform NHS primary dental services. The outcome of this structured conversation may identify a need for induction and an educational/clinical support plan (ECSP) to be drawn up with Agreement Terms to ensure that the performer is supported as they start work in primary care. A sample plan can be found in the Resources Repository (access via the NHS England internal SharePoint system).   

The Agreement will set out how success against the terms will be monitored and the process to be followed if the agreement terms are not satisfactorily achieved or if the time to complete the actions needs to be extended.  The assessment of equivalence under Regulation 34 (4) will be linked to the requirement of the ECSP and will be used to bring forward evidence of equivalence at the end of the Agreement Term period.   

Automatic recognition of EEA/Swiss dental qualifications

Following Brexit, automatic recognition of qualifications has undergone dramatic changes so regional teams are asked to refer to the latest guidance on the GDC website: Dentists with EEA qualifications

Dental foundation trainees

Applicants who are in an approved Dental Foundation Training Scheme must provide evidence of appropriate indemnity and occupational health clearance (including clearance to perform exposure-prone procedures), and their application will normally progress to the “Consideration of all information” stage at this point, for inclusion on the list as a Dental Foundation Trainee (DFT). There is a three-month grace period from the start of Foundation Training during which the DFT can work whilst their application to join the list is under consideration, in accordance with Regulations 4, 31 and 33. At the end of Foundation Training candidates must produce a certificate to demonstrate satisfactory completion of the Foundation Training programme, which releases them from the undertakings under the PLR to work with an approved trainer.

All other applicants

For all other applicants who have previously worked in primary care in the UK, a dental clinical adviser must hold a structured conversation with the applicant (face-to-face or virtually) to assess whether the applicant is up to date to perform NHS primary dental services. This assessment will identify whether the applicant requires an ECSP to be drawn up to enable them to work safely in primary care.

If the clinical adviser confirms that in their opinion the applicant does not need any form of support, the application moves to the “Consideration of all information”. If the clinical adviser advises that support is needed, an ECSP is drawn up at this point. A sample plan can be found in the Resources Repository (access via the NHS England internal SharePoint system).     

The structured conversation should take into account the length of absence from NHS primary care, experience obtained prior to their absence from primary care, the reason for their absence, whether any relevant practice or CPD was undertaken during that period, evidence of keeping up to date; any other relevant factors, e.g. health needs, and any self-assessed learning needs or specific request for support. A sample risk assessment matrix which may be helpful for the structured conversation can be found in the PL Resources Repository (access via the NHS England internal SharePoint system).

Occupational health evidence

Applicants from overseas cannot arrange an occupational health assessment until they are based in England; however, visa rules require these applicants to start work within 28 days of arriving in the UK. This does not allow enough time to arrange for the assessments/training to take place and to also receive the required certificates for their application. Applicants can be included to the Performers List without this evidence and can provide it at a later date as part of Agreement Terms.

6.3 Ophthalmic applicants

Optometrists are permitted to apply for inclusion to the English Ophthalmic Performers List (OPL) up to a maximum of three months prior to the expected date of successful completion of their training and some may await completion of their exams before applying.  In this event, their application would normally progress to the “Consideration of all information” at this point if they have provided evidence of appropriate indemnity or insurance. An application may be considered ahead of full GOC registration to enable NHS England to comply with the decision making it is required to make within seven days of the full application being made available (Regulation 39(7)). 

For applicants who are not applying on completion of their training (including international applicants, applicants who have been out of primary care practice or applicants whose NHS experience during training has been entirely in non-primary care practice) an ophthalmic clinical adviser must hold a structured conversation with the applicant (face-to-face or virtually) to assess whether the applicant is up to date to perform the NHS sight test or whether they may need an ECSP in order to work safely in primary care.  

If the clinical adviser confirms that in their opinion the applicant does not need any form of support, the application then moves to the “Consideration of all information” stage. If the clinical adviser advises that support is needed, an ECSP will be drawn up. A sample plan can be found in the Resource Repository.     

The structured conversation should take into account the length of absence from NHS primary care, experience obtained prior to their absence from primary care, the reason for their absence, whether any relevant practice or CPD was undertaken during that period, evidence of keeping up to date, any other relevant factors, e.g. health needs, and any self-assessed learning needs or specific request for support. A sample risk assessment matrix which may be helpful for the structured conversation can be found in the PL Resources Repository.

6.4 Ophthalmic Medical Practitioners (OMPs)

Applications from OMPs wishing to perform NHS services in primary care are considered under a similar route to Optometrists with the exception that the professional registration is with the GMC rather than the GOC. In addition, a prerequisite to the application for the PL is evidence, provided by the OMP, that the OMP has been approved by the Ophthalmic Qualification Committee, which should be included at the point that the application is passed to NHS Engand for consideration. All applicants to the OPL must show evidence of appropriate indemnity or insurance.

Consideration of applications and decision making

If there are no issues of note and an ECSP is not required, the application moves to inclusion.

If an ECSP is required and the issue of note does not warrant regulatory consideration, the Medical Director System Improvement and Professional Standards or staff member with delegated responsibility can approve the application for Agreement Terms and Probationary Flag.

If there are issues of note which may warrant regulatory consideration, the relevant notice is issued in accordance with the Regulations and the application is referred to a PLDP for a decision. The decision may be either Inclusion, Agreement Terms, Defer, Include with Conditions or Refuse. 

Inclusion (NHS England)

Where a decision has been taken to include an applicant on the PL, this must be approved by a Clinical Adviser and by the MD SIPS or member of staff with delegated authority to do so.

The full application and all supporting documents must be uploaded to the PL case management system.

The applicant’s entry on PCSE Online should be updated to ‘include’. Their name should appear as a performer on the list the following day.

Agreement terms (NHS England)

Summary of when Agreement Terms and Probationary Flag are to be used

1. Applicants who meet the following requirements may be included on the PL without the necessity to invoke Regulation 10(1)(a) when:

1.1 All required application evidence has been supplied or agreed to provide by a defined date and there are no issues of note arising from any of the information submitted in accordance with Regulation 4, and considered by NHS England in accordance with Regulation 5; and

1.2 The evaluation of the application has identified that the applicant requires an ECSP as part of their induction into working within the primary care setting; and

1.3 The regional NHS England MD SIPS or colleague with delegated authority to make the decision agrees with the ECSP recommended by WTE (where applicable) or the Clinical Advisor; and

1.4 An Agreement Term has been drafted that reflects the ECSP is agreed and signed by both NHS England and the performer.

1.5 A ‘Probationary Flag’ is applied to the performer’s record both on PCSE Online and the PL case management system whilst the performer works to successfully complete the requirements set out in the Agreement Terms.

Process to be applied when offering Agreement Terms and Probationary period (applicant agrees)

2. NHS England must follow the procedure set out:

2.1 The case manager will confirm in writing to the applicant that the criterion set out in 1.1 – 1.3 has been met and that following their professional discussion with WTE Directorate colleagues and/or the Clinical Adviser, that an ECSP has been developed and agreed to support the applicant’s safe induction into NHS primary care services.

2.2 The Agreement Term will reflect the agreed ECSP and it will set out specifically the actions required of the applicant, including the evidence expected and the review dates. There may be multiple review dates depending on the actions required, and each action should have the review date clearly set out. The Agreement Term will be signed by an NHS England officer with appropriate delegated authority.

2.3 The applicant will be invited to agree with the Agreement Terms. An agreement will be conferred when the applicant has returned their signed Agreement Terms. This must be received within 28 days of the date of offer.

2.4 On receipt of the signed document, NHS England will confirm the applicant’s inclusion on the list by:

2.4.1 Approving the application on PCSE Online and adding a probationary flag to the performer record

2.4.2 Creating/updating the PL case management system with the approved status and probationary flag, uploading the signed Agreement Terms and by entering the first review date, as defined in the ECSP.

2.4.3 Confirming to the performer that their name has been included on the list and advising them of the first review date and the evidence they are required to submit to provide assurance that they are working within the Agreement Terms.

Process to be applied when the applicant does not agree to the Agreement Terms 

3. NHS England must follow the procedure set out:

3.1 If the applicant:

3.1.1 Does not accept the Agreement Terms; or

3.1.2 Fails to return a signed Agreement Terms within the 28-day period

The application is to be treated as an ‘application of note’ and will be referred to the PSG or the PLDP to confirm that notice should be given in accordance with Regulation 10(2) to impose conditions on initial inclusion as set out in Regulation 10(1)(a).

3.2 Following the issue of a notice to impose conditions, the decisions open to the PLDP are as prescribed within the PLR and all other consequential regulations must be followed.

Process to be applied when reviewing the performer’s progress against the Agreement Terms 

4. NHS England must review the performer’s progress at agreed intervals as set out in the Agreement Terms. NHS England must inform the performer that they intend to review their progress and provide them with 28 days to submit evidence that they wish NHS England to consider when undertaking the review. The review will give rise to one of four outcomes:

4.1 Partially complete

4.2 All actions satisfactorily completed as set out in the Agreement Terms

4.3 Further work required to satisfactorily complete action(s) (further details to be confirmed with the performer)

4.4 Non-compliance with the agreement

Process to follow if the outcome of the review is ‘Partially Complete’

5. This outcome will occur when there are a series of actions to be achieved with different completion dates. NHS England and/or the performer should review the progress of each action as and when the action has been completed. Reviewing action(s) immediately after the review date falls to both parties to either provide assurance that delivery of the Agreement Terms is on track or provide a timely checkpoint to address any actions that might be needed if the action has not progressed satisfactorily. When a review has been conducted, the case manager must:

5.1 Within seven days of the review, confirm the outcome and the reason for this to the performer in writing; and

5.2 If the action has not been completed satisfactorily, notify the performer of what action is required to achieve a satisfactory outcome and the date that the action will next be reviewed.

5.3 Upload all the evidence and confirmation letter to the performer onto the PL case management system.

5.4 Amend/add the next review date to the PL case management system.

Process to follow if the outcome of the review is ‘Satisfactory completed all actions set out in the Agreement Terms’

6. When NHS England is assured that all action(s) set out in the Agreement Terms have been completed satisfactorily, the case manager must:

6.1 Within seven days of the review confirm the outcome and the reason for this to the performer in writing

6.2 Remove the probationary flag on PCSE Online

6.3 Upload all the evidence and confirmation letter to the performer onto the PL case management system

Process to follow if the outcome of the review of an action is ‘Further work required to satisfactorily complete action (further details to be confirmed with the performer) and this is the second time.

7. If NHS England decides that the performer has not satisfactorily completed the action(s) set out in the Agreement Terms, the case manager will already have notified the performer of what action is required to achieve a satisfactory outcome and provided a date for a second review of progress to be undertaken. Where evidence of satisfactory completion is reliant on a third party (e.g. a report from a clinical supervisor), care must be taken that the performer is not adversely impacted by any delay in the third party providing the evidence. If following a second review, NHS England decides that the performer has not satisfactorily completed the action (s) set out; the case manager must:

7.1 Within seven days of the review, confirm the outcome and the reason for this to the performer in writing

7.2 Notify the performer of what action is required to achieve a satisfactory outcome and the date that the action will be next reviewed; and

7.3 Advise the performer that the case will be referred to a PSG or PLDP for consideration as to what further action may be necessary.

7.4 Upload all the evidence and notification letter to the performer onto the PL case management system.

7.5 Amend/add the next review date to the PL case management system.

Process to follow if the outcome is that the performer has not complied with the Agreement Terms and/or the third review of an action results in an outcome ‘Further work required to satisfactorily complete action (further details to be confirmed with the performer)

8. If NHS England decides that the performer has not complied with the Agreement Term and/or the performer has not presented satisfactory evidence on two previous occasions to demonstrate that they have completed the action satisfactorily, the case manager must:

8.1 Within seven days of the review, confirm the outcome and the reason for this to the performer in writing;

8.2 Notify the performer that the case will be referred to a PSG or PLDP for consideration as to what further action may be necessary.

8.3 Upload all the evidence and notification letter to the performer onto the PL case management system.

8.4 Update the PL case management system to reflect that the case will be considered by a PSG or PLDP.

Cases referred to PSG and/or PLDP for consideration

9.1 On consideration of the case, the PSG or PLDP may decide that no regulatory action is required, and the matter may be referred to the case manager with a recommendation to continue under a revised Agreement Term. If the PSG or PLDP decides to invoke the regulations, NHS England must follow the governance arrangements set out in the Policy on managing the NHS Performers Lists (England) and the requirements set out in the PLR.

Defer (NHS England)

Deferment of decision on application – Regulation 8

NHS England must comply with the requirement set out in Regulation 8.

1. Where an application of note is considered by the PLDP, the PLDP may defer its decision as to whether or not to include where it is awaiting the outcome of proceedings set out in Regulation 8 and within 7 days of making that decision, the applicant must be notified in writing of that decision and the reason(s) for it.

2. Once the outcome of the matter in question is known, or in circumstances where the reasons for the deferment was a suspension, the applicant must be notified that they have 28 days from the date of the notification to confirm in writing that they wish to proceed with their application; and if they wish to proceed to provide any additional information required.

If the confirmation to proceed and the additional information is received within the required time, the PLDP must review the application together with the additional information supplied and make a decision to either include; include with conditions, or refuse the application. 

3. All decisions must be transacted on PCSE Online and all documentation must be uploaded to the PL case management system. 

Include with conditions (NHS England)

Conditions on initial inclusion to a PL – Regulation 10 (1)(a)

NHS England must comply with the requirement set out in Regulation 10.

1. In circumstances where applicants have either

a. Not agreed with the Agreement Terms; or
b. Failed to confirm their agreement to the Agreement Terms offered, the application must be reviewed by either PSG or PLDP to consider giving notice of regulatory action.

1.1 The PSG/PLDP must assure itself that the Agreement Terms process has been followed. In the event that they believe the process prescribed has not been followed; the application will be referred back to the case manager for appropriate action to be taken.

1.2 Where the PSG/PLDP is satisfied that the process has been followed; the PLDP must give notice as set out in Regulation 10 (2) that it proposes to impose conditions under Regulation 10 (1)(a). The notice must meet the requirements set out in the Regulations, including setting out the allegations, providing notice of what action it is considering and on what grounds; the opportunity to make representation to it within 28 days of the date of the notification and the opportunity for an oral hearing, if so requested within the 28 day period notified.

1.3 After consideration of any representation made; the PLDP must confirm its decision to the applicant within seven days of the date of the decision.

1.4 If the PLDP decide to impose conditions; it must notify the applicant of the decision and the reasons for it, including any facts relied upon, any right of review and any right of appeal.

1.5 If the applicant does not, within 28 days of the date of notification of the decision, confirm to NHS England that it wishes to accept the conditions and does not provide NHS England with their undertaking to comply with the conditions, NHS England must refuse the applicant inclusion on the list as set out in Section 12.

2. In circumstances where:

2.1 There is an issue of note within the application pack and that this issue of note has not arisen because the applicant has either disagreed with the Agreement Terms; or failed to confirm their agreement to the Agreement Terms offered, the PLDP must consider the issue of note and decide if the applicant could be included on the list with or without conditions.

2.2 The PLDP may make one of three decisions:

Decision 1 

If the PLDP decides that the issue of note does not impact on the efficiency of the service, and the applicant has not been assessed as requiring an ECSP, the PLDP can confirm its approval to include on the list without conditions.

Decision 2

If the PLDP decides that the issue of note does not impact on the efficiency of the service and the applicant has been assessed as requiring an ECSP, and the applicant has not previously declined the ECSP, or failed to confirm their acceptance of it, the case can be referred back to the case manager to progress inclusion on the list with a probationary flag with the ECSP set out in an Agreement Term.

Decision 3

If the PLDP decides that the issue of note impacts on the efficiency of the service, the PLDP must follow the requirements of the PLDP and must give notice as set out in Regulation 10 (2) that it proposes to impose conditions under Regulation 10 (1) (a). If an ECSP has been agreed for the applicant, the PLDP will need to incorporate the ECSP in the conditions drafted. The notice must set out the allegations, notice of what action it is considering and on what grounds; the opportunity to make representation to it within 28 days of the date of the notification and the opportunity for an oral hearing, if so requested within the 28-day period notified. 

After consideration of any representation made; the PLDP must confirm its decision to the applicant within seven days of the date of the decision. 

If the PLDP decide to impose conditions; it must notify the applicant of the decision and the reasons for it, including any facts relied upon, any right of review and any right of appeal. 

If the applicant does not, within 28 days, confirm to NHS England that they wish to accept the conditions and does not provide NHS England with their undertaking to comply with the conditions, NHS England must refuse the applicant inclusion on the list.

Refuse (NHS England)

Refusal to include the performer inclusion on the List – Regulation 7

NHS England must comply with the requirement set out in Regulation 7.

1. Where an application of note is considered by the PLDP, and the PLDP is considering refusing the applicant’s inclusion on the PL; it must take into consideration the requirements set out in Regulation 7(2) and 7(3). If it determines that any of the matters set out in Regulation 7(4) are applicable to the applicant, NHS England must refuse inclusion on the list. This is with the exception of Type 1 or Type 2 armed forces GP where regulation 7(4)(a) does not apply.

2. Where a decision to refuse inclusion on the list is made by the PLDP, it must notify the applicant in writing of the decision within seven days and include the reason for the decision, any facts relied upon and set out the applicant’s right of appeal.

3. The decision to refuse inclusion must be transacted on PCSE Online, a notification must be sent to persons and bodies set out in Regulation 18 and all documentation must be uploaded to the PL case management system.

Readmission to the Performers List – Regulation 6

NHS England must comply with the requirements set out in Regulation 6.

1. Where a performer has been removed from a PL on the grounds that they were convicted of a criminal offence and that conviction is overturned on appeal, if the performer requests in writing that they wish their name to be returned to the PL, NHS England may decide to do so without the need to comply with the requirements set out in Regulations 4, 26, 33 or 39.

2. Where a performer has requested that their name is returned to the list, it will be for the PLDP to decide whether the performer should be readmitted to the list and in so doing may request any information relating to the matter for consideration before making the decision.

3. If the PLDP decide that the performer may be readmitted to the list, NHS England must notify the performer within seven days and request that the performer provides an undertaking to comply with the requirements of the regulations. The performer will not be readmitted to the list until the undertaking is received.

4. NHS England must issue a notification to the performer confirming their readmission to the list and the date the readmission will take effect. A copy of the notification must be sent to all persons and bodies set out in Regulation 18 that were notified of the original decision to remove.

5. The decision to readmit must be transacted on PCSE Online and all documentation must be uploaded to the PL case management system.

6. If the conviction is reinstated following a further appeal, the previous decision of NHS England to remove the performer from the list will take effect again. NHS England must notify the performer that this is the case, update PCSE Online and all documentation must be uploaded to the PL case management system.

Legal advice

There may be circumstances where NHS England teams may wish to seek legal advice regarding an application to join the list.

In the first instance, regional teams are encouraged to consult the internal Legal Repository to check whether advice has already been provided on a similar theme. If not, regional teams must complete an NHS England Legal Requisition form available at the link shown below and forward with any accompanying documents to: england.pscentralteam@nhs.net and england.nhse.legal@nhs.net 

The national professional standards team will liaise with the legal team to confirm if a legal opinion is required or to confirm if the query can be resolved from previous legal advice sought or from within the national team. The legal team or national professional standards team will confirm the next steps to the requester.

Where legal opinion is sought, the national professional standards team must be copied into any subsequent request for advice on the case and the legal advice provided to enable the central repository of advice to be updated.

The national team will maintain the central repository, anonymised as appropriate, and make this available for all teams to access.  

The NHS England Legal Requisition form is available on the NHS England intranet (only accessible by NHS England staff).

First Tier Tribunal – Regulation 17

In the event that an applicant appeals the decision to refuse inclusion to the list, the applicant may appeal the decision to the Primary Health Lists First Tier Tribunal. The Tribunal may make any decision available to NHS England. 

If the performer appeals NHS England’s decision to impose conditions on inclusion to the list under Regulation 10(1)(a), the performer must comply with the conditions until the appeal has been disposed of.

Once the appeal has been disposed of; NHS England must follow the regulations and NHS England’s policy relevant to the appeal decision.

Following any First Tier Tribunal decision, the status of the performer must be updated on PCSE Online and all associated documentation uploaded to the PL case management system.

Stalled applications

A decision cannot be taken on an application to the Performers List when there is missing essential information. If an application remains incomplete three months from submission to NHS England and the applicant has been chased for this information three times during the three-month period, then the applicant must be informed by the regional team that no further action will be taken in relation to the current application.

Current guidance on the operational process for management of stalled applications can be found in the resources library.

Publication reference: PRN02271