The following case is fictitious but based on the types of calls we receive to the MDU advice line.

The scene

A GP registrar had almost completed his training. His certificate of completion of training (CCT) date was set for the end of the week., and he had secured a salaried GP post where he planned to work part-time, combining this with some regular locum work at an NHS Hospital Trust working in the urgent treatment centre (UTC).

He had been called by the practice manager of the GP surgery where he planned to start work. She explained that when she had been completing the usual administration associated with a new GP joining the practice, it had become apparent that the GP registrar was not named on the National Performer List (NPL).

The practice manager explained that this meant the registrar could not start work with them and asked him to make the necessary application to have his name included on the NPL.

The GP registrar immediately made the application online but was advised that it might take several weeks for his application to be processed. He was concerned about the implications of this and asked his future employer if he could commence work as planned with a GP partner 'supervising' his work in the interim.

He had not realised he needed to be on a performers list and wondered how this related to his GMC registration, so he called the MDU for advice.

Our advice

The MDU adviser explained that the Performers Lists Regulations provide a legal framework for managing doctors (known as 'performers') who undertake any clinical work under the provisions of an NHS primary care contract.

NHS primary care contracts require performers to be included on the performers list as well as being on the specialist register with the General Medical Council (GMC). The GMC is the regulator and ensures that doctors are fit to practise by confirming they have the qualifications, knowledge and skills required of a registered medical practitioner.

In addition to being fit to practise, performers working in primary care need to demonstrate they are safe and able to work independently in that setting. This is commonly referred to as being 'fit for purpose'. GPs must be named on the performers list before they start working in primary care. There is an exemption for GP registrars - but this exemption ends once the CCT is awarded.

Each home nation in the United Kingdom has its own performers list. The GP registrar was working in England and the adviser explained that he would need to apply to the list for England, which is managed by NHS England.

He would be assigned to an NHS England area team, which would become his designated body and provide him with a named responsible officer for future revalidation, and provide a mechanism for his annual appraisal.

Applications from GP registrars to join the list will only be accepted from those within six months of their CCT date, and it is recommended that applications are made at least three months before the CCT date. All performers list application processes are managed online by Primary Care Support England (PCSE).

The adviser reiterated that the performers list is a national list, so if he wanted to work as a GP in Wales, Scotland or Northern Ireland at any stage in future, he would need to apply to join the relevant list for that home nation.

Importantly, it is the provision of NHS primary care services that requires inclusion on the list. Doctors working in a hospital environment would not usually need to be on a performers list, but the MDU adviser suggested that the GP registrar check his terms and conditions of employment with the NHS trust and seek advice accordingly.

The adviser and the GP registrar agreed that both he and his future employing GP practice could be vulnerable to criticism if he were to work as a GP after his CCT date without being included on the list. This would be the case even if there were an informal agreement that his work would be supervised.

The outcome

After discussing the case with the MDU, the GP registrar and his future employing practice agreed that he could not commence work until his name was added to the performers list. He was nevertheless able to work at the hospital in the meantime.