Long-term issues with the performers list registration system in England have not been resolved in recent years, and may even have ‘gotten worse’, GPs have warned.
GPs told Pulse that they have been having trouble signing up to the English performers list from other UK nations or changing their employment status using the online portal.
Grassroot GP organisation GP Survival told Pulse of two cases where it took GPs returning from abroad 12 to 18 months to get on the register.
More widely, its chair Dr John Hughes said issues with the performers list have been ‘ongoing’ and causing applicants ‘immense problems’.
Capita, which runs the Primary Care Support England (PCSE) website on behalf of NHS England, took the performers list application process online in 2019 in a bid to simplify the process.
However, in that same year, GP Survival said it heard of numerous cases where GPs were being affected by performers list issues, including problems with their pensions and even at times being unable to practise.
Dr Hughes said of the service: ‘It’s certainly an ongoing problem. Nothing has improved, if anything, it’s gotten worse in the last couple of years.’
GP and emergency medicine consultant Dr Linda Dykes told Pulse that she has relocated from Wales to England but has been battling with the English performers list application process due to a technical restriction with the online form.
She said: ‘Like many GPs, I have a portfolio career – so I’ve had more than one job at once. From 2005 to 2020, my substantive position was in consultant and emergency medicine. The online form doesn’t allow me to enter any concurrent roles, such as GP locum work. If I try to, it won’t recognise it, and then you can’t go forward or back on the application.’
Dr Dykes said she emailed PCSE for support, and was advised to upload her CV as an alternative, though this option was not mentioned on the application itself.
She said the application also asks potentially confusing questions in places and has unnecessary requirements that proved to be an extra ‘burden’, taking many hours to sort out, adding that the system ‘is not fit for purpose’.
She said: ‘Why have we got the performers list at all? What is the point of it now that we have appraisal and revalidation? It’s absurd. And if you are already registered on one UK performers list, why is there not mutual recognition between all four nations of the UK?’
Merseyside GP Dr Heather Ryan told Pulse that she is currently on the English performers list, but has been unable to update her employment status on the PCSE online system, having recently transferred from a locum role to being employed by two secondary care trusts, doing mental health and out-of-hours GP work.
She said: ‘On 9 March, I logged into PCSE online and attempted to change my status to a salaried GP. I was unable to do so because on the PCSE portal, you have to give the surgery you work for, and it wouldn’t let me enter them, because neither role is at a GP surgery.’
Dr Ryan added that she contacted PCSE, explaining her situation and requesting help, and received two template responses weeks later, which ‘failed to address the issue’, adding she has still not had a response to the complaint she subsequently logged.
She added: ‘If, because I’m employed by secondary care trusts, they can’t add my employer to the system, that’s fine, but PCSE needs to tell me that and help me find a solution, rather than refusing to help or engage. My out-of-hours GP work is indisputably general practice work which qualifies me for inclusion on the performers list.’
Dr Ryan said this issue means she can’t be allocated a local appraiser, and that if that isn’t sorted, this could have implications for her revalidation next year.
Dr Amy Small, a locum GP in Scotland, told Pulse that she wants to visit her mother in England over the summer, but that because she can’t afford to take annual leave, planned to do locum work once there, meaning she needs to be on the English performers list.
She said: ‘I applied to the performers list, and the hoops I have to jump are ridiculous. One of the things they ask you for is an independent occupational health assessment. I have got certificates proving that I’m hep B immune, don’t have HIV or hep C, which is all you need to get on the Scottish performers list, but that’s not enough to get on the English performers list. You need to pay an independent occupational health person to do an assessment of you.’
She added that the application requires proof of a recent child and adult safeguarding course, and that she went on the e-learning platform to complete the modules and submit her certificates. However, she said PCSE would not accept the ‘advanced’ training award given in Scotland, meaning she has to redo the modules on the English learning platform to get the equivalent ‘level 3’ award.
She said: ‘I don’t know how long it will take to get this occupational health assessment. It’s not going to be able to do this this summer. The sheer number of modules I have to go through again, that in itself is going to take me days to go through because I’m trying to work as well. It’s all just needless bureaucracy.’
Speaking to Pulse, GP Survival campaign lead Dr Nick Grundy said: ‘What is the performers list for? It’s not just that it doesn’t work, but why does anyone have to do it? We know some of the data has been wildly inaccurate for years in some cases, that it doesn’t take account of people doing different types of jobs in different areas, and therefore, it doesn’t serve any useful purpose.
‘It’s meant to let patients and employers check that the doctor is on the performers list for validation, but it clearly doesn’t do that if the data it holds is wrong routinely.’
Dr Krishna Kasaraneni, BMA GP committee executive team member, said: ‘At a time when general practice is under unprecedented pressure we should be making it as simple and stress-free as possible for qualified GPs to offer their skills.
‘Ever since Capita took on the PCSE contract we’ve been vocal in our concerns about the company’s failings in relation to GP admin services, and we’d urge GPs experiencing problems with the performers list to raise these with the BMA.’
A Capita spokesperson said: ‘PCSE processes thousands of applications a year from GPs looking to join the performers list for England, managing the initial and final stages of adding GP performers to the list, in conjunction with NHS England’s regional teams who review and approve additions to it.
‘In 2019, we transformed and simplified this application process by taking it online, improving the overall processing time for applications significantly. We continue to work with NHS Improvement to review the wider approval process, so that improvements can be identified and made.’