GPs providing urgent care to remain on performers list, NHSE confirms

NHS England has confirmed that GPs providing services including urgent care, NHS 111 and out-of-hours are to be allowed to remain on the medical performers list, following concerns raised by grassroots GPs and the BMA.

Earlier this year Pulse revealed that GPs had been threatened by NHS England with removal from the performers list due to exclusively working for an ambulance trust.

They raised concerns that the removal would prevent them from working as GPs in the future, since any GP ‘offering primary care in an NHS setting’ is required to be registered on the performers list for England.

And the BMA told Pulse would be ‘unfair’ and ‘absurd’ for GPs working in a non-practice setting to face ‘barriers to securing work’ in the future due to being removed from the performers list, especially during the current unemployment crisis.

Now NHS England has told BMA officers that if services are commissioned under a standard NHS contract using Schedule 2L – sometimes known as APMS Schedule 2L ‘bolt-on’ – such services are ‘considered to be primary care’, and doctors delivering services under this schedule ‘are required to be included on the performers list for this work’.

These services may include NHS 111, out-of-hours, or urgent care, which may be delivered remotely as well as face to face.

In a message to GPs, GPC England deputy chairs Dr Samira Anane and Dr Julius Parker said: ‘After a recent meeting between GPC England officers and NHS England, we can now confirm that, due to different models of service delivery and settings within which primary medical services are delivered, NHS England is advising all regional heads of professional standards to give careful consideration to the nature of, and contractual arrangements for, the care being delivered by a GP before any proposal for removal from the Performers List.

‘NHS England were also clear that it is their role to remove practitioners from the list, and not for GPs to remove themselves, or initiate this process.

‘While the regulations are related to specific national GP contracts, NHS England also confirmed that, if services are commissioned under a standard NHS contract using Schedule 2L (sometimes known as APMS Schedule 2L ‘bolt-on’), such services are considered to be primary care, and doctors delivering services under this Schedule are required to be included on the performers list for this work.

‘These services may include (but are not limited to) integrated 111, out-of-hours, or urgent care, which may be delivered remotely as well as face to face.’

They also clarified that there is no minimum of delivery or scope of primary medical services required to remain included on the performers list.

They added: ‘GPs who are continuing to deliver intermittent, low volume or defined scope primary medical services should not be considered for removal under Regulation 14(5).

‘While we’re aware that some teams/appraisers set a specific number of sessions per year (most often 40) to help prompt reflective discussion, it is not the case that it is a requirement for medical practitioner to demonstrate that they have worked 40 sessions in the appraisal period/previous 12 months and it is not a criterion for continued inclusion on the Performers List.’

YOR LMC medical secretary Dr Brian McGregor said that in light of this any suggested removal should be discussed with the LMC.

He said: ‘Clarity has been provided on membership of the performers list and GPs undertaking schedule 2L work (includes 111, OOH, urgent care) are definitely considered to be primary care and performers list inclusion a requirement of their employment.

‘Essentially, it confirms no minimum requirement to remain on the performers list, and any suggested removal by a responsible officer should be discussed with the LMC.’

Pulse has contacted NHS England for comment.