I'd be really grateful for some advice and news on others experience of their local perfomers lists. I've moved, fairly recently, from being a GP for homeless people, doing a fair amount of primary care drug treatment work, to a medical lead in a primary care drug treatment service. I do not do any work apart from this - no mainstream GP work, nor do I want to at the moment. My PCT, who employ me, are telling me I must resign from the performers list because they say I am not doing "primary care". (I've said I am - not general practice, but primary care drug treatment) The line the PCT is taking this year is contrary to that they were giving out 1-2 yrs ago to colleagues.
The BMA, so far, tell me NOT to resign from the peformers lists. They are being helpful and looking into what I should do.
The main point of contention seems to be whether the performers list is a list of people doing general practice, or any work in primary care - I think.
I thought it would be useful (and might possibly cheer me up!)to hear whether anyone else in a similar position had received similar advice and if so what they had done about it. Thankyou!

i don't think anybody is very clear about this, but unless you're very sure you never want to work as a mainstream GP again i think it's probably wise to keep a toehold in GP and stay on the performer's list. what difference does it make to the PCT? for all they know you might want to do the odd locum or OOH session to keep up your skills. the danger of leaving GP altogether is that you can't get back........you end up as that non-existent-in-the-UK creature, an addiction physician, and you then fall in among the SAS and "Trust" docs with no contract or defined salary scale.......

Hi both - I have been on a local performers list but decided to come off it a few years ago as I didnt see myself as a GP, and realised that my " GP " knowledge and skills were probably quite out of date. I now work solely for CDT's, and would have to consider re training to practice as a GP again, which is probably quite right. However it depends what the performers list is for - maybe the BMA will clarify this.

You should continue on the GP local provider/performer list. I agree with catkin that you should be able if you want to continue doing other "GP" work. Certainly if you were working with the homeless you would have been working with people who had a multitude of problems that is true General Practice. You should ask the PCT to allow you to take advice before taking any action.

Thanks for your replies. I think this is a confusing /confused issue - the BMA advice on performers lists is that ANY doctor doing primary care should be on it - this should surely include people like Gill and me doing only drugs work (its still primary care, after all). Its not so much an issue of wanting to do GP work - for my own part I don't, but of what we need to do primary care drug treatment work.The BMA advice has dried up a bit now but I am challenging this with the PCT.

i can't see what difference it makes to the PCT whether you're on the list or not? it doesn't cost them anything AFAIK.........

I had a similar situation, and elected to take on half a day a week of GP. The difference it makes to the PCT is I think the cost of appraisals, and ensuring you are in the loop re updating/m,andatory training etc.

After 4 years out of GP, going back to it was very hard, so much has changed. I may in the future elect to undertake further training with a view to becoming an Addictions specialist, in order to avoid the no-man's-land limbo that Catkin mentions above.

i've made some enquiries about this and i must admit i'm not terribly sure what the performers' list is actually *for*, but the sticking-point does seem to be about appraisal and who should be doing it (or rather who should be paying for it). out of interest, what *are* people doing about appraisal? i did mine through the GP system, but some of my colleagues used the consultant paperwork which isn't really appropriate for us, and some did both! i heard that the College are piloting an appraisal package for GPwSI's but i haven't had sight of it yet........

This survey of primary care supstance misue apprisal and supervision might be of interest:
http://www.smmgp.org.uk/download/reports/rcgp11/rcgp11p29.pdf

And this is the college's old appraisal toolkit - I am not sure if this is the one you are referring to, but it may be something else - I have heard that there is at least an intention to reddraft it
http://www.smmgp.org.uk/download/guidance/guidance012.pdf

Hi

all you need to know about all these subjects and more is contained in a government white paper called 'trust assurance and safety' which outlines the future for the regulation of helathcare professionals. The performers list is a list held by every PCT which all GPs have to be on (within a year of starting)PCTs have the ability to suspend, pending investigation or remove GPs if there are serious concerns about their perfomance. It therefore gives PCTs quite considerable theoretical power. However the white paper says that this should eventually be scrapped once the GMC GP register get fully operational and the 'recorded concerns' and local GMC affiliate programmes kick in. These should apparently do the same job.

Appraisal is described as not fit for purpose in the white paper. The purpose being clinical governance and revalidation. This is because it was originally designed as a self- improvement tool not a formal quality control tool.

The appraisal system needs to be beefed up the white paper says and be both 'sumative and formative' in order to feed into the 5 yearly revalidation cycle. It needs to be linked with a 360 degree feedback session to acheive relicensure and that needs (for GPs) to be allied with specialist recertification, done by the RCGP to amount to revalidation.

there you go

heres a link
http://www.dh.gov.uk/en/Publicationsandstatistics/Publi...ndGuidance/DH_065946

This message has been edited. Last edited by: Jim Barnard,

I'm hoping they'll continue to be very very slow about this, to give me time to retire.

However, I'm sure its all a Jolly Good Thing.

quote:

Originally posted by judith yates:
I'm hoping they'll continue to be very very slow about this, to give me time to retire.

However, I'm sure its all a Jolly Good Thing.

Judith,
You are far too young to retire.

Jim's answer is spot on. If you want a licence to practice you will need to be on a performers list. I don't know if there is to be a separate list for drug work only, that could be interesting for some of our local private clinics

I'm starting to get worried ! I have just been contacted by the CPD / Appraisal person at PCT and it was suggested that I should not be on a GP performers list, as I am no longer a practising or "locum "ing GP. However, where would that leave me ? I have no intention to offer myself for GP work of any kind without re-training, but I would want to know that I was on some sort of Validated list of Medical Practitioners, working within levels of competence in my present field. I need to get back to the PCT to check how I am registered on their list of practitioners I think.
Thanks for this thought
Gill

Local PCT say that we don't need to be on a performers list if not practising as GP's - just keep a CPD portfolio and have annual Specialist appraisals.
Is this what others do ?
Gill

It all seems very complicated, and the future still seems unclear. I'm definately going to hold on to my performer status though.
In the future it seems we will either be a GP (on performers list) or not. I suspect one practical consequence of losing performer status may be in pay - if you're not a GP you can't be employed as a salaried GP by a PCT. It's unlikely we will be accredited for the specialist register and paid as a consultant. You may have to be on another official pay scale. That could be staff grade or clinical medical officer, and the pay for that is much less than we're used to

Errghh! Do not leave the performers list - offer to not be paid for the time involved, whatever to stay on. There is potentially no way back on without retraining and this will likely have to be self-financed. Jim's response is very useful - thanks - as it holds perhaps some hope for the future but I have grave doubts there is the manpower or time required to do a 'proper' job of revalidation.
My own solution is to keep my toe in general practice by doing a session weekly. I worry that this will be deemed inadequate but I'm keeping my head down for now and carrying on with PCT appraisal in order to keep on the list. I have managed to avoid PCT apprasial for about three years by having a 'specialist appraisal' via the RCGP network and letting the PCT know this is what I have done. I am hoping to alternate between the two from now on but have not had that conversation yet with the PCT.
I am also stressing within my apprasial the primary care nature of the work that I am doing over and above the straight prescribing, in terms of general health screening and signposting to other services.
Susi, what road would you go down for 'specialist' status?
Again, please don't leave the list if you can avoid it as it feels like the only rock available in a sea of uncertainty - although a very slippy one!

being very brief here:
1. Get MRCGP if not got it via imap THIS YEAR
2. Spend some time attached to a specialist eg a consultant psych team
3. Get a masters level qualification in Addictions
4. Stay on the performers list until you've done it all

This is not prescriptive nor certain, but seems to be safe within Roles and Responsibilities/ RCGP stuff I've seen so far

I've already done your first three points, Susi, but am still not letting go of number 4! I worry that the RCPScyh/RCGP document has no statutory status beyond being a nice idea from two royal colleges. I really don't believe that achiveing the goals given in the document will enable us to be entered onto the specialist register; entry to that register is very specific and strongly regulated. It involves either award of a CSST or CTT after PMETB approved SpR training in a speciality.
The 'Trust, assurance...' document that Jim refers to clearly points to revalidation either to stay on the specialist register OR the general practitioners' register. There are no other options apart from getting a license to practice, but this is to work as neither a GP nor a specialist.
I do find it hard to make sense of. The PMETB website is of some help, and they do have a link to the statutory doceument on specialist and Gp training and registers http://www.opsi.gov.uk/SI/si2003/20031250.htm#6

So, my guess is whatever the 'roles and responsibilities' document says, we will not be eligible for the specialist register without full, approved training in a recognised speciality, eg psychiatry. There would then be a very strong argument for staying on the GP register to avoid ending up on neither register, and placed with other 'non career grade' doctors, who work in 'staff and associate specialist grades, as clinical assistants, hospital practitioners and other non-standard, non-training grades', without an easy pathway back.
I might be wrong, but I'd echo John's warning, and advise keeping fully up to date with proposed changes

This message has been edited. Last edited by: Jez.Thompson,