What this means
Start with the exact decision in front of you.
Conditions can restrict or structure NHS primary care work and may be reviewed, maintained or varied. Compliance should be documented against the exact wording, with difficulties raised before an alleged breach develops.
Immediate priorities
Organise the position before responding.
Create a term-by-term compliance schedule
Confirm who will monitor and report progress
Seek formal review where a condition becomes unworkable
Detailed guidance
The procedure, evidence and possible route from here.
01
Use the exact condition as the compliance standard
Performers-list conditions may arise on inclusion, continued inclusion or as part of managing a concern. Obtain the complete decision, reasons and current wording. Create a schedule that states each obligation, due date, responsible person and required proof. Employer policy or a manager's interpretation cannot amend a statutory condition. If wording is unclear, seek written clarification from NHS England before undertaking the disputed activity.
Conditions may overlap with undertakings, professional-register restrictions, remediation plans or contract terms. Compare them line by line. A report sent to a regulator may not satisfy a separate NHS England reporting requirement, and a supervisor approved for one scheme may not meet the other. A single coordinated plan can reduce duplication, but only after every decision-maker confirms its own terms are met.
- Build a term-by-term compliance schedule
- Seek formal clarification of ambiguity
- Cross-check every parallel restriction
02
Generate evidence that shows risk reduction
Supervision logs should record relevant observations, feedback and action, not merely signatures. Audit should use a defined sample and measure linked to the concern. Education should show application to practice. Where health is relevant, reports should address function and adherence to agreed safeguards. The evidence should let NHS England see whether the risk that justified conditions has changed over time.
Keep records contemporaneously and review them before each reporting date. If a supervisor leaves or the performer changes practice, establish replacement arrangements before affected work continues. Locum and multi-site work need particular planning because monitoring can fragment. Tell NHS England about a material change through the route required by the condition rather than assuming the new contractor will handle notification.
- Use evidence tied to the original concern
- Replace lost supervision before restricted work continues
- Report material role changes through the formal route
03
Respond early to difficulty or alleged breach
If compliance becomes impossible, record why, what steps were taken and any interim protection. Seek review or variation before departing from the wording. An informal alternative that seems clinically sensible may still be a breach. Where a breach is alleged, establish the exact term, date, knowledge and conduct, then provide records. Avoid minimising a technical breach if it exposed patients or concealed monitoring information.
NHS England may review, maintain or vary conditions and may consider further action where conditions are not met. The current policy notes that failure to comply can alter how the case is categorised. Review submissions should address both the reason for any breach and the present protective plan. If conditions are no longer necessary, show sustained evidence and explain why removal of each term will not reintroduce risk.
- Document obstacles and interim safeguards
- Analyse an alleged breach against the exact term
- Support variation or removal with sustained evidence
Key questions
Keep the analysis tied to this stage.
Whether each condition remains necessary
Whether compliance shows reduced risk
Whether variation, continuation or further action is justified
Advice is provided only by the regulated firm that accepts a matter.
Common questions
Clarifying the route without assuming the outcome.
Can my practice manager change a performers-list condition?
No. Only the competent regulatory decision-maker can vary the formal condition. Seek written clarification or review before relying on a local alternative.
What evidence helps at a conditions review?
Evidence should show exact compliance and whether the original risk has reduced, using relevant supervision, audit, assessment, health or practice material rather than attendance records alone.
Connected guidance
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Official sources
Check the material for this question.
Sources checked 19 September 2026. Rules change, so compare the current notice and linked official material and tell the operator if a citation or summary needs correction.