Practitioner Performance Advice

What we do

We provide impartial advice to healthcare organisations to effectively manage and resolve concerns raised about the practice of individual doctors, dentists and pharmacists.

Practitioner Performance Advice was established in 2001 and is now a service delivered by NHS Resolution under the common purpose, to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care. We use national frameworks, guidance and standards to underpin and inform our work.

Practitioner Performance Advice provide a range of core services to NHS organisations and other bodies in England, Wales and Northern Ireland such as advice, assessment and intervention, training courses and other expert services.

We know that a pressured working environment can impact on a practitioner’s ability to perform well, put strain on working relationships and lead to physical and mental health problems. Where these circumstances give rise to performance concerns, we are available to help, whether by providing advice or support for resolution through our own services or by signposting to other means of support.

There is no minimum threshold for seeking advice and we encourage healthcare organisations and practitioners to contact us as early as possible when concerns come to light.

We welcome contact from individual practitioners who may be seeking advice about performance concerns or might wish to know more about the services we provide. For example, a practitioner may want help clarifying procedural aspects of the management of their case, be concerned about some aspect of their own practice, or wish to access advice about rebuilding their skills after a career break. We can also provide information about other avenues of support that may be available to practitioners.

We believe that organisations should foster a just and learning culture which balances fairness, justice and learning when things have not gone as planned. For more information on this please see NHS Resolution’s Being fair and Being fair 2 publications.

The Care Quality Commission and NHS Resolution are committed to working collaboratively to support and improve the quality of care provided within both the NHS and independent sectors. In particular both organisations are committed to improving the safety culture when teams are in difficulty and encouraging providers to seek the support of external organisations where appropriate, for example accessing Practitioner Performance Advice’s team review service – a step that both CQC and NHS Resolution consider can be a positive indicator of a well led organisation.

Care Quality Commission

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Our core services

Healthcare Practitioner Alert Notices (HPANs)

We are responsible for the management of the Healthcare Professional Alert Notices (HPANs) system. This is a system where notices are issued by us to inform NHS bodies and others about health professionals who may pose a significant risk of harm to patients, staff or the public.


Our training courses aim to provide healthcare organisations with the knowledge and skills to identify and manage performance concerns locally. They also provide delegates the opportunity to share good practice and network with colleagues.