Brad is on the roll of solicitors of England & Wales but does not hold a practising certificate and does not provide legal advice.
Updated June 2026 · England & Wales
If the NHS Commissioning Board has made a decision affecting your place on a primary care performers list or the pharmaceutical list, you may have a right of appeal to the First-tier Tribunal (Primary Health Lists). This tribunal sits independently of the NHS and hears challenges from dentists, doctors, opticians, pharmacists and other primary care providers who have been refused inclusion, removed, conditionally included, or otherwise affected by a listing decision.
The process is designed to be accessible without requiring a lawyer, although many applicants choose to take guidance from a professional body, defence organisation or insurer before they file. This page walks you through who can appeal, the deadlines you need to meet, what to send and where, and the kinds of orders the tribunal can make along the way.
It also explains where to find the official forms and how the tribunal communicates with both sides once an appeal is under way.
Overview
The First-tier Tribunal (Primary Health Lists) is part of the General Regulatory Chamber within HM Courts and Tribunals Service. It handles disputes between primary care practitioners and the NHS Commissioning Board (now operating as NHS England) about inclusion on the lists that allow practitioners to provide NHS-funded services.
Those lists include the medical performers list, the dental performers list, the ophthalmic performers list, and the pharmaceutical list for community pharmacy contractors. A practitioner who has been refused, removed, suspended, conditionally included, or had contingent removal imposed can usually ask the tribunal to look again at the decision.
The tribunal is made up of a legally qualified judge, often sitting with specialist members who understand the relevant clinical or commercial field. Hearings can take place in person, by video, or on the papers depending on the case. The tribunal is not there to discipline practitioners or hear fitness to practise issues, those belong to the professional regulators.
Its role is narrower: to review the listing decision itself and decide whether it should stand, be varied, or be replaced.
Key steps
Check that you have a right of appeal. Read the decision letter from NHS England carefully. It should state what has been decided, the reasons, and whether you can appeal to the First-tier Tribunal. Not every NHS decision carries a right of appeal to this tribunal, so confirm the route before spending time on paperwork.
Note your deadline and act quickly. Appeal time limits are short and run from the date you received the decision. For most performers list decisions the window is measured in weeks, and pharmaceutical list appeals can have a slightly different limit. Check the decision letter and the tribunal's current guidance on gov.uk for the precise period that applies to you.
Complete the appeal form and supporting papers. Use the tribunal's notice of appeal form and set out clearly what decision you are appealing, why you disagree, and what outcome you want. Attach a copy of the NHS decision letter. If you need documents held by the clinical commissioning body or NHS England, you can ask the tribunal to order disclosure.
Send the appeal to the tribunal and the respondent. File your appeal with the First-tier Tribunal (Primary Health Lists) by email or post to the Darlington address published by HMCTS. You must also send a copy to the respondent, usually NHS England, so they know the appeal has been lodged and can prepare their response.
Engage with directions and prepare for the hearing. Once your appeal is accepted, the tribunal will issue case management directions covering evidence, witnesses and hearing format. Meet every deadline, respond to the respondent's bundle, and consider whether you want to attend in person, join remotely, or ask for a decision on the papers.
Q Who can bring an appeal to the Primary Health Lists Tribunal?
Generally, practitioners whose inclusion on an NHS primary care list has been refused, removed, suspended, or made conditional can appeal. This covers GPs, dentists, opticians and community pharmacy contractors affected by performers list or pharmaceutical list decisions made by NHS England. The decision letter should confirm whether you have a right of appeal and the period within which you must use it.
Q What if I have missed the deadline to appeal?
The tribunal has discretion to extend time in some circumstances, but it will not do so as a matter of course. You would need to apply promptly, explain clearly why the appeal is late, and show that it is fair to allow it in. Illness, delayed receipt of the decision, or serious personal events may be relevant, but the decision is entirely for the tribunal.
Q Do I have to attend a hearing in person?
Not always. The tribunal can hold hearings in person, by video link, or decide a case on the papers where both parties agree and the issues allow it. The judge will set the format as part of case management directions. If travel, health or work make in-person attendance difficult, you can ask for a remote or paper hearing when you file your appeal.
Q Can the tribunal order the NHS to disclose documents?
Yes. If relevant documents are held by NHS England or a commissioning body and are needed to deal fairly with the appeal, the tribunal can make a disclosure order. You should identify the documents as specifically as possible and explain why they are relevant. Orders are not automatic, and the tribunal will weigh relevance, proportionality and any confidentiality concerns.
Q Will I need legal representation?
There is no requirement to be represented. Many practitioners instruct solicitors or counsel, while others are supported by their professional defence organisation, trade body or insurer. The tribunal staff can help with procedure and signposting but cannot tell you how to argue your case. If the facts are complex or your livelihood is at stake, taking guidance early is usually sensible.
Q What outcomes can the tribunal reach?
The tribunal can confirm the NHS decision, overturn it, or substitute a different decision within its powers. It can also impose, vary or remove conditions attached to listing. It cannot award compensation, and it does not replace professional regulators such as the GMC, GDC, GOC or GPhC, who handle fitness to practise matters separately from listing decisions.
Q Is there an interpreter service available?
Yes. If you need a Welsh or English language interpreter, or a signer for a hearing-impaired party or witness, the tribunal can arrange this. Ask as early as possible, ideally when you submit the appeal form, so that suitable arrangements can be made in good time for the hearing.
Appealing a performers list or pharmaceutical list decision can feel daunting, especially when your ability to work is on the line. An experienced legal adviser can help you think through your options on the call, based on what you describe about the decision and your situation.
✓Plain-English answers to your specific questions about the tribunal process
✓Practical perspective on the points the tribunal may focus on in your circumstances
✓Guidance tailored to what you describe about the NHS decision you received
✓A clearer sense of your next steps before you file anything
Personal call · For information only · Independent advisers
Written & reviewed by
Brad Askew Solicitor (non-practising)
Brad is on the roll of solicitors of England & Wales but does not hold a practising certificate and does not provide legal advice. LegalDocuments.co.uk is not a law firm and does not provide regulated legal advice.
This article is for general information only. It is a tool to help you find your way — not legal advice, and not a substitute for speaking to a qualified adviser about your situation.
