On the same day that the GP Out of Hours Services report (referred to above) appeared, the Department of Health published a raft of recommendations and interim guidance relating to the commissioning of such services, the selection and training of out-of-hours clinicians, and the management of Medical Performers Lists operated by PCTs.

Regulation 6(2)(b) of the National Health Service (Performers Lists) Regulations 2004 (as amended) states that a PCT must refuse to include a performer in its performers list if it is not satisfied that he has the necessary knowledge of and proficiency in the English language to perform medical services properly and without jeopardising himself or his patients. Once a doctor has been included in the list of one PCT, he is entitled to perform primary medical services in any other PCT’s area in England.

Many doctors coming from overseas to practise in England will already have provided evidence of their language competency to the GMC, but this is not required if they are from a country within the European Economic Area (EEA), like Dr Ubani. Nevertheless, before deciding to include an EEA national in their list, PCTs must consider the sufficiency of the evidence provided with the application and decide whether or not they require the applicant to provide any further evidence of language competency, so that their knowledge of English may be properly assessed.

The department has now issued interim guidance to assist PCTs in reaching their decision about whether or not a doctor has a sufficient knowledge of English to perform primary medical services. The guidance can be accessed here.

Although the department intends to review and revise all of its current guidance on the Performers Lists as part of the implementation of the Performers Lists review, it was clearly felt that the urgency of the situation, as highlighted by the Gray inquest, warranted an interim publication and a reinforcement of the message that, for the safe practise of medicine, English language proficiency is critical.