How to appeal if you're left off a list of NHS providers, such as the medical, dental or ophthalmic performers lists, or pharmaceutical list. Replaces PHL Guide.
Applies to England and Wales
Includes information from the withdrawn PHL Guide.
What you can appeal against
You can appeal to the First-tier Tribunal Primary Health Lists if the NHS Commissioning Board (NHS):
- refuses to add you to a performers’ list
- removes you from the list
- keeps, changes or adds to the conditions of including you on the list
The tribunal is independent of the government, and will listen to both parties before reaching its decision.
Time limit for appealing
You normally have to appeal within 28 days of receiving the NHS decision.
This is 30 days for some pharmaceutical appeals.
If you miss the time limit you can ask for more time to appeal, but you’ll have to explain in detail why you’re late.
You should also send a copy of your request to the respondent, so that they can tell the judge whether they agree with it.
The tribunal will decide if it can go ahead with your case.
How to appeal
First-tier Tribunal Primary Health Lists
HM Courts and Tribunals Service
Darlington Magistrates' Court
Telephone: 01325 289 350
Fax: 01264 785 013
You should also send the tribunal a copy of the decision letter giving you the right to appeal.
The tribunal can help you fill in the form, but cannot give you legal advice.
You may be able to get advice from your professional association or through your insurer.
You can ask the tribunal to:
- conduct the hearing in Welsh (if you live in Wales)
- provide an interpreter or signer at the hearing for you or a witness for other languages in England and Wales
How the tribunal will decide your case
The tribunal will then arrange a conference call with you, the judge and the NHS. This is to discuss what you need to do before the hearing and is called a telephone case management hearing. The tribunal will send you instructions about how to prepare for and join the telephone hearing.
During the call, you’ll usually decide when to:
- exchange documents and witness statements
- put together the papers for the hearing (the ‘bundle’)
The tribunal will send you a guide to statements and bundles.
The judge will set a date and time for the hearing. The details will be added to the list of hearings.
You can also ask the judge any questions about the process, or what to expect at the hearing.
Asking for documents and witnesses
You can ask the tribunal to:
- issue a witness summons (if you want a witness to come to the hearing, but they have refused)
- make an order to get the clinical commissioning group to give you relevant documents that support your case
People summonsed must have 14 days’ notice of the hearing. They may object to the summons.
If you ask for a witness to be summonsed and they ask you to pay their expenses to attend the hearing, you will have to meet this cost.
You can ask the judge to make a witness summons or an order:
- during the telephone hearing
- by sending a written request
The tribunal can order that parties do not disclose information if:
- it would identify someone who should not be identified
- it would likely cause serious harm
Asking for more time or to change a document
You can use Form T109 to ask a judge to:
- allow you to amend a document you’ve already provided
- give you more time to file a statement
- postpone or adjourn the hearing
- put the hearing on hold (‘stay’ proceedings)
You should say on the form why you’re asking for the change.
You should also send a copy of the form to the other party so they can give the judge their views as well.
The hearing can be held in a court or tribunal building in your local area.
Your case will be decided by a panel including:
- a judge
- a specialist with professional experience (for example, a GP, dentist or ophthalmologist)
- a non-professional with relevant health experience
The hearing will also be attended by:
- a clerk or usher
- a lawyer acting for the NHS
- your lawyer or other representative (if you have one)
- witnesses for both parties
The hearing will be normally be open to members of the public.
You will be given a chance to:
- present your case to the tribunal
- call witnesses to give evidence
- highlight any important points at the end
The tribunal will send you a copy of its decision within 10 days of the end of the hearing.
If you reach agreement with the other party
If you and the clinical commissioning group come to an agreement before the end of the hearing, you can ask the tribunal to ‘dispose’ of the appeal.
If the tribunal agrees with your request, it will issue a ‘consent order’.
If the tribunal made a mistake
You can challenge the decision if there was a mistake in the way the tribunal handled the case (for example, you weren’t sent important documents).
To do this, fill in the application to set aside a decision form.
You must apply within 28 days of receiving the decision.
Appeal against the decision
If you think the tribunal made a mistake in the way it interpreted or applied the law, you can ask for permission to appeal.
Get legal advice from a solicitor if you need help.
Find out more about appealing to the Upper Tribunal.
You can search the decisions database to find out how the tribunal decided previous cases.
If you do not want your or other people’s names to be published with the decision, you can ask the tribunal to make a ‘restricted reporting order’. You can ask for this:
- at the telephone hearing
- by writing to the judge
- by asking the panel at the hearing
Each party in the hearing usually pays their own costs.
If the tribunal considers that one party has acted unreasonably, it can order them to pay some or all of the other party’s costs.
To complain about:
- how your appeal is or was handled by the tribunal’s administration, write to the Delivery Manager
- any members of the appeal panel, write to the Chamber President
- the Deputy Chamber President, write to the Chamber President
The address is in the How to appeal section.
Rules and legislation
Read detailed rules on how your appeal will be handled in the Health, Education and Social Care Chamber procedure rules.
You can find the right to appeal to the tribunal in: