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Behind the healthcare profession is a complex and vast network of organisations, procedures, and frameworks that set out how care is delivered, funded, and regulated.
Understanding who you need to approach for education, insurance, performance frameworks and regulation is essential to engaging confidently with the system.
This glossary of common terms in NHS performance and regulatory processes, has been compiled to provide brief and accessible definitions of the key organisations and procedures that underpin the healthcare landscape. Each entry is designed to demystify the language used across the field.
Entries are presented in alphabetical order and cover a broad range of terms relevant to both clinical and administrative contexts.
We hope this resource serves as a reliable and practical reference point, whatever your journey.
An independent public body providing free, impartial advice, mediation and other services to employers and employees on employment rights, workplace disputes, and best practices.
It offers early conciliation for Employment Tribunal claims, helping resolve disputes before formal litigation. It provides guidance on disciplinary procedures, grievances, redundancy, discrimination, and employment contracts.
Is the “risk transfer and financing scheme” for NHS Scotland. It is managed by NHS National Services Scotland (NSS) and provides indemnity/insurance to NHS Boards and Special Health Boards for both clinical and non-clinical risks (such as employer’s liability).
Like the CNST, members contribute annually. The scheme reimburses members for losses incurred from clinical negligence claims, but it does NOT cover private work, inquests, or regulatory (GMC) investigations, for which, individuals must still retain membership of a Medical Defence Organisation (MDO) or have other arrangements in place.
The CNSGP is a state-backed indemnity/insurance scheme administered by NHS Resolution. It covers all GPs and staff working in general practice for clinical negligence liabilities arising from NHS work and services they provide.
The scheme handles the costs of legal defence and compensation for patient, but it does NOT cover private work, inquests, or regulatory (GMC) investigations, for which, individuals must still retain membership of a Medical Defence Organisation (MDO) or have other arrangements in place.
(Note for Scotland and Northern Ireland – GPs in Scotland and Northern Ireland are responsible for arranging their own professional indemnity. While the Scottish Government provides funding support to help offset these costs, the legal liability and responsibility for arranging cover remain with the individual practitioner or practice.)
The CNST is a state-backed indemnity/insurance scheme administered by NHS Resolution. It covers NHS Trusts and Foundation Trusts for clinical negligence claims arising from incidents. Membership is voluntary but effectively all Trusts take part.
All members pay an annual contribution based on their risk profile. Private hospitals and clinics can also join the CNST but ONLY to cover any NHS-commissioned work they perform and the cover is not automatic to all those employed. The scheme handles the costs of legal defence and compensation for patient, but it does NOT cover private work, inquests, or regulatory (GMC) investigations, for which, individuals must still retain membership of a Medical Defence Organisation (MDO) or have other arrangements in place.
The independent regulator of health and social care in England. It registers, inspects, and rates services including hospitals, care homes, GP surgeries, dental practices, and ambulance services against their standards of quality and safety.
The CQC uses a five-point rating system (Outstanding, Good, Requires Improvement, Inadequate, and Inadequate with enforcement action) based on whether services are safe, effective, caring, responsive, and well-led. It has enforcement powers including issuing warnings, fines, and closing unsafe services.
A superior court of record that hears appeals on points of law from decisions made by Employment Tribunals in England, Scotland, and Wales.
Among others, it reviews appeals from healthcare workers or NHS organisations challenging Employment Tribunal decisions on matters such as unfair dismissal, discrimination, whistleblowing, contractual disputes, or regulatory employment issues. The EAT only considers legal errors in the original tribunal’s decision, not factual disputes.
A national NHS improvement programme that aims to reduce unwarranted variation in medical and surgical practice across England. GIRFT conducts in-depth reviews of individual specialties by analysing data, visiting trusts, and comparing practices to identify best performers and areas for improvement. The programme examines clinical outcomes, efficiency, patient experience, and resource utilization to develop evidence-based recommendations.
The independent regulator for doctors and medical associate professionals (Anaesthesia Associates, Physician Associates) in the UK. The GMC maintains the medical register, sets standards for medical education and practice, and investigates complaints about doctors. Healthcare professionals interact with the GMC when: registering as a medical student or doctor, applying for a license to practice, undergoing fitness to practice investigations, facing complaints or concerns about their conduct or performance, renewing their registration annually, and during revalidation every five years.
Is the state-backed scheme for GPs in Wales, operated by NWSSP Legal & Risk Services. It mirrors the English CNSGP, it provides clinical negligence cover for NHS work undertaken by GP partners, salaried GPs, locums on the All Wales Locum Register, and practice staff. Like its English counterpart, it only covers clinical negligence for NHS services and GPs must maintain separate MDO membership for private work, professional conduct hearings, inquests and regulatory investigations.
(Note for Scotland and Northern Ireland – GPs in Scotland and Northern Ireland are responsible for arranging their own professional indemnity. While the Scottish Government provides funding support to help offset these costs, the legal liability and responsibility for arranging cover remain with the individual practitioner or practice.)
The independent regulator for pharmacists, pharmacy technicians, and registered pharmacy premises in Great Britain (England, Scotland, and Wales).
Established in 2010, the GPhC maintains professional registers, sets standards for education, training, conduct, and performance, and handles fitness to practise cases when concerns arise about registrants. The regulator inspects and registers all pharmacy premises including community pharmacies, hospital pharmacies, and internet pharmacies to ensure they meet safety and quality standards. The GPhC also accredits pharmacy degree courses and postgraduate training programmes.
Formerly known as CPSM – Council for Professions Supplementary to Medicine.
The regulator for 15 health and care professions including paramedics, physiotherapists, radiographers, operating department practitioners, and biomedical scientists. The HCPC is involved when: registering to practice in a regulated profession, renewing registration every two years, facing fitness to practice proceedings, and when complaints about professional conduct or competence arise.
The organization formerly responsible for planning and developing the NHS workforce, including training and education for healthcare professionals. As of April 2023, HEE’s functions were integrated into NHS England.
Healthcare professionals interacted with HEE (now NHS England workforce functions) during: medical and healthcare training program applications, postgraduate training and specialty training, educational supervision and training quality, workforce planning and training numbers, and funding for training posts and education.
The Scottish equivalent of HIW.
The independent regulator and inspector of healthcare in Wales, equivalent to the Care Quality Commission in England. Established as a Special Health Authority, HIW regulates and inspects NHS and independent healthcare services including hospitals, GP practices, dental services, mental health facilities, and private clinics.
In Northern Ireland, clinical negligence indemnity for hospital care is provided directly by the Health and Social Care (HSC) Trusts.
This is funded by the Department of Health. The Directorate of Legal Services (DLS) acts as the provider of legal services to the HSC sector, handling the defence and settlement of clinical negligence claims on behalf of the Trusts.
Formerly known as Healthcare Safety Investigation Body.
An independent statutory body that investigates patient safety incidents in NHS-funded care in England. HSSIB conducts blame-free investigations focusing on systemic issues rather than individual accountability. Investigations aim to identify underlying causes and make evidence-based recommendations to prevent future harm. To promote openness and transparency, staff providing information to HSSIB receive legal protections.
A tribunal that considers whether interim restrictions should be placed on a doctor’s registration while fitness to practice investigations are ongoing.
IOT involvement occurs when: urgent patient safety concerns arise about a doctor, serious allegations require immediate action before a full hearing, interim conditions or suspension of registration are being considered, and during the period between initial complaint and full MPTS hearing
NHS England’s system that replaced the National Reporting and Learning System (NRLS) in 2024. It provides a centralised platform for reporting and recording patient safety incidents.
The system allows healthcare providers to share incident data, access comparative analytics, and disseminate safety alerts and recommendations.
Is the NHS England framework for handling concerns about doctors’ and dentists’ conduct, capability, or health. It sets out procedures for investigating and managing performance issues, from informal concerns to formal capability hearings. It includes exclusion from work, investigation timelines, and disciplinary procedures. It operates separately from GMC fitness-to-practise proceedings.
An independent body that conducts fitness to practice hearings for doctors on behalf of the GMC. The MPTS becomes involved when: a doctor faces serious allegations requiring a tribunal hearing, fitness to practice cases proceed to formal hearings, decisions about a doctor’s registration status are being made (sanctions, conditions, suspension, or erasure), and during appeals of GMC decisions.
An arm’s length body of the Department of Health and Social Care that provides critical support services to the NHS, healthcare professionals, and patients across England and Wales. Its key functions include processing NHS prescription payments and managing exemption and prepayment certificates, administering the NHS Pension Scheme for healthcare staff, managing student bursaries and training grants, and operating the NHS Jobs recruitment platform.
It also deals with payments to GPs, dentists, and opticians in primary care, and processes overseas visitor charging and European Health Insurance Card schemes.
The arm’s-length body of the NHS that manages clinical negligence/medical malpractice and other claims against the NHS in England. It provides indemnity cover through the Clinical Negligence Scheme for Trusts (CNST). NHS Resolution handles the investigation, resolution, and payment of claims, offers advice on legal matters, and works to learn from incidents to improve patient safety. It protects NHS staff from personal liability for clinical negligence claims arising from their NHS work.
Formerly known as UKCC – United Kingdom Central Council for Nursing, Midwifery and Health Visiting.
The independent regulator for nurses, midwives, and nursing associates in the UK. The NMC becomes involved when: registering to practice as a nurse, midwife, or nursing associate, facing fitness to practice investigations or complaints, renewing registration annually, undergoing revalidation every three years, and when concerns are raised about professional standards or conduct.
They are reports issued by Coroners in England and Wales. They were also known as Regulation 28 reports. PFD reports are published after an inquest where the Coroner believes there might a risk of future deaths reoccurring in similar circumstances. Coroners have a legal duty to report these risks to relevant organisations or individuals who have the power to take action, for example NHS trusts, regulatory bodies, or government departments. Once an organisation or individual is addressed in such reports, it must respond within 56 days explaining what action will be taken to address the identified risks and prevent future deaths.
Formerly known as NCAS National Clinical Assessment Service and NCAA.
It’s a service provided by NHS Resolution and an independent advisory body in the UK designed to help healthcare organisations (like NHS Trusts) and practitioners resolve concerns related to the performance, conduct, or health of doctors, dentists, and pharmacists.
It is not a regulator and has no disciplinary powers against healthcare professionals; it focuses on remediation. Examples of their services are:
NHS England’s approach to investigating and learning from patient safety incidents, which replaced the Serious Incident Framework in 2022. It focuses on learning and improvement rather than blame. It promotes proportionate investigations tailored to the circumstances, patient and family involvement throughout the process.
Groups that provide occupational health advice and support to healthcare professionals across different regions. ROAGs offer guidance on fitness to work, reasonable adjustments, and occupational health matters.
Healthcare professionals may encounter ROAG when: seeking advice about health conditions affecting their ability to work, requiring assessment for fitness to practice related to health issues, needing guidance on workplace adjustments or accommodations, facing concerns about their health impacting patient safety, and during return-to-work planning after illness or injury.
The Northern Ireland equivalent of HIW.
The Welsh equivalent of MHPS.
The Welsh Risk Pool is the equivalent of the CNST in Wales. It’s managed by the NHS Wales Shared Services Partnership (NWSSP) Legal & Risk Services, it reimburses Health Boards and Trusts for losses incurred from clinical negligence claims.
Like CNST it does NOT cover private work, inquests, or regulatory (GMC) investigations, for which, individuals must still retain membership of a Medical Defence Organisation (MDO) or have other arrangements in place.
