The Adviser role is an interesting one. Formally speaking "Practitioner Performance Advice (formerly NCAS) sits within NHS Resolution and provides impartial advice to healthcare organisations to effectively manage and resolve performance concerns raised about the practice of individual practitioners." Performance concerns covers a multitude of issues - and after more than 15 years, I have heard almost all of them. This ties in to various aspects of NHS life, particularly organisational culture. Our neutral position as advisers provides a perspective that is useful to medical managers trying to deal with such issues; and to the doctor who is the subject of the local (Trust) procedures.