Healthcare regulation across the UK nations

England - Care Quality Commission (CQC)

CQC is the independent regulator of health and adult social care in England, established under the Health and Social Care Act 2008.

• Scope: regulates both health and social care services providing regulated activities
• Rating system: 4-point scale - Outstanding, Good, Requires Improvement, Inadequate
• Assessment framework: Single Assessment Framework based on 5 key questions (Safe, Effective, Caring, Responsive, Well-led)
• Workforce registration: Professional regulators (GMC, NMC, GDC, GPhC, HCPC) are UK-wide - same registration regardless of nation
• Disclosure checks: Enhanced DBS check with barred list check

Scotland - Healthcare Improvement Scotland (HIS) and Care Inspectorate

Scotland splits healthcare and social care regulation between two bodies, operating under the Public Services Reform (Scotland) Act 2010.

• Healthcare Improvement Scotland (HIS): created by the 2010 Act, HIS regulates independent healthcare services (private hospitals, clinics) under the National Health Service (Scotland) Act 1978 as amended. NHS Scotland is governed separately through NHS Scotland governance arrangements, not HIS registration.
• Care Inspectorate: regulates social care services (care homes, care at home, day care, childcare)
• Grading system: 6-point scale from 1 (Unsatisfactory) to 6 (Excellent) - note there is no equivalent to CQC's 'Outstanding'; the highest grade is 'Excellent'
• Standards: Health and Social Care Standards (2018) replaced the previous National Care Standards
• Workforce registration: Scottish Social Services Council (SSSC) registration is mandatory for social care workers in Scotland, in addition to UK-wide professional registration
• Disclosure checks: PVG (Protecting Vulnerable Groups) scheme via Disclosure Scotland, rather than DBS

Wales - Healthcare Inspectorate Wales (HIW) and Care Inspectorate Wales (CIW)

Wales also splits regulation between health and social care inspectorates, with social care governed by the Regulation and Inspection of Social Care (Wales) Act 2016 (RISCA).

• Healthcare Inspectorate Wales (HIW): regulates and inspects both independent healthcare and NHS Wales services
• Care Inspectorate Wales (CIW): regulates social care services under RISCA 2016
• Bilingual requirements: Welsh Language Standards may require you to provide services in Welsh as well as English, depending on your service type and location
• Key personnel: CIW requires a Responsible Individual and a registered service manager (similar to CQC's nominated individual and registered manager)
• Workforce registration: Social Care Wales registration is mandatory for social workers, social care managers, domiciliary care workers (since 2020), and adult care home workers (since October 2022) — the rollout is complete
• Disclosure checks: Enhanced DBS checks with barred list check for regulated activity apply in Wales (same system as England)

Northern Ireland - Regulation and Quality Improvement Authority (RQIA)

Northern Ireland is unique in having a single regulator (RQIA) for both health and social care, reflecting the integrated nature of health and social care delivery through 5 Health and Social Care (HSC) Trusts.

• RQIA: regulates both health and social care under the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003
• Integrated system: Northern Ireland's 5 HSC Trusts deliver both health and social care services together, unlike the separate NHS/local authority split in England
• Standards: Minimum Care Standards for each service type, with a 4-level compliance rating system
• Key differences: no equivalent to CQC's single published rating for the public; RQIA publishes inspection reports with compliance levels
• Workforce registration: Northern Ireland Social Care Council (NISCC) registration for social workers and social care workers
• Disclosure checks: AccessNI provides criminal record checks, rather than DBS

Professional registration - UK-wide bodies

The following professional regulators operate UK-wide. Registration with these bodies is the same regardless of which nation you practise in:

• GMC (General Medical Council) - doctors
• NMC (Nursing and Midwifery Council) - nurses and midwives
• GDC (General Dental Council) - dentists and dental care professionals
• GPhC (General Pharmaceutical Council) - pharmacists and pharmacy technicians
• HCPC (Health and Care Professions Council) - allied health professionals (physiotherapists, paramedics, radiographers, and others)

Revalidation requirements are the same UK-wide for each profession. A doctor registered with the GMC can practise in any UK nation without additional professional registration.