Compare healthcare regulation across the UK nations

Guide summary

In England, register with the Care Quality Commission (CQC) before you carry on a regulated activity
In Wales, do not start a regulated service until Care Inspectorate Wales issues a notice of decision
In Wales, name a responsible individual for each place where you provide the service
In Scotland, register care services with the Care Inspectorate; independent healthcare goes to Healthcare Improvement Scotland
In Wales, register independent healthcare, including private dental practices, with Healthcare Inspectorate Wales
In Northern Ireland, apply to register with the RQIA through its web portal
In Scotland, pay the application fee before the Care Inspectorate will consider your application
A doctor on the GMC register can practise in any UK nation without further professional registration

Health and social care regulation is devolved. Each nation has its own regulator, legislation and registration process, and a registration in one nation does not cover another. If you provide services in more than one nation, register with each nation's regulator.

Healthcare regulators by UK nation

Different healthcare regulators across the four UK nations

Healthcare regulation is devolved across the UK. Each nation has its own independent regulator with similar but distinct requirements.

England: Care Quality Commission (CQC) - health and adult social care
Wales: Care Inspectorate Wales (CIW) - social care; Healthcare Inspectorate Wales (HIW) - independent healthcare
Scotland: Care Inspectorate - social care; Healthcare Improvement Scotland (HIS) - independent healthcare
Northern Ireland: Regulation and Quality Improvement Authority (RQIA) - both health and social care

Cross-border services: If you provide services in multiple UK nations, you may need to register with multiple regulators. Each regulator has its own registration process, fees and inspection regime.

Registering in England

The Care Quality Commission (CQC) regulates health and adult social care in England under the Health and Social Care Act 2008. You must be registered with CQC before you carry on a regulated activity, and doing so unregistered is an offence. CQC rates registered providers outstanding, good, requires improvement or inadequate.

Criminal record checks in England come from the Disclosure and Barring Service (DBS).

Care Inspectorate Registration Requirements (Scotland)

Who must register with the Care Inspectorate in Scotland, the care home registration fees, and which body registers independent healthcare.

By law, care services in Scotland must be registered with the Care Inspectorate, which regulates them under the Public Services Reform (Scotland) Act 2010. You must not provide a care service unless you are registered. The Care Inspectorate assesses services against the Health and Social Care Standards published by the Scottish Government.

The application fee must be paid before the Care Inspectorate will consider your application, and an annual continuation fee applies for every year you are registered. Fees vary by service type and size.

Independent healthcare is regulated separately. Healthcare Improvement Scotland regulates independent hospitals (including voluntary hospices), independent clinics and independent medical agencies.

Regulator: Care Inspectorate
Care home application fee: £3,849
Care home annual continuation fee: £157 per registered place
Other fees: Vary by service type and size; see the Care Inspectorate fee schedule
Service types: Care home, support service (care at home), housing support, support service (day care), nurse agency, child care agency, daycare of children, childminding, fostering, adoption, adult placement, secure accommodation, offender accommodation
Independent healthcare: Registered with Healthcare Improvement Scotland

Care Inspectorate Wales (CIW) Registration Requirements

Registration requirements for care and childcare services in Wales, regulated by Care Inspectorate Wales

You must register with Care Inspectorate Wales (CIW) before you provide a regulated service in Wales. Providing one without being registered is an offence under section 5 of the Regulation and Inspection of Social Care (Wales) Act 2016. You can apply as an individual or as an organisation, and you must not start until CIW issues a notice of decision. In your application you designate a responsible individual for each place where you provide the service, and CIW must be satisfied that both you and the responsible individual are fit and proper.

Fees for registration under the Care Standards Act 2000 were abolished from 1 April 2006. The Welsh Ministers have had a power to set fees by regulations under section 40 of the 2016 Act since 2 April 2018, and CIW's registration guidance sets out no fee.

Independent healthcare is registered separately with Healthcare Inspectorate Wales (HIW). HIW registers private dental practices, independent hospitals, independent clinics and independent medical agencies.

Regulator: Care Inspectorate Wales (CIW)
Fees: None set out in CIW registration guidance
Key person: Responsible individual
Initial application: In general up to 14 weeks to process
Responsible individual or registered person application: 6 weeks
Service types: Care homes, domiciliary support, secure accommodation, residential family centres, fostering, adoption, adult placement, advocacy
Independent healthcare: Registered with Healthcare Inspectorate Wales

RQIA Registration Requirements (Northern Ireland)

Which health and social care services must register with the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland, and how to apply.

The Regulation and Quality Improvement Authority (RQIA) registers and inspects health and social care services in Northern Ireland, under the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003. Its inspections are based on minimum care standards. You apply to register through the RQIA web portal.

Regulator: Regulation and Quality Improvement Authority (RQIA)
How to apply: RQIA web portal
Services registered: Adult placement agencies, children's homes, day care settings, domiciliary care agencies, independent clinics, independent hospitals, independent medical agencies, nursing agencies, nursing homes, residential care homes, residential family centres, voluntary adoption agencies
Independent hospitals include: Private dental practices, hospices, cosmetic laser services, refractive eye services, IVF

Professional registration is UK-wide

Individual professionals register with their own regulators, and the registration is valid in every nation. The General Medical Council registers doctors, the Nursing and Midwifery Council registers nurses and midwives, the General Dental Council registers dentists and dental care professionals, and the Health and Care Professions Council registers professions such as physiotherapists, paramedics and radiographers. A doctor on the GMC register can practise in any UK nation without further professional registration.

Legal basis

Primary legislation and key regulations

RISCWA 2016 Primary 2016 · Wales Public Services Reform (Scotland) Act 2010 Primary 2010 · Scotland Health and Social Care Act 2008 Primary 2008 · UK-wide Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003 Primary 2003 · N. Ireland Care Standards Act 2000 Primary 2000 · UK-wide National Health Service (Scotland) Act 1978 Primary 1978 · Scotland The Care Standards Act 2000 and the Children Act 1989 (Abolition of Fees) (Wales) Regulations 2006 Welsh SI 2006 · Wales

Browse UK legislation legislation.gov.uk

Official guidance

Healthcare Improvement Scotland - Regulation of independent healthcare (opens in a new tab)

www.healthcareimprovementscotland.scot · Scotland

RQIA - Register as an independent provider (Northern Ireland) (opens in a new tab)

www.rqia.org.uk · Northern Ireland

Care Inspectorate Wales - Registration (opens in a new tab)

www.careinspectorate.wales · Wales

Care Inspectorate - Registering a service (Scotland) (opens in a new tab)

www.careinspectorate.com · Scotland

Healthcare Improvement Scotland - Registration (opens in a new tab)

www.healthcareimprovementscotland.org · Scotland

Healthcare Improvement Scotland (opens in a new tab)

www.healthcareimprovementscotland.scot · Scotland

Registration (opens in a new tab)

www.cqc.org.uk · England

PVG scheme guidance (mygov.scot) (opens in a new tab)

www.mygov.scot · Scotland

AccessNI criminal record checks (nidirect) (opens in a new tab)

GOV.UK · Northern Ireland

Compare healthcare regulation across the UK nations

Registering in England

Professional registration is UK-wide

Legal basis

Official guidance

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