Register with the Care Quality Commission (CQC)

Step 1: Check if you need to register

Not all healthcare services require CQC registration. The first step is to establish whether your planned activities are 'regulated activities' under the Health and Social Care Act 2008.

Step 2: Understand the costs

CQC does not charge a fee to apply for registration, or to vary it. Once registered, you pay an annual fee, invoiced on the anniversary of your registration.

Step 3: Establish your legal entity

Before you can apply, you must decide on your business structure. CQC accepts applications from:

• Limited companies and other organisations - Most common for healthcare businesses; organisations must appoint a 'nominated individual'
• Partnerships - The partners register together; partnerships do not appoint a nominated individual
• Sole traders - Individuals can register; no nominated individual is required

Most healthcare providers operate as limited companies because this provides liability protection and clearer separation between personal and business responsibilities.

Step 4: Prepare the fit and proper person evidence

This is the most time-consuming part of the application. CQC must be satisfied that all directors, the nominated individual, and the registered manager (if appointed) are 'fit and proper persons' to provide regulated activities.

Step 5: Develop essential policies

CQC will expect to see evidence that you have robust policies and procedures in place before they approve your application. At minimum, you need:

• Safeguarding policy - How you protect vulnerable adults and children from abuse
• Complaints procedure - How service users can raise concerns
• Medication management policy - Safe handling, storage, administration, and disposal of medicines
• Infection prevention and control policy - Including hand hygiene, PPE, and outbreak management
• Health and safety policy - Risk assessments, accident reporting, fire safety
• Recruitment and selection policy - Safe recruitment including DBS checks and references
• Information governance policy - Data protection, confidentiality, records management

These policies must be specific to your service, not generic templates. CQC assesses whether your policies demonstrate you understand the risks specific to your regulated activities.

Step 6: Arrange insurance

You must have appropriate insurance in place before registration. CQC requires evidence of:

• Employers' Liability Insurance - Minimum cover as legally required if you employ anyone
• Public Liability Insurance - Appropriate cover for healthcare services
• Professional Indemnity Insurance - Essential for clinical services, amount varies by service type

Healthcare insurance can be expensive, particularly for higher-risk activities like surgical procedures. Obtain quotes early in your planning process. See the insurance requirements in Step 7 below for minimum amounts.

Step 7: Complete the CQC application

Once you have all evidence gathered, you're ready to apply. The CQC provider portal closed for new registration applications on 18 November 2024 - you apply using downloadable forms submitted by email (the portal is still used for notifications).

Step 8: Respond to CQC queries

CQC will review your application and almost always comes back with requests for additional information or clarification. You have 28 days to respond to any information requests.

Common queries include:

• Requesting updated DBS certificates or clarification on employment gaps
• Asking for more detail on how specific policies will work in practice
• Requesting additional information about premises or equipment
• Asking how you'll meet fundamental standards in specific scenarios

Respond promptly - Failure to respond within 28 days can result in your application being rejected.

Step 9: Registration decision

There is no fixed decision period - the process is rigorous and registration can take a few months.

Possible outcomes:

• Approved - You'll receive your registration certificate and can begin providing regulated activities
• Approved with conditions - Registration granted but with specific restrictions or requirements
• Refused - Application rejected, usually due to concerns about fit and proper person requirements or ability to meet fundamental standards

If refused, you can appeal the decision.

After registration: What happens next

Once registered, your obligations are ongoing:

• Display your rating - You must display your CQC rating at your premises and on your website within 21 calendar days of its publication
• Pay annual fees - Invoiced each year on the anniversary of your registration, based on your service size and type
• Submit notifications - Tell CQC about specific events (deaths, serious injuries, safeguarding incidents, staffing changes)
• Meet fundamental standards - Maintain compliance with all regulations
• Prepare for inspections - CQC will inspect your service and publish a rating

Enforcement and penalties

CQC has significant enforcement powers. It's crucial you understand the consequences of non-compliance:

Geographic variations: Devolved nations

CQC only regulates health and social care in England. If you operate in Scotland, Wales, or Northern Ireland, different regulators apply:

Get help with your application

CQC offers support to help you through the registration process: