Registering an independent hospital or clinic with CQC: a step-by-step guide

Step 1 — Decide your regulated activities

Independent hospitals and clinics typically register for treatment of disease, disorder or injury, surgical procedures and diagnostic and screening procedures. Add maternity and midwifery services, termination of pregnancies, management of supply of blood and blood-derived products or assessment or medical treatment for persons detained under the Mental Health Act only where you will actually provide them. Every activity needs its own evidence of competence, equipment and governance, so do not over-register.

Step 2 — Fit and proper persons

You need a registered manager for each location and a nominated individual for the provider. Both are interviewed. Directors are subject to the fit and proper person requirement (Regulation 5): DBS, references, employment history, financial standing and evidence of good character. Start these checks early — they are the most common cause of delay.

Step 3 — Statement of Purpose

Map every service line to a regulated activity, describe the patient pathway, the staffing model, the clinical governance structure and how you will meet the fundamental standards. Keep it accurate: it is the document inspectors test you against.

Step 4 — Governance before go-live

CQC will expect to see, before registration:

• A clinical governance framework — quality committee, medical advisory committee, risk register and audit programme.
• Practising privileges policy for consultants working under practising privileges: scope of practice, appraisal, revalidation, indemnity and annual review.
• Surgical safety — WHO checklist, theatre governance, sterile services or decontamination arrangements, implant tracking.
• Medicines — controlled drugs accountable officer, prescribing and administration, medical gases.
• Resuscitation, sepsis and deteriorating patient pathways with escalation and transfer arrangements to an NHS acute trust.
• Safeguarding adults and children, consent and mental capacity, chaperoning.
• Incidents, never events, duty of candour and notifications to CQC.
• Information governance — Caldicott guardian, DSPT, records retention.

Step 5 — Premises and equipment

Expect questions on HTM-compliant ventilation in theatres, water safety, medical device management, radiation protection (if imaging) and fire safety. Have the commissioning reports and maintenance contracts ready.

Step 6 — The registration visit and interview

The registered manager interview covers your understanding of the five key questions and the healthcare quality statements, how you assure the quality of consultants' practice, how you would handle a never event or a deteriorating patient, and how the board hears the patient voice. Rehearse it with the CQC GP & Hospital mock interview.

Timeline

Allow 10–14 weeks from a complete application, longer if the fit-person checks or premises evidence are incomplete. The Complete GP & Independent Hospital Policy & Procedure Package gives you the governance document set; the AI Compliance Assistant can help map your service list to regulated activities and, if needed, connect you to a specialist.