The Health and Social Care Act 2008 (the Act) stipulates that any provider of 'regulated activities', including the NHS, must be registered with the Care Quality Commission (CQC) in order to legally provide services.
Under the new system, NHS trusts need to show that they comply with legally enforceable essential standards of quality and safety (registration requirements), set out in the Act.
As well as applying to NHS providers and independent sector providers already registered with the Healthcare Commission under the Care Standards Act, the new registration system applies to some new types of services not currently regulated. These include private ambulance services, and primary medical and dental services.
The new registration system signals a move away from ‘snap shot evaluation’ - for example the Annual Health Check - and instead places an emphasis on ongoing compliance. It is designed to provide a more rigorous method of monitoring and should help to ensure greater consistency and higher standards in the quality of care.
NHS Confederation support for members
The NHS Confederation is committed to supporting member organisations as they prepare for and get used to the new registration system.
Guidance
We produced Guidance in November 2009 to help NHS trusts, including PCT providers, to begin to consider the new statutory registration requirements. The guidance also sets out how the requirements relate to the Standards for Better Health.
Our Future registration framework for health and social care briefing (published May 2008) summarised the main proposals and implications of the new registration system.
See also:
Timetable for registration
Draft regulations on the scope of registration and registration requirements
Demonstrating compliance
Registration fees
See the CQC website for guidance on the application process, including information about adding or removing regulated activities from applications already submitted.
Member survey
The NHS Confederation surveyed its membership between 12 March and 9 April to gain a picture of how NHS trusts had experienced the initial registration process. We received a total of 62 responses to the survey. The Confederation intends to share the results with the CQC to help shape our discussions about the future of both the registration process and regulation of health care more broadly. A summary report of the survey findings is now available for members.
FAQs
We have complied a list of FAQs to respond to the range of questions and queries that we have received from our members about the new registration process.
If you have a specific question or query about the new registration system, you can email registration@nhsconfed.org and we will endeavour to respond within ten working days.
Engaging with the CQC
At our meeting with the chair, chief executive and other senior CQC figures on 8 April 2010 the discussion focused on the new registration system, specifically how the CQC could better support trusts with the move to demonstrating ongoing compliance with essential standards.
Concerns were raised at the meeting about the fees for 2010/11, felt to be particularly onerous for small providers, and we agreed to liaise with the CQC on development of the fee system for 2011/12.
Other topics discussed included quality assessments and periodic reviews, and a general discussion about the future of healthcare regulation.
We are working to ensure that the CQC is effectively engaging with the full spectrum of NHS organisations on the issue of regulation and have facilitated a number of opportunities for our members to meet with CQC representatives.
- October - Cynthia Bower, CQC chief executive, attended our Foundation Trust Network (FTN) chairs and chief executives meeting
- November - Anthony Dreary, CQC head of mental health operations, attended FTNs Mental Health Group Meeting
- November - Andy Cook, CQC representative, attended our PCT provider forum
- December - Julie Inggs, CQC representative, attended FTNs company secretaries meeting
- March 2010 - Linda Hutchinson, CQC director of regulation, attended FTNs Mental Health Group meeting
We are also arranging CQC representatives to attend upcoming meetings with our NHS Partners Network and Ambulance Service Network.
In addition, we have secured seats for a number of our members on the CQC Provider Advisory Committee.
NHS Confederation viewpoint
We support the key principles of the new registration system, namely:
- a single registration framework based on essential standards of safety and quality that apply consistently to all providers of health and adult social care
- registration based on activities and services provided
- use of more patient-focused outcomes as the basis for assessing compliance.
However, we are concerned that some high risk services will not be covered by registration. In particular, services provided by or under the supervision of psychologists or psychotherapists for the treatment of mental disorder will not automatically come within registration. We believe that some registration requirements and the expected outcomes outlined in the guidance require further definition to provide a workable framework for providers.