Regulation of health and social care in England is changing. The Health and Social Care Act 2008 establishes a new single regulator, the Care Quality Commission (CQC), and a unified regulatory regime for all providers of health and adult social care.

The CQC will be responsible for regulating the quality of health and adult social care in England. It takes over the functions of the Healthcare Commission, the Commission for Social Care Inspection (CSCI) and the Mental Health Act Commission (MHAC).

The new regulator is already starting to take shape and becomes a legal entity in October 2008. It takes up its responsibilities for the quality of health and social care in April 2009, operating the current systems inherited from its predecessor bodies.

The new registration system will come into force in April 2010. However, from April 2009, the CQC will assess NHS organisations on their compliance with standards relating to healthcare associated infections.

From 2010, all providers of defined health and social care activities will be required to register with the Care Quality Commission. It will be illegal for any body not registered with the CQC to provide any health and adult social care service that comes within the scope of registration.

Registration with the CQC will depend on compliance with legally enforceable essential standards of quality and safety, known as registration requirements. All providers, NHS, private and voluntary sector, will be required to meet these standards. The proposals will also require primary medical and dental care services to register with the CQC.

The Department of Health has consulted on the framework for registration including:

• The scope of registration i.e. which services or activities will require CQC registration
• The topics for the registration requirements
• How and when primary care can be brought within the scope of regulation.
• Our briefing summarises the key points of the consultation.

The NHS Confederation's response to the consultation can be found on this page. We support the establishment of a single registration framework based on essential standards of safety and quality that apply consistently to all providers of health and adult social care. We generally agree with the suggested generic list of registration requirements outlined but suggest some need clarification or more detailed definition.

We support the principle of registration based on activities and services provided. However, we are concerned that some of the current definitions of services requiring registration excludes some high-risk activities and believe that some definitions require clarification. We strongly support inclusion of primary medical and dental services within the scope of regulation.