Enforcement: NHS trusts

Page last updated: 12 May 2022
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If the care you provide harms people or puts people at risk of harm, we can take enforcement action to protect them.

We do this so that you make improvements to prevent any further harm or risk of harm. If the improvements you need to make are small and low risk we may work with you without taking enforcement action.

If you provide poor quality care you may be committing an offence. If you do commit an offence we can take criminal enforcement action to hold you to account. Our guidance on the regulations helps you to understand the level of care that people should receive.

If the level of care falls below this and people are harmed or put at risk, you may be committing an offence and we may take criminal enforcement action.

Types of enforcement action

The type of enforcement action we can take will depend on whether we are protecting people or holding you to account:

  • we will take civil enforcement action to protect people
  • to hold you to account we will take criminal enforcement action if you fail to meet prosecutable fundamental standards

Our enforcement policy describes this in more detail.

Deciding which enforcement action to take

This will depend on a number of factors including:

  • the level of harm or risk that has occurred
  • the actions you have taken to prevent harm from happening again
  • the quality of care you have provided previously
  • whether you have had any enforcement action taken against you before
  • in respect of criminal enforcement, in accordance with the Code for Crown Prosecutors

Our enforcement policy and enforcement decision tree explain in more detail how and when we take enforcement action.

Following up enforcement action

We will inspect your services to check whether you have made the changes needed to improve. If you have not made the necessary changes we can take more severe enforcement action. In serious cases we can cancel your registration so you can no longer provide care.

Offences

Certain regulations have offences attached to them. This means that if you breach the regulation, it can amount to an offence and CQC can consider prosecution as part of our enforcement action.

The offences and our powers to prosecute are set out in the following legislation:

Our enforcement policy details the fixed penalties and fines payable for offences.

For the regulations where we cannot prosecute, we can use other regulatory actions, which are set out in our enforcement policy.