The Care Quality Commission checks whether hospitals, care homes and care services are meeting government standards. Visit our website at www.cqc.org.uk.
Applying to be a registered manager
As you may be aware, GPs and other primary medical services must now register with CQC. As part of the registration process, most providers need to appoint one or more people to the role of registered manager.
If you’ve been asked to be a registered manager, you can read more about the role and what it means to you and the provider below.
What is a registered manager?
A registered manager is the person who’ll be in day-to-day charge of the regulated activities carried out by the provider.
They’ll be legally responsible, with the provider, for ensuring compliance with the essential standards of quality and safety.
Who should be appointed to this role?
The practice manager shouldn't necessarily be the registered manager.
Some practice managers may be suitable for the role of registered manager. However, in most cases a partner (clinical or business) will be more appropriate.
Since registered managers share legal responsibility for compliance with the provider (e.g. the GP partnership) they need to be able to influence compliance with the essential standards.
Sally is the practice manager for a practice that has three GP partners.
Sally has been appointed the person at their practice who’ll complete the main registration application form and gather all the information from the partners required for the form.
In her practice, Sally manages the day-to-day running of the practice – including things like human resources, information technology and financial management. However, it's the partners who manage how the regulated activities are carried out. They're responsible for making sure that the services provided in the practice are safe and that there is good-quality care provided in line with the essential standards.
For example, when delivering the regulated activity relating to diagnostics and screening, it's the partners who are responsible for ensuring that patients receive this care in a clean environment that meets infection control guidelines (essential standard: outcome 8) and that the equipment used is safe (essential standard: outcome 11).
Therefore – in this scenario – it's one of the partners who should be the registered manager, not Sally.
As a partner, Bob is jointly responsible with two other partners for the day-to-day management of the care that's delivered at the practice. As such, he's in a position to take legal accountability for the overall quality and safety of the service and he's able to influence and ensure compliance with the essential standards.
This means Bob is a suitable candidate to take on the role of registered manager.
For example, as the registered manager for the regulated activity of maternity and midwifery services (and in his role as partner in the practice) Bob can ensure the activity is delivered in a way that meets the essential standards, including making sure that people are safeguarded from abuse (essential standard: outcome 7) and that the medicines involved in the care are managed appropriately (essential standard: outcome 9).
Janine is part of the senior management team of the limited company, which runs two walk-in centres. She's already responsible for monitoring the quality of the services in both walk-in centres and for ensuring their compliance with existing legislation and best-practice guidance. As such, she's in a position to take legal accountability for the overall quality and safety of the service and is able to influence and ensure compliance with the essential standards across both walk-in centres.
Therefore Janine wold be an appropriate person to take on the role of registered manager.
For example, as the registered manager for the regulated activity of Treatment of Disease, Disorder and Injury (and in her role as clinical director) Janine can make sure the activity is delivered in a way that meets the essential standards, including ensuring the care and welfare of people who use services (essential standard: outcome 4) and assessing and monitoring the quality of service provision (essential standard: outcome 16).
Andrew job shares his role with Katie and works Monday, Wednesday and Friday. Katie takes on the role on Tuesday and Thursday.
Within their practice, Andrew’s and Katie’s position has been identified as the most appropriate role to be given the responsibility of registered manager for the regulated activity of ‘Treatment, Disease, Disorder and Injury’. Together, with the care provider, they share the legal responsibility of ensuring they are compliant with the essential standards for that activity.
In the registered manager section of the registration application form they will tick the ‘job share’ option, and both will be able to be identified as the registered manager for that activity.
What should you do now?
If you agree to be a registered manager for your organisation, you’ll need to register with CQC.
If you're not willing to be the registered manager for the regulated activities you've been asked to take responsibility for, you shouldn't fill out the form.
In order to register with us, you will need to fill out the application form. You can download this and find more guidance at the page below.
If you don't want to take on the responsibilities of being a registered manager, you should discuss with your line manager whether someone else would be more appropriate for the role.
CQC's role is to ensure that all providers meet the standards of quality and safety so that staff and patients are not put at risk.
To fulfil this role, we need to know who's responsible for the day-to-day management of the regulated activities the provider carries out. The registered manager role is required in the Health and Social Care Act (2008).
As a registered manager you have legal liability – shared with the provider – for the overall quality and safety of the activities the provider carries out.
As a registered manager, you must be in a position where you're able to influence and ensure compliance with the essential standards.
Your responsibility as a registered manager with CQC is limited to the specific regulated activities at the specific locations included in your registered manager application.
What happens if you don't comply with the legal requirements?
If we find that a registered manager is in breach of the regulations, we take action to make sure they improve.
We have a wide range of enforcement powers, such as issuing warning notices or, in more serious circumstances, we can fine or prosecute the registered manager.
The registered manager form asks you to supply your contact details and your GMC number (if you have one). You’ll also need to confirm that you accept the responsibilities of being a registered manager and that you’re fit for the role.
It's important that you understand the responsibilities you're accepting so you should read more about the essential standards and regulated activities in the sections below.
What if you don’t have a GMC number?
It’s not a problem if you don’t have a GMC number, but you’ll need to get a CQC-countersigned, enhanced CRB check instead.
If you need a CRB check, you should apply for it a couple of months before you need to submit your application form. You’ll see the submission dates in your invitation email to be a registered manager.
Read more about how to apply for a CQC-countersigned, enhanced CRB check.
A provider registering with CQC must declare their compliance with the essential standards for each location they manage or provide regulated activities from.
The standards can help you decide if you're compliant with the regulations as they focus on patient outcomes and describe the levels of quality and safety that patients should expect if you're compliant with the regulations.
The standards are CQC's interpretation of the regulations from the Health and Social Care Act 2008 relating to the quality and safety of care.
Read more about the Essential standards.
A 'regulated activity' is an activity related to care and treatment that requires registration with CQC.
It may be helpful to think of these as reflecting the services you provide.
Your responsibilities as a registered manager will be specific to selected regulated activities at particular locations.
Other registered managers may be appointed to cover the rest of the regulated activities and/or locations.
The five most common regulated activities for GP practices are:
- Treatment of disease, disorder and injury.
- Surgical procedures.
- Diagnostic and screening procedures.
- Maternity and midwifery services.
- Family planning services.
As part of the provider's registration application with CQC, we'll assess if the registered managers are fit for the role and able to uphold the standards of quality and safety for the regulated activities they're responsible for.
We'll base our assessment on the information you provide in your application and references from other sources. We will also conduct an interview with the registered manager before deciding on their application.