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Joint licensing and registration: Help with the form

Categories:
  • Organisations we regulate

This page contains help with the form for new providers of NHS health care services applying for registration with us and Monitor's provider licence at the same time.

Section one: Application details

1.1 Provider name and contact details

Organisation’s name

This is the legal name of the organisation registered at Companies House, with the Charities Commission, or shown in legal documents, as appropriate.

Name you trade under

If your organisation trades under a different name please include it here.

Address

This is a key piece of information about you. It must be completed in full (without any abbreviations etc) and in the format indicated in the specific boxes (for example, do not put the 'Town/City' in the 'Address' lines; do not include the 'County' in the 'Town/City' line etc).

For the purposes of CQC registration, the postal address you enter must be an address in England and must not be a PO Box number.

This is the address we will use for service of documents in accordance with sections 93 and 94 of the Health and Social Care Act 2008 and, where applicable, section 149 of the Health and Social Care Act 2012 (if you do not agree to service by email).

If you can't provide an English address, please contact us.

We will publish this address as the organisation's contact details on our websites and on your certificate of registration and the licence. We will also use this address for sending other correspondence by post, including draft and final inspection reports (if you do not agree to receive it by email).

Email address

We will use the email address you include here to send you formal legal notices and other documents, unless you tick the box on page 11 of the form indicating you don't wish to receive these types of correspondence in this manner. (There may be some occasions where we will need to post formal notices to you).

Website/Main business telephone

Please provide these helpful basic items of information (you must provide your main business telephone number).

Legal status of the provider

Select which description applies to your organisation. If an appropriate description is not shown, please select 'Other' and give further details below.

If you select 'Other' You should provide details of the legal status of your organisation if you have entered 'Other'.

Company/charity number

Companies or charities must provide their company and/or charity number.

Other number

If you have any other number please insert here and provide an explanation of what it is.

1.2 Alternative temporary address

You can supply alternative temporary contact details in Section 1.2 if this would be helpful. We will only use these details while processing this application. We will not use this address or any alternative temporary email address for service of documents or for other correspondence.

For an NHS provider licence, the email address provided in 1.1 will be used for all notifications, unless you have ticked the box above.

1.3 Invoice and financial details

If your invoice and financial contact details are different from the address provided at sections 1.1/1.2, please fill in the relevant address and contact details. This will ensure the CQC are able to contact you when required.

Where this is not the case move on to Section 1.4.

1.4 Financial interests in registered services

If your organisation has any current financial or business interests in a registered provider, or if a registered provider has any current financial or business interests in your organisation please check the ‘Yes’ box and fill in the details of these. Please include their CQC numbers (as shown on their certificates of registration).

1.5 Essential business relationships

If carrying on the regulated activities proposed in this application will depend upon formal contractual relationships with any other service provider(s), please tick or check the ‘Yes’ box and fill in the details in the space provided.

1.6 Financial year end information

We require certain information about the way you maintain your financial records. This is to assist us with our ongoing monitoring of CQC registered organisations and NHS provider licence holders.

1.7 Insolvency processes

If any of the below applies to people in your application you must check or tick the 'Yes' box and provide the dates and details of the processes involved. Where this is the case we may contact you for more information about this.

If your organisation or (where applicable) its parent holding company or companies) has ever been in administration or receivership, or subject to any other insolvency process(es). This includes any current unresolved processes or proceedings.

Part A: CQC registration

1.1 Subsidiary organisations

If your organisation is a subsidiary of another main holding company, please check or tick ‘Yes’ and provide its contact details in the appropriate parts of Section 1.1. Where this is not applicable, please move on to Section 1.3.

1.2 More information about parent/subsidiary companies

Where your organisation is the subsidiary of a holding company or companies please provide information about their name(s) and company number(s) in the Section 1.2 text box. In addition if your organisation is a parent company please provide information about its subsidiaries.

Please explain the relationships between the applicant organisation and the other organisations involved and their structure of ownership. Please include information about the wider ownership structure where the holding company is itself the subsidiary of another company or companies.

Where this is not applicable, please move on to Section 1.4.

1.3 Nominated Individuals

Where you are asked for your name please use your legal name as stated in your legal documents.

Nominated individuals are persons ‘employed as director, manager or secretary of the body (who are) responsible for supervising the management of the carrying on of the regulated activity’ (Regulation 15(3), the Care Quality Commission (Registration) Regulations 2009).

Use this section (and any additional sections that are required) to provide details of the person(s) who will act as the nominated individual(s) for each of the regulated activities you are applying to carry on in this application.

One person can act as nominated individual for more than one regulated activity.

In certain circumstances, registered managers can act as nominated individuals, normally where the organisation is small.

If you plan to have more than one nominated individual, you must download additional sections from the website page where you found this application form and guidance. If you don't identify a nominated individual for each regulated activity, we will have to return your application.

Please put appropriate numbers into the part of the nominated individual section reproduced below. We will use this information to check that you have sent us details for all of the nominated individuals you need in your application.

Details of a nominated individual for regulated activities

Enter the regulated activities the nominated individual will cover and then their personal details, as requested in the form. You must identify a nominated individual for each of the regulated activities you select in Section 2.

Check or tick ‘Yes’ or ‘No’ as appropriate to show whether you have received an enhanced DBS disclosure certificate for the proposed nominated individual. The law requires you to have this, and if you have not done so we will have to return your application.

Fill in the DBS disclosure certificate number and the date the certificate was issued.

1.4 Disciplinary proceedings

Check or tick ‘Yes’ if any nominated individuals proposed in section(s) 1.3 are subject to any disciplinary action, current proceedings, investigations or restrictions or bars on activity by a health or care professional regulator or the Disclosure and Barring Service.

Relevant health and care professional regulators include the General Medical Council, the Health and Care Professions Council, the General Dental Council and the Nursing and Midwifery Council.

If whilst the proposed nominated individual has been working in a health and social care setting (in any role) has been investigated due to safeguarding concerns then the ‘yes’ box should be ticked or checked.

Where you tick or check ‘Yes’, please provide summary details in the box provided. We may contact you for more information about this. Where this is not the case, tick or check ‘No’ and move on to Section 1.6.

1.5 Previous registration history

If your organisation, any parent organisation or subsidiary, or any of its directors (or equivalent) has ever been registered or licensed under any of the Acts of Parliament listed in this section, please check or tick the appropriate box or boxes. Please also explain the circumstances and dates in the box provided.

We may contact you for more information about this.

2.1 Purchase or transfer of locations

If your application involves buying or otherwise taking over a service or location(s) being run by an existing registered provider, it is important that CQC knows about this.

Where this is the case, please check the ‘Yes’ box and provide the requested details in this section.

We also ask that you check the box if you do not agree to us discussing your application with the existing provider. If you do this, we will need to talk to you about it.

CQC must also receive and process relevant applications from the existing provider(s) and manager(s), as well as from your organisation and proposed new managers. These applications must be processed in the right order, therefore it is essential to have coordination and cooperation between CQC, your organisation and the existing provider to achieve this.

2.2 - 2.14 Additional locations

If you are applying to provide regulated activities at more than one location, you can download additional location sections from the website page where you found the main form.

If you are filling in this form on paper and need extra space, please add extra numbered sheets as needed, and mark them with the question number from this form.

Please give each location a number in the same way as you did for nominated individuals, so that we know you have sent us information about all of your locations.

You must check or tick the boxes for the services you will provide at each location you are registering. The service types you declare should match the description of your service in your statement of purpose.

If you don’t give us information about all of your locations we will have to return your application.

2.2 Location details

CQC location ID

If this location is already being used by an existing registered provider to carry on regulated activities, please enter its CQC location ID number. You can find this on the existing provider’s certificate of registration. Leave this question blank if it does not have a CQC location ID number.

No of places or beds

Fill in the number of people who will use the service at this location.

It is important for care home providers to record the number of overnight beds/places at this location as CQC makes it a condition of registration for care homes.

For providers of care homes, residential substance misuse services, and specialist college services we will also need this information to calculate the annual fee payable to CQC for your registration.

For specialist college services, please state the number of beds at this location used to accommodate students receiving education who also require nursing or personal care, rather than the total number of beds.

For residential substance misuse services, please state the number of beds at this location where the accommodation is provided together with treatment for substance misuse, and it is provided in a residential setting rather than a hospital or in the community.

Where we cannot agree the number you propose in this box, we will contact you about this.

Day-to-day management

Please note that, where required, applications for registration from proposed managers for this location, including from existing managers to continue their registration to manage it under your registration, must be submitted with your application.

2.3 - 2.7 Planning, building, food, equipment and landlord details

Please check / tick the appropriate boxes to confirm whether the permissions, certificates registrations and authorisations referred to in questions 2.3 to 2.7 have been obtained (or to show that they are not applicable or not yet received) in relation to the location.

Planning consent; the Local Planning Authority (LPA), will grant planning permission through a Decision Note identifying what needs to do to satisfy planning requirements. Not all decisions will have to be completed before a provider can commence its business, but there should be documentary evidence from the LPA to evidence that they are satisfied the building can commence business.

Building regulations; Approval is required under building regulations to change the use of a property for business or institutional purposes (for example, a hospital, a nursing home, or a home for caring for elderly people or children). A building regulations completion certificate will be issued by either a Local Authority Building Control (LABC) or Approved Inspector Building Control (AIBC).

You should select 'Yes' or 'No' as needed to show whether you have maintenance contracts in relation to all the equipment, plant and utilities you own, lease or use – or will own, lease or use – in relation to providing your service at this location.

If 'No', please describe the equipment, plant and utilities not covered by maintenance contracts and how you will ensure that servicing and repairs are undertaken in a timely and prompt way, as required by their manufacturer's instructions.

CQC must be confident that you are providing your service lawfully, and that services to people will not be disrupted by difficulties over essential permissions and legally required authorisations.

2.8 Location readiness

Check or tick 'Yes' or 'No' as needed to show whether the location's premises are ready for use to provide the regulated activities and services you have proposed in your application.

It takes CQC up to eight weeks to process most applications, sometimes more. You must not begin to provide regulated activity(s) until you are registered to do so. Equally, you should not submit applications until you are ready to provide your proposed service, or very nearly so.

This is because by law, CQC can only register providers that we are confident will comply with the Act and regulations. We will not be able to assess whether the Act and regulations are likely to be complied with in certain circumstances, these could include:

  • Where there are substantial outstanding building works
  • Where essential equipment, staff or other resources are not yet available
  • Where the systems, procedures and policies that will be needed are not in place.

We recognise that new providers may not be able to demonstrate actual compliance with all requirements as they are not yet providing the service. Because of this we assess whether the 'inputs' and 'processes' applicants have put in place are likely to enable them to comply with the Act and regulations, and deliver the 'outcomes' described in the 'Guidance about Compliance: Essential standards of quality and safety'.

These essential inputs and processes must therefore be ready for us to assess before you apply for registration.

Please provide the date when you plan to begin carrying on the regulated activities in this application.

You must ensure that all required certificates, registrations and permissions referred to in the guidance to Sections 2.3 to 2.6 above are available or very shortly will be before you apply for registration.

2.9 Regulated activities at this location

Please check / tick all of the regulated activities you want to carry on at this location.

If you propose to carry on the regulated activity ‘Accommodation for persons who require nursing or personal care’ you must also fill in Section 2.11 of the form, but make sure you read the guidance to Section 2.11 carefully before you do so.

For each regulated activity you are wanting to carry on at a location please provide an explanation. The explanation should tell us what service you are providing at the location.

2.10 Service types at this location

The service types you select are used to calculate your annual fee so it is important to select only those that apply to each location included in your application.

Before you fill in this section you are strongly advised to read the detailed guidance about service types that can be found on pages 13 to 31 of the Guidance about compliance: Essential standards of quality and safety.

You should also read our guidance for providers about fees before completing the rest of Section 4.

Acute Services (ACS)

If you have ticked this service type, this will place you into the 'Healthcare, Hospitals' fee category, meaning that you will be charged the fee associated with the hospitals charging bands under our fees scheme.

However, if you have ticked this service type, but the only, or main, activity provided at this location is one of those listed in the boxes in the form, you should also tick the relevant box. Selecting one of these boxes will place you in the Single-speciality services charging bands of the fees scheme.

If you provide other services at this location as well as Acute Services (ACS), or more than one of the activities in the list at this location, do not complete the boxes in the list.

Dental services (DEN)

If you have only one location and you provide dental services, we require information about the number of dental chairs you have at the location. This is so we can correctly calculate your annual fee, which, for single-location dental providers, is based on the number of dental chairs at the location. A dental chair is defined as 'a chair that is used for the purposes of carrying on the regulated activity of dental services'.

If you are a provider of domiciliary dental services, providing services in places such as people’s homes or care homes, and you do not have dental chairs of your own, please enter ‘0’ as the number of chairs. This will place you in the lowest fee band in the single location part of the fees scheme for dental providers.

If you are registering for more than one location, please do not complete this box.

Diagnostic and screening services (DSS)

You should only have ticked the service type of DSS if diagnostic and/or screening services are the sole or main activity you provide at this location. Please refer to page 22 of the Guidance about compliance: Essential standards of quality and safety.

You should not select this service type if you provide other services at this location, even if you are registering for, or are already registered for the regulated activity of Diagnostic and screening procedures.

Check or tick all of the service types listed in this section that will be provided at this location.

2.10 - 2.13 Agreeing to routine conditions

Agreeing 'in writing' to routine conditions of registration can significantly reduce the time needed for CQC to process your application. We will accept a check or tick in the relevant boxes to show that you have agreed 'in writing' to these conditions.

Where you do not agree to the 'numbers condition' or the 'no nursing condition' in respect of relevant locations, or to a 'locations condition', we will make a judgement about whether to approve your application with or without conditions of registration. Where we decide to propose conditions we will do so in formal Notices of Proposal under Section 26 of the Health and Social Care Act 2008.

Where you do not agree to conditions of registration in a Notice of Proposal you are able to make representations to us about them, and also to formally appeal to an independent tribunal if we decide to adopt our Notice of Proposal.

2.11 Condition: Number of people receiving nursing or personal care

Only check or tick the box in this Section if you checked / ticked ‘Accommodation for persons who require nursing or personal care’ at section 2.9 above and either 'Care home service without nursing' or 'Care home service with nursing' at Section 2.10. If you did not do so please go straight to Section 2.13.

CQC routinely agrees a condition of registration with providers of this regulated activity about the number of people who can be accommodated at each relevant location. This condition is called the 'numbers condition'.

The numbers condition says: "The number of persons accommodated to receive nursing or personal care at this location must not exceed [number]."

CQC will contact you if we decide we cannot agree to your proposed number for this condition.

Please tick the box in Section 2.10 to show that you agree to the 'numbers condition', using the number you proposed in Section 2.2. You must do this in the application form location sections for each location that will provide 'Accommodation for persons who require nursing or personal care'.

If you did not tick the 'Care home service without nursing (CHS)' at section 2.10, please now go straight to Section 2.13.

2.12 Condition: Not providing nursing care

Only check / tick the box in this section if you checked / ticked ‘Accommodation for persons who require nursing or personal care’ at section 2.9 above AND ‘Care home service without nursing (CHS)’ at section 2.11 above. If you did not do so please go straight to section 2.13.

CQC routinely agrees a condition of registration with providers of the regulated activity ‘Accommodation for persons who require nursing or personal care’ who also check / tick the ‘Care home service without nursing’ (CHS) service type at Section 2.11.

The condition makes it a legal requirement that that they must not provide nursing care at the relevant location(s). This condition is called the 'no nursing condition'.

The no nursing condition says: "The provider must not provide nursing care under the accommodation for persons who require nursing or personal care regulated activity at this location."

Please tick the box in Section 2.12 to show that you agree to the 'no nursing condition'. You must do this in the application form location sections for each location that will provide a care home service without nursing.

2.13 Condition: Regulated activities at the locations

CQC routinely agrees conditions of registration with providers about the locations where each regulated activity will be carried on at or from. This condition is called 'location condition'.

The locations condition says: "This Regulated Activity may only be carried on at or from the following locations: [list of locations]."

The locations in this condition will be those specified in each version of Section 2 submitted with this application. The regulated activities will be the ones you specified in each Section 2.9.

Please tick the box in this section to confirm that you agree in writing to this condition of registration.

2.14 Service user bands

Please check or tick as needed to show any additional characteristics the people who use your service at this location may have.

2.15 Checklist

Use the checklist in this section to confirm that you could provide the information the law says must be available on request by CQC.

3.1 - 3.5 Are your services safe, effective, caring, responsive and well led?

Use this section to answer the questions to describe how you will provide your service. The questions asked are the five key questions CQC now asks about providers and the services they deliver. However, as described in the guidance to Section 6, we need to feel confident that the inputs, processes and evidence you describe in this section will comply with the Act and regulations, and provide the outcomes described in the Guidance about compliance: Essential standards of quality and safety. If you are completing this by hand please use additional paper as necessary.

We need to know that there is evidence to support your answer to this section. Please describe the evidence you have to support each answer, and where it can be found.

Your evidence could include relevant policies, procedures, processes, contracts, and staff induction and training arrangements. Evidence must be directly relevant to the topic, and help us to assess whether you are or will be compliant with the relevant regulations.

You should cross-refer to answers in other parts of the form where relevant.

Your answers should satisfy us that the five key questions we ask about providers and their services are going to be addressed:

  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well led?

In answering these questions it is important that you are able to demonstrate how the requirements of the Health and Social Care Act 2008, and associated regulations will be met. In particular the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009.

Part B: NHS Provider Licence (issued by Monitor)

1.1.1 Providing services through a CCG or NHS England contract

The 2012 Act requires every provider which provides a health care service for the purposes of the NHS to hold a licence unless they are exempt. You can be a provider of health care services for the purposes of the NHS if you provide services as a contractor commissioned directly by a Clinical Commissioning Group (CCG) or NHS England.

This also applies if you provide services as a subcontractor. Please let us know if you provide services directly through arrangements with a CCG, or NHS England, or if you provide services as a subcontractor. For guidance on what it means to be a provider of NHS health care services, please see the Exemptions guidance.

1.1.1.1 Providing services through a multi-party CCG or NHS England contract

In this question, we ask you whether you are providing NHS health care services through a contract with Clinical Commissioning Groups and/or NHS England when there may be one or more other providers who are a party to that contract.

1.1.2 Providing services through an arrangement with another provider

NHS health care services can be provided through an arrangement with another provider. If you provide health care services through an arrangement with another provider, such as subcontracted services, you need to consider if you are required to hold a licence independently.

For information on the definition of a provider for the purposes of working out if you may be required to hold a licence, please refer to the Exemptions guidance.

2 Licence exemptions

In this section, we ask for information which will allow us to assess whether or not you might be exempt.

If you submit an application, and we assess, based on the information provided, that you are exempt from the requirement to hold a licence, we will not consider your application further. In some circumstances, we may contact an applicant to state that we are unable to consider the application.

This could be because the answers given under Part B Section 2 of the application demonstrate that the provider is exempt, or because of inconsistencies within the application. An applicant will be advised as to how to proceed if this is the case.

It remains the provider’s responsibility to ensure compliance with all the legal rules of the licensing regime, including compliance with the requirement to hold a licence if applicable. If you fail to obtain a licence when you are required to do so, you will be acting in breach of legal rules and you could be subject to enforcement action including, potentially, a fine.

Assessing if an exemption applies

The exemptions to the requirement to hold a licence are explained in the Exemptions Guidance. It is the responsibility of providers, taking independent advice if necessary, to check if a licence is required in their particular circumstances. Monitor can take enforcement action as described above against providers who do not hold a licence when required to do so.

The following are NOT required to hold a licence:

  • NHS trusts
  • Providers who are not required to register with the CQC
  • Providers of primary medical and dental services
  • Providers of NHS continuing health care and NHS-funded nursing care
  • Small providers of NHS health care services, whose annual applicable turnover from the provision of NHS services is less than £10 million.

However, all providers of Commissioner Requested Services will be required to hold a licence, even if they are otherwise exempt.

If you cease to qualify for an exemption, you must obtain a licence. For guidance on the time frame which applies when an exemption ceases to be available, see the Exemptions guidance.

The exemptions to the requirement to hold a licence as set out below. For guidance to help you work through the exemptions and assess whether you are exempt, or will need to apply for a licence, please see the Exemptions guidance.

2.1 Health care categories

Providers of nursing care, defined as providing either NHS continuing health care and NHS-funded nursing care, will not be required to hold a licence.

This exemption is set to expire on 31 March 2015. Before that point, the Department of Health will review the exemption and determine whether it should continue.

For guidance which will assist you in understanding whether you are a provider of NHS primary medical or dental services, NHS continuing health care or NHS-funded nursing care, please see the Exemptions guidance.

In Question 2.1, we ask you to tell us whether all the health care services you provide for the purposes of the NHS fall under one or more of the following categories:

  • Primary medical and dental services
  • NHS continuing health care
  • NHS-funded nursing care.

If all the health care services you provide for the NHS fall under one or more of these categories, please state 'Yes'. Otherwise, please state 'No', for example, if you provide additional health care services for the NHS to those listed above, or if none of the health care services you provide for the NHS fall under one or more of those categories.

2.2 Turnover of £10 million or more

Providers are exempt if their annual applicable turnover from the provision of NHS services is less than £10 million. To qualify for this exemption, the provider’s applicable turnover for the last business year in which turnover figures are available, must be less than, or reasonably expected to be less than, £10 million. For guidance on the definition of applicable turnover, please see the Exemptions guidance.

In particular, please note that the applicable turnover excludes turnover from:

  • Primary medical services
  • Primary dental services
  • NHS continuing health care
  • NHS funded nursing care

For applicants that are organisations, the applicant will be deemed to be aware that it no longer meets the criteria for this exemption on the day that its accounts for the relevant business year are signed. The exemption will be withdrawn 60 days from that date. You will need to apply and obtain a licence from us within the 60 days.

2.3 Commissioner-requested services

Commissioner-requested services are services which NHS England or commissioners may determine as requiring additional regulation in order to protect the interests of patients who use those services in the event that the provider gets into financial difficulty. Services are designated as commissioner requested based on guidance from Monitor.

If commissioners have designated any of the services you provide as commissioner-requested then you are required to hold a licence even if you are otherwise exempt from that requirement.

Commissioners will be able to use a form developed by Monitor to complete their commissioner-requested services designations. This form will then be used to formally notify you and us of the designation.

If you are exempt from the requirement to hold a licence and you subsequently contract to deliver any commissioner-requested services, it is your responsibility to apply for a licence. You have a maximum of 60 days from the point at which you are notified of such a designation to obtain a licence. Should you fail to do so, we can take enforcement action against you.

Where we receive an application under these circumstances, we will first confirm with the relevant commissioners that such a designation exists. We ask you to forward us, as an appendix to your application, the designation notification you have received from your commissioners.

This should be sent to crs@monitor.gov.uk.

When completing your application, you will also be prompted at the start to confirm you have submitted an appendix to your application. You should confirm that you have done so and then progress normally with your application.

Should we require any additional information to consider your application under the above circumstances, we will contact you as soon as possible to discuss our requirement.

We will aim to complete the review of your application within a reasonable timeframe to ensure that you are able to have a licence in place within 60 days. However, should you delay your application to us, if we need additional information and/or require longer to review your application, this may impact the time we take to make our final decision.

If you are notified that one or more of your services have been designated as commissioner-requested services and this notification happens after you have submitted your application to us, but before we have issued a licence or a Notice of Refusal, you will need to amend your application.

If, after we have issued a licence to you, you are notified by your commissioner that your services have been designated as commissioner-requested services, please let us know as soon as possible.

Information about commissioner-requested services contracts

In question 2.3.1 we have requested information about the contracting arrangements under which you provide commissioner-requested services. We need this information to reconcile a provider with a commissioner who has designated the services as commissioner-requested services.

In response to question 2.3.1, please provide:

  • the name of the commissioners for whom you provide commissioner-requested services (for example, NHS Barnet CCG)
  • your contract reference (this can be a reference number or the name that appears on the contract documentation)
  • a short description of the services and value of the contract
  • the contract start date
  • contract end date
  • name of the parties to the contract.

Where a company provides a number of different NHS services, more than one exemption may apply. Therefore, you should consider whether or not an exemption applies by reference to each NHS service provided.

For example, a provider of primary care services, sexual health and community services would not be required to hold a licence in respect of the primary care services provided under Part 4 and 5 of the 2006 Act.

That provider may be required to hold a licence for the other services it provides. However, if the income (calculated in terms of applicable turnover) is less than £10 million annually, then the provider will not require a licence.

All exemptions (except for NHS trusts) are conditional on providers complying with requests from Monitor for any information we consider necessary or expedient to have in order to perform our regulatory functions.

3 Licensing grant criteria

In Part B Section 3 of the application, we need to ask for information which will allow us to assess if you meet Criteria 1 and 2 and therefore whether we can grant you a licence.

Criterion 1: CQC Registration

If an applicant is, in providing a health care service for the purposes of the NHS, carrying on a regulated activity, the applicant must be registered with the CQC in respect of that regulated activity. Therefore, we must consider whether or not an applicant who is required to be registered with the CQC – because it is carrying out a regulated activity – is in fact registered. This will be confirmed with the CQC on the basis of the information provided in the first part of the application form.

A provider who is not required to register with the CQC may still be required to hold a licence. Where the provider does not provide an activity which is regulated by the CQC, but provides services which have been designated as commissioner-requested services, that provider will still be required to hold a licence.

A provider who is not required to register with the CQC will still have to satisfy Criterion 2.

Criterion 2: Provider Fitness

The second criterion we must consider is whether or not the provider of health care services for the purposes of the NHS is fit to hold a licence. The criterion sets out the definition of unfit persons, and describes how these are to be applied to assess the fitness of applicants.

The definition of unfit persons is set out below.

Applications from those who are not individuals, including companies and other entities (legal persons)

Where the provider is not an individual, such as a company or other entity, we must consider that provider’s fitness by reference to:

  • all its directors (if any) and all its governors (if any), none of whom must fall within the definition of individual unfit persons
  • all its corporate directors (if any) in the following way:
    • the corporate directors, none of whom must fall within the definition of corporate unfit persons (note that this definition includes reference to parent bodies of such corporate directors if any)
    • the individual directors or governors of that corporate director, and of any parent body of that corporate director, none of whom must fall within the definition of individual unfit persons
  • all those performing equivalent or similar functions to directors or governors (if any) as described below.

The definition of a 'corporate director' here is a director which is a corporate body. An organisation may decide to appoint a corporate body as a director instead of a person.

3.1 Details of directors and governors

We ask you to list all the directors, governors and those performing equivalent or similar functions. You should provide the name and date of birth for each individual for each of the relevant bodies: the applicant, any corporate directors of the applicant and any parent bodies of all the corporate directors of the applicant (if applicable).

Directors and governors

When determining who are the directors, governors or those performing equivalent or similar functions, to whom the individual fitness test apply, you should consider the following guidance.

The regulations define 'director' as including “any individual who performs the functions of…a director of an NHS Foundation Trust…or of a company registered under the Companies Act 2006". Therefore those who have been formally appointed as directors of registered companies are directors for the purpose of this criterion.

The regulations define 'governor' as including any “individual who performs any of the functions of…a governor of an NHS foundation trust, as conferred by any enactment”. Therefore those who have been formally appointed or elected as governors of NHS foundation trusts are governors for the purpose of this criterion.

The regulations provide that any individual who performs any of the functions of, or equivalent or similar to, the functions of 'director' and 'governor', includes a partner in a partnership.

Those performing equivalent or similar functions to directors or governors

In responding to all the questions in 3.1, it is the responsibility of providers to consider whether they have within their organisations any people who are performing equivalent or similar functions to directors or governors. We will accept the responses of providers unless alerted to information indicating that these responses need to be queried further or challenged.

In considering this point, providers should have in mind, as described in the explanation of the regulations2, that the aim of this part of the regulations is to include within the fitness test those other than actual directors or governors who are involved in overseeing the provider organisation and thus influencing the provision of health care services by that provider in a comparable way to directors and governors.

Providers should consider this point by taking into account all the relevant facts and circumstances in the round. In each case, the role performed by the relevant person must be considered in the context of the governance of your organisation given its size, operations and financial status.

The focus of any assessment must be the substance of the role performed by the relevant person and not their job title alone. Set out below is a non-exhaustive list of considerations for this assessment by reference to the roles of actual directors and governors.

If a person holds themselves out as a director, and carries out the role of director even if not formally appointed as such, that person is to be regarded as performing functions of, or similar or equivalent to, a director. This position is consistent with that taken under the Companies Act 2006, which defines the expression 'director' as including “any person occupying the position of director by whatever name called".

We consider that the following can be indicators that a person may be regarded as performing a function equivalent or similar to a director:

  • the person presumes to act as if he/she were a director
  • the person is either solely directing the affairs of the company, or he/she has a predominant influence and force with respect to those affairs
  • the degree of his/her involvement with the management of the company is at least equivalent to that of the named directors
  • the functions performed are ones that would generally be undertaken by a director, rather than a manager or other employee below board level
  • the person is not accountable to others in their organisation, other than at board level, for their decisions.

A person in accordance with whose directions or instructions the directors of a company are accustomed to act, referred to as a 'shadow director', will also be considered to be a person performing functions of, or similar or equivalent to, a director.

To assess whether someone is performing equivalent or similar functions to an NHS foundation trust governor, providers should have regard to governors’ statutory functions and consider whether they have a person other than an actual director or governor performing such functions.

NHS foundation trust governors perform a range of functions, prescribed by statute1, and these include the following:

  • appoint and, if appropriate, remove the chair of the board of directors
  • decide the remuneration and allowances and other terms and conditions of office of the chair and the other non-executive directors
  • approve (or not) any new appointment of a chief executive
  • approve an application by the trust to enter into a merger, acquisition, separation or dissolution.

Given the relatively unique combination of functions of foundation trust governors, when considering if someone performs equivalent or similar functions to their statutory functions, providers should consider the role that such functions enable governors to play in the governance of their organisations, including in relation to strategic, operational, regulatory or financial matters.

3.2 - 3.4.1 Detailed provider fitness questions

Where the provider is a company or other entity i.e. not an individual, that provider’s fitness must be considered by reference to:

  • all its directors (if any) and all its governors (if any), none of whom must fall within the definition of individual unfit persons as set out in the application form under question 3.2 (i) to (v)
  • all its corporate directors (if any) in the following way:
    • the corporate directors, none of whom must fall within the definition of corporate unfit persons as set out in the application form question 3.3.2 (i) to (iv) (note that this definition includes reference to parent bodies of such corporate directors if any exist)
    • the individual directors or governors of that corporate director, and of any parent body of that corporate director, none of whom must fall within the definition of individual unfit persons as set out in the application form questions 3.3.1 and 3.4.1 (i) to (v).

Reference above to directors and governors also covers all those performing equivalent or similar functions to directors or governors (if any) as described under question 3.1 above.

An answer of “Yes” to any of the following questions in the form will indicate that the provider does not meet the fitness criteria required for granting a licence:

  • questions 3.2 (i) to 3.2 (v)
  • questions 3.3.1 (i) to 3.3.1 (v)
  • questions 3.3.2 (i) to (iv)
  • questions 3.4.1 (i) to (v)

4.1 Ultimate controller

An ultimate controller is any body that could instruct the licensee to carry out particular actions so long as that body cannot be required to act in accordance with the instructions of another. In practice, the ultimate controller would usually be the parent company of a subsidiary company, where it is the subsidiary company that has been licensed by Monitor. If there is no body that can instruct the licensee in this way, then the licensee does not have an ultimate controller.

Where a licence holder has an ultimate controller, it will be required to put in place a legally enforceable agreement with their ultimate controller called an ultimate controller undertaking. An ultimate controller undertaking is a regulatory instrument designed to prevent parent companies from taking actions that would cause a licensee to breach its licence. The agreement between the licensee and the ultimate controller would require the ultimate controller to refrain from taking any action that would cause the licence holder to breach its licence obligations.

It may be unusual for a provider to have more than one ultimate controller. However, if you consider that you have two or more ultimate controllers, please provide the specified details for all of them.

If you answer “Yes” to this question please provide:

  • name of ultimate controllers
  • company registration numbers (if applicable)
  • website addresses
  • key contacts at ultimate controllers
  • job title
  • first name
  • last name
  • address for correspondence
  • email address
  • business telephone.

4.2 - 4.4 Previous NHS Provider Licence applications

You need to tell us if you have previously held, or applied for, a licence. If so, please provide the name of the licence holder, the licence number, and the date the licence was granted or refused.

If the application was withdrawn before a decision to grant or refuse was made by us, please state the applicant name, the date of the application and the reason why the application was withdrawn.

Section two: Application declaration

General: the declarations

All applicants must sign the declaration.

The declaration MUST be signed by an individual duly authorised by the organisation to sign the declaration.

All organisations should have a key contact (see Section 1 Question 1.2 of the application form). This is a person who will act as the main contact with us. The key contact must be a person who has the authority to complete the application and we can contact if we need further clarification or information relating to your application.

Please carefully read the declaration before signing it to ensure what you are committing to by signing it

Declaration

The person who is submitting an application must sign the declaration on the application. If you are submitting the application electronically we will accept a typed-in name as a signature. This person (i.e. the key contact), who has been duly authorised to submit the application on behalf of the organisation, must make the required declaration.

Pursuant to the declaration, the key contact must:

  • acknowledge that he/she has the authority to submit the application
  • confirm that the information provided on the application is accurate, complete and not misleading, to the best of the applicant’s knowledge and belief at the time of entry
  • undertake that where information which has been entered on the application is no longer accurate, complete and not misleading, updated information, which is accurate, complete and not misleading, will be provided to the CQC and Monitor promptly
  • acknowledge that Section 37 of the Health and Social Care Act 2008 makes it an offence to knowingly make a statement which is false or misleading in a material respect in this application for a registration with CQC, or in any of the documents submitted with the application and understand that to knowingly make a false declaration could render you liable to prosecution and could lead to the refusal of this application.
  • confirm that it is their responsibility to inform the Care Quality Commission of any information that is relevant to the application for a registration and which may not have been requested, and to update this information accordingly (and to keep a copy of all the information submitted in your application for your records).
  • understand that if you change your postal or email address for service of notices and delivery of other documents you must update the relevant part of your Statement of Purpose, notify CQC and Monitor about the change and supply a copy of the amended Statement of Purpose to CQC.
  • in making this application for a registration with the Care Quality Commission agree to comply with the Health and Social Care Act 2008 and associated regulations, and have regard to the CQC ‘Essential Standards of Quality and Safety: Guidance about Compliance for Providers'.
  • agree that once registered you will inform the Care Quality Commission (as appropriate) if there are any changes to compliance with the above Acts and any regulations. That you understand that non-compliance with the relevant legislation could lead to the refusal of this application for registration if you do not comply once registered.

By submitting this application the organisation agrees that the information contained in the form may be used as conditions of registration.

We may share the information you provide on the application with other regulators and public bodies. If any of the information you have provided changes prior to your receiving a Notice of Decision or Notice of Proposal pursuant to this declaration, you must inform us as soon as reasonably practical.

You must also check/tick the box on the declaration reproduced below to confirm the appropriate submissions relating to registered managers.

CQC Registration

The declaration, which asks you to formally confirm certain important pieces of information and informs you of your continued obligations should you be registered.

Before you sign the declaration you should refer to the Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, and the Care Quality Commission (Registration) Regulations 2009. The Act and regulations set out the legal obligations on a provider registered to provide regulated activities. You must be sure you have understood their requirements, and be confident that you can and will meet them.

The ‘Guidance about compliance: Essential standards of quality and safety’ shows providers how the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 can be met.

You may decide to comply with relevant regulations in another way. If you do you should explain how and why you comply with the relevant regulations in the appropriate parts of this application form, and provide evidence where necessary about how your alternative approach will be just as or more effective in making sure that the regulations are met.

You must have regard to Regulation 26(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which requires registered persons to have regard to the Guidance about Compliance.

You must declare compliance with all of the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the regulated activities you will carry on at this location.

The application ends with a checklist you can use to make sure that all required enclosures and additional sections are included with your application, and the address it must be sent to.

If you do not submit all required forms and information, your application will be returned to you.

If you have any questions you can call our National Customer Service Centre on 03000 616161.

Once you've finished the form

Submitting the form

Please submit the application for registration and for an NHS provider licence to the Care Quality Commission, making sure that all required additional forms and documents are included.

The checklist below lists the CQC documents that you need to include with the application:

  • Statement of purpose
  • Additional nominated individual sections as needed
  • Additional location sections as needed
  • Registered manager application forms

You should wherever possible email your completed forms and accompanying documents to HSCA_Applications@cqc.org.uk.

You must attach all the forms and documents to the same email. If you are unable to send us your application by email you should print and sign your completed form(s) and post them with any accompanying documents in the same envelope to:

CQC HSCA Registrations
Citygate
Gallowgate
Newcastle upon Tyne
NE1 4PA

Please ensure you have competed, in full, both Part A (registration) and Part B (NHS provider licence). If you do not submit all required forms and information your application will have to be returned to you.

You can read more information on this website or call our National Customer Service Centre on 03000 616161.

For enquiries regarding the NHS provider licence, please contact Monitor’s enquiries team on 020 3747 0606. You can also find further information on the NHS Provider Licence on the Monitor website.

Next steps

On submission of this application you will receive an acknowledgement of receipt.

If CQC and Monitor are satisfied that the applicant meets the criteria for registration under section 11 of the Health and Social Care Act 2008 and licensing under section 86 of the Health and Social Care Act 2012, we will, as soon as reasonably practicable, grant the applications for both a CQC registration and an NHS provider licence and advise you accordingly.

If you need subsequently to amend any details of your application (prior to notification of the above decisions), please send us the full details of the requested amendments. You should be aware that amendments to applications can cause delay. Depending upon the changes you wish to make we may ask you to complete a new application for us. We will then process your amended application.

Withdrawing an application

If at any point in the application process, you want to withdraw your application, you will need to confirm this in writing either by email to HSCA_Applications@cqc.co.uk or by post to:

CQC HSCA Registrations
Citygate
Gallowgate
Newcastle upon Tyne
NE1 4PA

You must include the reasons why you are withdrawing your application.

If you withdraw your application this may lead to further information requests and/or action from us if, for example, we consider that you may not be exempt from the requirement to register or hold a licence.

Representations and appeals

The CQC will refuse an application for registration where the registration grant criteria are not met. Equally, Monitor will refuse an application where the licence grant criteria are not met. In such cases you will receive from either CQC or Monitor (whichever is relevant) a Notice of Proposal to Refuse (including the reasons) and this will specify the period within which you may make representations with respect to the above Notice(s). This period will be no less than 28 days.

CQC or Monitor may not accept your representations, or your representations may not be made within the allocated period of time. In such cases you will receive from either CQC or Monitor (whichever is relevant) a Notice of Decision to Refuse (including the reasons). This will specify the period within which you may appeal against the Notice of Decision(s). This period will be no less than 28 days.

The Notice(s) of Decision will explain the right of appeal. Your appeal must be made to the Care Standards jurisdiction of the First-tier Tribunal, which is an independent tribunal. Appeals may be made based on errors of fact, errors of law or on the unreasonableness of a decision.

More information on the First-tier Tribunal will be available if required. The tribunal service’s address is:

First-tier Tribunal – Care Standards Appeals
Mowden Hall
Staindrop Road
Darlington
DL3 9BG

Additional information request: licensing only

If a licence is granted, you will be asked to send us additional information within one month of this grant, via a provider portal. The information sought will include financial information, the nature of your contractual arrangements, compliance with CQC conditions as well as information regarding commissioner-requested services, if relevant.

Information to be provided by all licensed providers

1.1 The value of your applicable turnover and total turnover in pounds for the relevant business year

The definitions of 'applicable turnover' and 'relevant business year', for the purpose of this calculation, are the same as used in relation to the de minimis exemption to the requirement to hold a licence. These are set out in Section 8 of the Exemptions guidance.

Total turnover is the total turnover of the provider in the last relevant business year.

We require this information to understand what proportion of the provider’s turnover is derived from the provision of NHS health care services.

Information to be provided only by providers of commissioner-requested services

We require information about the value and nature of CRS as well as the way in which they are delivered. We seek information, in particular, on whether or not CRS are provided by prime contractors or subcontractors as well as the information regarding who has commissioned CRS. We also seek information regarding the financial position of providers of CRS.

2.1 The list of services designated as CRS in the specified format

You need to provide us with a list of all the services you provide which have been formally designated by a commissioner as CRS.

2.2 The value in pounds of the CRS you have been contracted to deliver by commissioner at the time you submit this information to Monitor

In response to question 2.2, state the annual contractual value of the CRS which you have been contracted to deliver. This information should be current, i.e. the annual contractual value as at the date the information is submitted.

2.3 If you are providing health care services to the NHS as a prime contractor, have you entered into sub-contracting arrangements with one or more other providers for them to provide part or all of these services?

If the answer to this question is yes, you will be required to provide further information (see question 2.4 below).

2.4 If you are providing Commissioner Requested Services as a prime contractor, have you entered into sub-contracting arrangements with one or more other providers for them to provide part or all of these services? If so, please provide the specified details

In response to question 2.4, providers of CRS should state:

  • the contract reference (this can be a reference number or the name that appears on the contract documentation)
  • the name of the commissioner the CRS are provided for
  • the list of CRS in the contract
  • whether the CRS is fully or partly delivered through a sub-contracting arrangement with other providers
  • the name of the providers who are sub-contracted to deliver these CRS.
2.5 Ultimate Controller declaration in accordance with the requirements of Condition CoS4 of the NHS Provider Licence

Under Continuity of Services licence condition 4, a CRS provider who has an ultimate controller must provide an undertaking declaration from its ultimate controller. We will provide a template for the undertaking.

2.6 Last available credit rating (if you have one)

Please provide your latest credit rating, as well as the date of that credit rating, if you have one. If you do not already have a credit rating, you do not have to provide this information. We will publish further information relating to credit ratings in 2014.

2.7 Information relating to your transactions
2.8 Information relating to your financial plans
2.9 Last full set of annual report and accounts

We will request routine information about your planned transactions, as well as about your financial planning generally.

Last updated:
29 May 2017