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Surgical procedures

  • Organisations we regulate

This regulated activity covers the following procedures carried out by a healthcare professional:

  • surgical procedures for the purpose of:
    • treating disease, disorder or injury
    • cosmetic surgery
    • religious observance, for example circumcision
  • surgery carried out for the purpose of sterilisation or reverse sterilisation

Types of service that should be registered for this regulated activity

If you plan to provide any of the following types of service then it is highly likely you will need to register for this regulated activity:

  • acute service
  • doctors' treatment service
  • dental service

You may need to register for this regulated activity if you plan to provide any of the following types of service:

  • urgent care service
  • ambulance service
  • prison healthcare service


This regulated activity covers all pre- and post-operative care associated with the surgical procedures. In relation to pre-operative care, this might include, for example, assessment by an anaesthetist shortly in advance of the procedure (where that assessment is an assessment of the patient’s suitability directly related to the procedure) but would not include an initial consultation with a surgeon before the procedures had been decided.


Minor surgical procedures are not captured if they are undertaken by a medical practitioner and the minor procedures are limited to curettage (scraping), cautery (burning) or cryocautery (freezing) of warts, verrucae or other skin lesions and are carried out using local anaesthesia (or no anaesthesia).

The following minor surgical procedures are not captured if they are undertaken by any health care professional and the procedures are limited to:

  • nail surgery and nail bed procedures on the foot and which are carried out using local anaesthesia (or no anaesthesia)
  • curettage (scraping), cautery (burning) or cryocautery (freezing) of warts, verrucae or other skin lesions on any area of the foot and which are carried out using local anaesthesia (or no anaesthesia)

Other regulated activities you may need to register for

You should apply for other regulated activities if you are providing them. For example the use of imaging techniques during surgery may require registration for 'diagnostic and screening procedures'.

Post-operative care

In relation to post-operative care, the activity must be related to the procedure for it to be captured and this will normally mean that it is planned to be related to them. This may include, for example, post-anaesthetic care (recovery), follow-up in an intensive care unit, or rehabilitation where they are part of a planned pathway of care. The extent of pre- and post-operative care may include a planned subsequent follow-up consultation after surgery, but would not include any further treatment (that is additional, beyond checking on the procedures) that is decided in that follow-up consultation. It would include other treatment where that is directly related to the surgical procedures and carried out under the surgical team. For example, a pre-existing prescription for medicines is temporarily changed by the anaesthetist in order to avoid any conflict with anaesthetic drugs. But if the treatment goes beyond the surgical team, for example, change of prescription not by the anaesthetist but by the patient’s cardiologist, then that is considered to be treatment in its own right rather than associated with the surgical procedures.

The key principles are that the activity must be:

  • directly related to the surgical procedures, so only from the point at which the surgical procedures are decided upon
  • only the planned pathway of care, not subsequent treatment
  • only within the surgical team, not the activity of other health care teams that may be taking place at the same time

Religious observance

Surgical procedures carried out for religious reasons, such as circumcision, are included where they are carried out by a health care professional. Where a health care professional carries out surgery for religious purposes they will be acting in their capacity as a health care professional rather than in a religious or spiritual role. This is because a registered health care professional's code of practice will prohibit them from disregarding the need to have appropriate skills, experience, equipment and facilities for this procedure and they cannot 'opt out' of their core duties and responsibilities as a registered health care professional, even if they are acting in a spiritual or religious role.

Cosmetic surgery

Cosmetic surgery is not defined separately but the procedures that are captured by this regulated activity include those described as being for cosmetic purposes if they involve the insertion of instruments or other equipment into the body. For the avoidance of doubt, the activity does not include:

  • piercing
  • tattooing
  • subcutaneous injections to enhance appearance
  • removal of hair or minor skin blemishes by application of heat using an electric current

As an example, we consider liposuction involving the insertion of instruments into the body to be included in this activity. This is regardless of whether the liposuction is carried out using general or local anaesthesia, or whether the procedure involves the administration of a laser through a cannula inserted into the body. However, a procedure such as the external application of ultrasonic energy without any incision or insertion of instruments into the body is not considered a surgical procedure.


A hospice should not ordinarily be registered for the regulated activity of 'surgical procedures'.

This is because it is unlikely that a hospice would carry out surgical procedures other than pleural taps and abdominal paracentesis. These will instead be considered as treatment under the regulated activity of 'treatment for disease, disorder or injury' for the purpose of registration.

Last updated:
05 February 2019