Do I Need to Register with the CQC? A Guide to Regulated Activities & Health Optimisation Treatments

If you are operating or planning to operate a health or social care service in England, you may be wondering: Do I need to register with the Care Quality Commission (CQC)? The answer depends on the nature of the services you provide and whether they fall under regulated activities as defined by the Health and Social Care Act 2008.

At Delphi Care Solutions, we specialise in CQC consultancy, supporting providers with CQC registration, compliance, and audits to meet the Single Assessment Framework requirements.

In this article, we will explore:

• What CQC registration is and why it matters
• The list of regulated activities that require registration
• The difference between medical treatments (which require regulation) and health optimisation treatments (which may not)
• Whether innovative therapies like hyperbaric oxygen therapy for long Covid require CQC oversight

What is CQC Registration?

The Care Quality Commission (CQC) is the independent regulator of health and social care services in England. It ensures that providers meet fundamental standards of care, safeguarding people from unsafe or poor-quality treatment.

If your organisation provides services that fall within regulated activities, you are legally required to register with the CQC. Operating a service without registration when required is a criminal offence and can result in significant penalties, including fines or prosecution.

The List of CQC-Regulated Activities

Under the Health and Social Care Act 2008, the following activities require CQC registration:

1. Personal Care

Providing personal assistance with daily living activities such as washing, dressing, and eating, typically for individuals unable to perform these tasks independently.

2. Accommodation for Persons Requiring Nursing or Personal Care

Operating care homes or residential services where personal or nursing care is provided.

3. Treatment of Disease, Disorder, or Injury (TDDI)

Diagnosing and treating medical conditions, whether through surgical, medical, or therapeutic interventions.

4. Surgical Procedures

Performing any form of surgery, including minor surgeries conducted by clinics, hospitals, or private healthcare providers.

5. Diagnostic & Screening Procedures

Conducting procedures such as MRI scans, X-rays, and blood tests for medical diagnostic purposes.

6. Maternity & Midwifery Services

Providing prenatal, childbirth, and postnatal care, including midwifery-led services.

7. Termination of Pregnancies

Performing abortion services in any setting.

8. Management of Supply of Blood and Blood-Derived Products

Handling blood transfusions or plasma-related treatments.

9. Transport Services, Triage, and Medical Advice Provided Remotely

Running ambulance services or providing urgent medical advice via telehealth platforms.

10. Services for People with a Learning Disability or Autism

Specialist services tailored to individuals with learning disabilities or autism.

11. Nursing Care

Providing nursing care in any setting, whether in a care home or within people’s own homes.

12. Family Planning Services

Offering contraception, sexual health support, or fertility-related treatments.

13. Rehabilitation Services

Providing recovery and rehabilitation services, often post-surgery or following medical events like strokes.

14. Treatment Using Medical Lasers or Intense Pulsed Light (IPL)

Using laser or IPL treatments for medical or cosmetic procedures requiring regulated oversight.

The Difference Between Medical Treatment & Health Optimisation

Not all health-related services require CQC registration. The key factor is whether the service treats a disease, disorder, or injury.

If a service is designed to improve overall wellbeing rather than treating a specific condition, it may not fall under CQC regulation.

Examples of Regulated Medical Treatments

These treatments DO require CQC registration:

• Prescribing medications for medical conditions (e.g., diabetes, hypertension, long Covid)
• Surgical and invasive procedures (e.g., mole removal, cosmetic surgery under local anaesthetic)
• Hyperbaric oxygen therapy for wound healing (as a prescribed medical treatment)
• IV vitamin therapy for diagnosed deficiencies

Examples of Health Optimisation Treatments (Likely Not Regulated)

These treatments focus on general health improvement rather than treating a disease:

• Wellness-based hyperbaric oxygen therapy (e.g., for general vitality rather than wound healing)
• IV vitamin therapy for general wellness (if not prescribed for a specific deficiency)
• Cryotherapy and infrared therapy
• Biohacking treatments such as red light therapy
• Holistic wellness coaching and lifestyle medicine advice

If a treatment is marketed as a wellness service rather than a medical intervention, it may not require CQC registration. However, the line can be blurry, so seeking professional guidance from a CQC consultancy like Delphi Care Solutions is advisable.

Hyperbaric Oxygen Chambers for Long Covid: Regulated or Not?

Hyperbaric oxygen therapy (HBOT) has gained attention as a potential treatment for long Covid. However, whether it requires CQC registration depends on its intended use:

• If provided as a prescribed treatment for a diagnosed condition, such as chronic fatigue syndrome or non-healing wounds → CQC registration is required.
• If marketed as a general wellness service for boosting oxygen levels or improving recovery → CQC registration may not be required.

The key distinction is whether a registered healthcare professional is overseeing the treatment for a diagnosed medical condition.

Case Study: A Clinic Offering HBOT

• Regulated Example: A clinic run by a doctor offering HBOT for long Covid patients under a prescribed treatment plan → CQC registration required.
• Non-Regulated Example: A wellness centre offering HBOT as an optional biohacking treatment to improve general energy and vitality → CQC registration likely not required.

How to Determine If You Need CQC Registration

To determine if your service needs CQC registration, ask the following questions:

1. Am I diagnosing or treating a medical condition?
2. Am I providing personal or nursing care?
3. Am I carrying out any procedures from the regulated activities list?
4. Am I employing healthcare professionals to provide medical care?

If yes to any of these, CQC registration is likely required.

Steps to Register with the CQC

1. Determine the Type of Service You Provide – Identify whether your services fall within regulated activities.
2. Appoint a Registered Manager – If required, designate a responsible person for compliance.
3. Complete the CQC Registration Application – Submit details of your service, leadership, and care approach.
4. Prepare for Inspection – Ensure policies, procedures, and governance frameworks align with CQC’s Single Assessment Framework.
5. Maintain Compliance – Once registered, continue to meet CQC’s Fundamental Standards.

Final Thoughts

If you are unsure whether your service requires CQC registration, Delphi Care Solutions can help. Our team of CQC consultants provides expert guidance on registration, compliance, and inspections.

Need help with CQC registration? Contact us today for a consultation!