Licensing

Providers should refer to this page for guidance on licensing criteria, making a licence application, and details of the NHS provider licence standard conditions.

This page replaces the original information and guidance previously hosted by Monitor on GOV.UK.

Content


Background

The NHS provider licence is our main tool for regulating providers of NHS services.

The licence sets out conditions that healthcare providers must meet to help ensure that the health sector works for the benefit of patients. These conditions give us the power to:

  • set prices for NHS-funded care
  • enable integrated care
  • safeguard patient choice and prevent anti-competitive behaviour that is against the interests of patients
  • support commissioners to protect essential health services for patients if a provider gets into financial difficulties
  • oversee the way NHS foundation trusts are governed

Who needs a licence?

All providers that deliver healthcare services for the NHS are required to hold a licence, unless exempt.

The following types of providers are exempt:

  • providers that are not required to register with the Care Quality Commission (CQC)
  • small providers of NHS-funded healthcare services whose annual applicable turnover from providing NHS services is (or is expected to be) less than £10 million
  • providers of primary medical or dental services only
  • providers of NHS continuing healthcare or NHS-funded nursing care only
  • NHS trusts (which will only be licensed when they are authorised as NHS foundation trusts)

However, these exemptions do not apply (apart from the exemption for NHS trusts) if you provide services designated by a commissioner as ‘commissioner requested services’ (CRS). If you provide these, you need a licence.

You can find more details in the regulations on licence exemptions and the Department of Health and Social Care licence exemptions guidance.

Licensing criteria

You will need to meet our licensing criteria to be granted a licence:

  • you must be registered with the CQC – see the CQC care directory for the list of registered providers.
  • your directors or governors must meet our fit and proper persons’ test. Further details can be found in condition G4 of the licence.

Types of licence

There are two types of licence:

  • the NHS provider licence, which is applicable to foundation trusts and independent providers.
  • the NHS-controlled provider licence, which is applicable to providers ultimately controlled by one or more NHS trusts or foundation trusts.

How to apply

Guidance on the application process is available here:

Once you are licensed

Conditions of your licence

The types of services you provide determine the conditions you will need to meet as a licensee. There are several universal requirements for all licensees:

  • general conditions – these conditions set out our standard requirements and rules covering areas such as providing and publishing information, paying fees, fit and proper persons requirements, and the requirement for providers to be registered with the CQC.
  • integrated care condition – this condition allows us to take action if you act in a way that is detrimental to the delivery of integrated care.
  • choice and competition condition – the competition condition aims to prevent anti-competitive behaviour that is not in the interests of patients. The choice condition requires you to notify patients when they have a right of choice of provider, and to tell them where they can find information about the choices they have. This condition applies wherever patients have a choice of provider under the NHS constitution or a choice that has been conferred locally by commissioners.
  • pricing conditions – these conditions require you  to comply with the national tariff and to provide us with information on costing.

There are additional requirements for:

  • licensees who supply commissioner requested services (continuity of services conditions) – if you provide essential NHS-funded services known as commissioner requested services, the continuity of services conditions require you to meet certain conditions, so that if you get into serious financial difficulty we can take action to ensure the services can continue to be provided on a sustainable basis.

Full details of all licence conditions are available in the NHS provider licence document Annex: Standard Conditions and the NHS-controlled provider licence document.

Certifying compliance with the licence conditions

All licenced providers will be asked to certify on an annual basis the they are compliant with the licence conditions. Full details certification requirements are set out in the Risk assessment framework and reporting manual for independent providers which can be found under Monitoring and enforcement.

Providers of commissioner requested services

If you are an independent provider of commissioner requested services, you will be monitored according to the principles set out in the Risk assessment framework and reporting manual for independent providers which can be found under Monitoring and enforcement.

Enforcement

We can take action:

  • if you breach (or are suspected to be in breach of) a licence condition or a requirement to provide information
  • if you provide NHS services without holding a licence when you are required to have one

This action can include making sure you put things right and, in certain circumstances, imposing a fine or revoking the licence. Full details can be found in our enforcement guidance which can be found under Monitoring and enforcement.

Maintaining your licence

There is no requirement to re-register every year. Instead, you will have to complete a simple annual self-certification that confirms your continued eligibility to hold an NHS provider licence. Further details are contained in the Risk assessment framework and reporting manual for independent providers.

Request the withdrawal of your independent provider licence

Contact us

For enquiries relating to the licence application process, please contact our licensing team at NHSI.Licensing@nhs.net.

Related content

Access the register of licensed healthcare providers

Regulatory action taken against licensed healthcare providers

The NHS provider licence