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.
The NHS provider licence is our main tool for regulating providers of NHS services. It sets out the conditions that providers of healthcare services for the purposes of the NHS in England must meet to help ensure that the health sector works for the benefit of patients, now and in the future.
Some providers are legally exempt from needing to hold an NHS provider licence. See ‘Who needs a licence?’ below for more detail.
Who needs a licence?
All independent providers that deliver healthcare services for the NHS and meet our licensing criteria are required to hold a licence, unless exempt.
You will need to meet our licensing criteria to be granted a licence:
- you must be registered with the CQC (or have made an application to become 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 G3 of the licence.
The following types of providers are exempt whether or not they meet the licensing criteria:
- 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
These exemptions do not apply if you have been told you are subject to the Continuity of Service (CoS) licence conditions (through being designated by an NHS commissioning body as a provider of ‘commissioner requested services’ (CRS) and/or through being identified by NHS England as a ‘hard to replace’ (HTR) provider). If this applies and the licensing criteria is met, you need a licence.
The NHS provider licence should not be an eligibility criterion for bidding for NHS contracts; you should still be able bid for NHS contracts if you are exempt from holding an NHS provider licence (assuming other eligibility criteria is met). For more information on opportunities for suppliers, please see below:
- Health Family single e-commercial system
- Contracts finder
- NHS commercial solutions – becoming a supplier
- Find your local integrated care board (ICB) – NHS (www.nhs.uk)
How to apply
Guidance on the application process is available here:
- Applying for a licence as an independent provider
- Applying for a licence as an NHS controlled provider
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:
- Integrated care conditions – These conditions allow us to take action if you act in a way that is detrimental to the delivery of integrated care, personalised care and patient choice.
- General conditions – These conditions set out our standard requirements and rules covering areas such as providing and publishing information, fit and proper persons requirements, and the requirement for providers to be registered with the CQC.
- Costing conditions – These conditions set out our standards requirements for maintaining accurate costing information, and to share this information where required.
- Pricing conditions – These conditions require you to comply with the NHS payment scheme and to provide us with information on costing.
There are additional requirements for:
- NHS controller providers (Trusts working in systems and NHS controlled provider conditions) – For providers ultimately controlled by one or more NHS trusts or foundation trusts, the trusts working in systems conditions require co-operation with other provider and compliance with duties relating to the triple aim and information standards. NHS controlled providers are also required to apply appropriate principles, systems and standards of good corporate governance.
- 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 (CoS) conditions require you to meet certain conditions. If you get into serious financial or quality difficulty, we can take action to ensure the services can continue to be provided on a sustainable basis.
- ‘Hard to replace’ providers (continuity of services conditions) If NHS England has identified you as a ‘hard to replace’ independent provider, most of the continuity of service licence conditions apply. If you get into serious financial or quality 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 at NHS England » NHS Provider Licence: standard conditions.
Certifying compliance with the licence conditions
All licenced independent providers will be asked to certify on an annual basis that they are compliant with the licence conditions. Full details of certification requirements are set out in the Risk assessment framework and reporting manual for independent sector providers of NHS services which can be found under Monitoring and enforcement.
Providers subject to the CoS licence conditions
If you are an independent provider subject to the CoS licence conditions, you will be monitored according to the principles set out in the Risk assessment framework and reporting manual for independent sector providers of NHS services which can be found under Monitoring and 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 sector providers of NHS services.
How to request the withdrawal of your independent provider licence
- Requesting the withdrawal of your NHS provider licence: This document contains guidance on requesting withdrawal of your NHS provider licence. It is intended for independent providers and NHS-controlled providers.
- Request form for withdrawal of an NHS provider licence
For enquiries relating to the licence application process, please contact our licensing team at firstname.lastname@example.org.