Leaving Hospital Practice to Open Your Own Clinic: What Nobody Tells You About CQC Registration

Every consultant who goes independent has the same week. The clinical plan is clear, the demand is obvious, the numbers work — and then someone mentions the Care Quality Commission, and it turns out there is a regulator standing between you and your first patient.

This is the part nobody trained you for. Here is what actually has to happen, in the order it has to happen, and where people lose months.

The uncomfortable first fact

You cannot see patients before you are registered. If your service involves a regulated activity, carrying it on without registration is a criminal offence, not an administrative oversight.

That single fact should reshape your plan. It means you do not sign a lease with an opening date, take bookings, or hand in your notice against an assumed timeline. Registration takes months, not weeks, and the date is not yours to choose.

The good news is that the part of the timetable you do control is the largest one: having everything ready before you submit.

Start with the three long-lead items

Most people start by writing policies. That is the wrong end. Three things take weeks of waiting and should be moving before you write a word.

1. Decide your regulated activities precisely. Everything else follows from this. The activities are defined in law, and the wording matters — "treatment of disease, disorder or injury" and "diagnostic and screening procedures" are different things with different consequences. Applying for the wrong one, or missing one you actually carry on, is a common and expensive error. It is also the question your whole application is built around, so getting it wrong late is costly.

2. Appoint your registered manager and nominated individual, and start their DBS checks. These need to be CQC-countersigned, and they take time. Start them first. In a single-handed clinic you may hold more than one of these roles yourself, which is fine, but the checks still have to happen.

3. Ask your accountant for a financial viability statement. This is the one that surprises people. CQC requires an independent statement — from an accountancy firm, a bank or another financial services firm — giving their professional opinion on whether your service is financially viable. CQC will not accept it from you. Most firms need two to three weeks and will want to see your business plan first. If you ask for it the week before you submit, you will wait.

Then write your statement of purpose

Your statement of purpose is the document CQC reads first, and it is the spine of the application. It sets out your aims, your regulated activities, each location, the type of service and the needs of the people who use it.

More importantly, every other document is checked against it. The single most common query raised on a registration application is an inconsistency between the statement of purpose and something else — a different address, an activity that appears in one and not the other, a service user band that does not match.

Write it early, on CQC’s own template, which is free from CQC, and then treat it as the master. When your business plan says one thing and your statement of purpose says another, the business plan is wrong.

The document set is where applications stall

CQC publishes a named list of supporting documents and states that it will reject an application that does not include all of them. For an independent clinic that is 23 items.

They fall into three groups, and it is worth understanding the difference because it changes who you have to chase.

Things you write. Recruitment, safeguarding, complaints, consent, governance and quality assurance, infection prevention and control, medicines management, business continuity, equality and diversity, a staff training plan, a service user guide, and your premises risk assessments. This is the bulk of it, and it is the part that can be prepared properly in advance.

Things you part-supply. Insurance, for instance: you need the policy that sits behind it, and the certificate from your insurer.

Things only someone else can give you. The financial viability statement from your accountant. Your floor plan. Evidence of legal occupancy. Gas and electrical safety certificates. Planning permission, where a change of use applies.

That last group is small but it is where timelines break, because each one depends on a third party who has no interest in your deadline.

Why generic templates get spotted

There is a particular failure mode worth naming, because it is so common.

An applicant downloads a policy pack, changes the name at the top, and submits. The assessor opens a document that still says [Insert Name] in the approval block, or describes a chaperone procedure for a service that has no chaperones, or references a governance meeting that does not exist yet.

It does not read as a shortcut. It reads as an applicant who has not thought about how their own service will work — which is precisely the judgement CQC is there to make. A policy is not a form to be filed; it is a description of how you intend to operate, and you will be held to it at inspection.

The fix is not to write everything from scratch. It is to make sure every document actually describes your clinic: your roles, your local escalation routes, your review cycles, your thresholds.

A realistic sequence

1. Decide your regulated activities.
2. Appoint your registered manager and nominated individual, start the DBS checks.
3. Send your business plan to your accountant and ask for the financial viability statement.
4. Secure premises and start collecting the certificates and the floor plan.
5. Write your statement of purpose, on CQC’s own free template.
6. Assemble the supporting documents, consistent with the statement of purpose throughout.
7. Apply online and pay the fee.
8. Be assessed. Agree assessment dates within 28 days of being contacted, or your application can be returned.

Steps 1 to 3 should be running in parallel in your first week. Step 6 is the one that takes the longest and the one most people start too late.

What this really costs you

The application fee is the smallest part. The real cost is your time, and the risk of a delayed opening while a lease runs.

That is worth weighing honestly. Preparing a complete document set from nothing, while still working clinically, is realistically weeks of evenings. Some people find that a reasonable trade. Others would rather spend the money and get the months back.

If you want the documents handled. We write and tailor the complete document set for a new clinic — every policy, procedure and risk assessment your service needs, completed with your organisation, your roles, your local contacts and your policy decisions, and returned within five working days. It is £2,145, and we are explicit about what it does not include: we do not submit your application, and the financial viability statement still has to come from your accountant.

See what starting a private clinic actually involves →

Or check CQC's full list of required documents first →

This article is general guidance, not legal advice, and CQC updates its registration guidance from time to time. Check the current requirements on cqc.org.uk before you submit.