Check if you need a licence

Who needs a licence

If your organisation is Care Quality Commission (CQC) registered as a provider of healthcare services for the NHS in England plus one of more of the following:

• your organisation has a reasonable expectation of generating applicable turnover of £10 million or more over the next 12 months; or
• a commissioner has notified NHS England that the services you provide are commissioner requested services (CRS); or
• NHS England has identified you as a hard-to-replace provider (HTR)

What is applicable turnover?

Applicable turnover is amounts (revenue) from the provision of NHS healthcare services in England. . This does not include:

• VAT and other taxes
• trade discounts
• amounts (revenue) from primary medical or dental services, NHS continuing healthcare or NHS funded healthcare

What is a commissioner requested service (CRS)?

CRS are essential services which must continue to be provided locally should the current provider fail, because:

• either there is no alternative provider close enough; or
• removing them would increase health inequalities; or
• removing them would make dependent services unviable.

Commissioners decide which of their services are CRS and formally notify NHS England.

What is a hard-to-replace provider (HTR)?

a provider’s services may be of sufficient scale or complexity nationally or regionally that NHS England considers that their unavailability – due to the provider’s insolvency or quality issues – would impact on patients.

NHS England decides which provider are HTR

The NHS England Independent Providers team will inform you by letter if any of your services are designated as CRS or your organisation is identified as HTR. If so, you only need to complete part two of the application, even if you do not meet the other licensing criteria.

Who does not need a licence

Some independent providers are exempt from the need to hold a licence.

You do not need to apply for a licence if:

• your organisation does not have a reasonable expectation of generating applicable turnover of £10 million or more over the next 12 months;
• your organisation only provides NHS primary medical or NHS dental services. These are often referred to as General Medical Services (GMS), Personal Medical Services (PMS), Alternative Provider Medical Services (APMS), and General Dental Services (GDS) or Personal Dental Services (PDS)
• your organisation only provides NHS continuing healthcare or NHS-funded nursing care

What is NHS continuing healthcare?

NHS continuing healthcare is a package of care arranged and funded solely through the NHS for individuals aged 18 or over who have been assessed as having a primary health need.

What is NHS funded nursing care?

NHS funded nursing care is where the NHS pays for the nursing care component of nursing home fees

If you do not require a licence

Holding an NHS provider licence is not a requirement for all independent providers and does not impact your ability to bid for NHS-funded contract opportunities.

You can still bid for and provide services to the NHS if you are not required to hold a licence.