Atlacare
Private general practice is a regulated activity, but there is an exception for treatment in a consulting room by a doctor on a medical performers list for a designated body. The trigger for registration is usually not going private. It is leaving the NHS entirely, which ends the performers list connection the exception depends on.
That is a genuinely counter-intuitive result, and it is written into the regulations rather than being a matter of interpretation.
What is the regulated activity?
Treatment of disease, disorder or injury, listed at Schedule 1 paragraph 4 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. General practice sits squarely inside it.
Carrying on a regulated activity without registration is a criminal offence, so this is not a question to resolve by assumption.
What is the exception?
Schedule 2 paragraph 3 excepts treatment provided in a surgery or consulting room by a medical practitioner who is on the medical performers list for a designated body, or employed by a designated body.
That is why a large number of private GP consultations happen without CQC registration and lawfully so. An NHS GP who does private sessions alongside their NHS work is normally within the exception, because the performers list connection exists.
The exception depends entirely on that connection. It is not about being a doctor, or about the setting being private. It is about the list.
Who loses the exception?
A GP who leaves the NHS altogether.
Come off the performers list and, absent employment by a designated body, the exception no longer applies. The clinical work is identical. The consulting room is the same. The registration position has changed completely.
This is the same mechanism that governs revalidation, which is why the two problems arrive together. Our guide to revalidation as a fully private GP covers the other half, and the practical advice is to treat leaving the NHS as one event with two consequences.
What removes the exception regardless?
Even where you would otherwise qualify, Schedule 2 paragraph 4 disapplies the exception for a list of specified activities. The ones that matter most in private general practice:
| Activity | Effect on the exception |
|---|---|
| Treatment under anaesthesia or intravenously administered sedation | Disapplied |
| Intravenous, intrathecal or epidural administration of medicines or diagnostic agents | Disapplied |
| Therapeutic or diagnostic use of X-rays, radiation, protons or MRI | Disapplied |
| Medical services in connection with childbirth | Disapplied |
| Termination of pregnancies | Disapplied |
The intravenous line is the one catching the current wave of private clinics. A private GP offering IV vitamin infusions, IV B12 or any intravenously administered treatment is outside the exception, whatever their performers list status.
Ultrasound reaches the same result by a different route. Examining the body by ultrasound is a diagnostic and screening procedure under Schedule 1 paragraph 7, a separate regulated activity that the consulting room exception never covered in the first place. The exception only reaches treatment.
If your service list has grown into wellness infusions or in-house imaging, the analysis has changed even if your NHS connection has not.
So what is the actual test?
Two questions, in order.
Do I have a current performers list connection to a designated body, or employment by one? If no, you need to register.
Do I do any of the paragraph 4 activities, or any diagnostic procedure in my own right, such as ultrasound or taking samples to send to a laboratory? If yes, you need to register regardless of the answer to the first question.
Only a doctor who answers yes to the first and no to the second sits within the exception.
What does registration involve?
An application to CQC specifying the regulated activities you carry on and the locations you carry them on from, a registered manager for each activity unless an exception applies, a statement of purpose, evidence of governance, and fit and proper person checks for directors.
On fees, take the current figures from CQC's published fees scheme rather than from any article. The scheme varies by provider type, location count and registered activities, and it is revised. Budget the annual fee as an ongoing cost rather than a one-off.
The timing point matters more than the cost. Registration takes time, and you cannot lawfully carry on the regulated activity while an application is pending. Clinics that buy the ultrasound machine first and apply afterwards have an expensive gap.
What changes once you are registered?
You become inspectable against the fundamental standards, with published reports. You need to evidence governance rather than describe it: audit, incident management, equipment checks, complaints handling.
And your clinical records become part of the regulatory evidence base as well as the clinical one. An inspector asking how you assure the quality of consent or prescribing is asking to see records. Records that are contemporaneous, attributable to a named clinician, versioned so amendments remain visible, and retained to a stated schedule turn that into a straightforward exercise. Systems like Atlacare hold notes with a lock on sign off and a full audit log, which is the shape the evidence needs to be in.
Registration sits alongside your other obligations rather than replacing them. Controlled drugs handling, covered in our guide to controlled drug storage, and data protection, covered in our UK GDPR guide, apply either way.
Where to start
- Confirm your performers list status in writing, not from memory
- List every activity you offer, including IV treatments and any imaging
- Check that list against Schedule 2 paragraph 4
- If you are planning to leave the NHS, resolve this before you do, alongside your revalidation connection
- Apply before you buy equipment or launch a service, not after
- Ask CQC directly if it is finely balanced. They will discuss scope, and a written answer is worth more than any article
The honest summary is that the exception is real, widely relied on, and more fragile than it looks. It depends on a connection that a career decision can end without anyone mentioning it.
This is general information about the scope of CQC registration, not legal advice. Whether a particular service is a regulated activity depends on exactly what you do and how. Check the current regulations and CQC guidance, and contact CQC where the position is unclear.
Sources: Regulated Activities Regulations 2014, Schedule 1 · Schedule 2, exceptions · Care Quality Commission
Related: Revalidation as a fully private GP · Private prescribing versus FP10 · Do I need CQC registration for a private gynaecology clinic?