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.
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 in partnership with NHS England
- 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?
As a provider of healthcare services for the purposes of the NHS, you will need an NHS provider licence from April 2014, unless you are exempt.
These 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 will need to meet our licensing criteria to be granted a licence:
- you must be registered with the CQC (see CQC care directory for registered providers)
- your directors or governors must meet our fit and proper persons test
You must continue to meet these criteria to keep your licence.
The fit and proper persons test
To be licensed, your directors and governors (or people performing equivalent functions) must be ‘fit and proper’. This is in line with the statutory fitness requirements set out for directors and governors of NHS foundation trusts, and certain requirements for directors of companies.
For example, directors and governors must not:
- be an undischarged bankrupt
- have undischarged arrangements with creditors
- be subject to a moratorium period under a debt relief order
- have received a prison sentence of 3 months or longer during the previous 5 years
- be subject to a disqualification order or undertaking
How to apply
This guidance is for independent providers only. You should read this before you start the online application for an NHS provider licence.
There are two stages to the online application process:
1. Pre-authenticate your application
Access the online application form.
Enter your CQC provider ID number and confirm your provider’s:
- registered address and contact details
- company/charity registration number
- legal status
- correspondence details of a contact person for the application
If you provide commissioner requested services, you will need to supply additional information at this stage.
Our licensing team will then send you a PIN (by email) and a passcode (by post).
Once you have received your passcode and PIN, enter these and your CQC provider ID to authenticate your account.
You can then set up a username and password to access the whole application form.
2. Complete and submit your application form
You will need to complete and submit the application form, using the Licensing application guidance: for independent providers to help you.
You will normally get a decision on your application within 20 working days of submitting it, unless queries or concerns are raised.
Applying for CQC registration and an NHS provider licence at the same time
You can save time by applying for your CQC registration and your NHS provider licence through a single application form.
The streamlined process is only for organisations applying as a new service provider for both the registration and licence.
Do not use this route if you are:
- already registered with the CQC
- a partnership or an individual
- exempt from needing an NHS provider licence
You can find guidance on the joint application process and an application form on the CQC website.
There is currently no fee for applying for or maintaining an NHS provider licence.
Once you are licensed
If you hold a licence, you can log on to the licensing portal to:
- view your licence
- manage your user accounts
Conditions of your licence
The types of services you provide determine the conditions you will need to meet as a licensee. Full details of all of the conditions are available in the NHS provider licence document.
There are a number of universal requirements for all licensees:
- general conditions
- integrated care condition
- choice and competition conditions
- pricing conditions
And additional requirements for:
- licensees who supply commissioner requested services (continuity of services conditions)
The general conditions set out our standard requirements and rules. These cover 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 conditions
The competition condition aims to prevent anti-competitive behaviour that is not in the interests of patients. The condition prevents you from entering into or maintaining any agreement, or engaging in any other conduct, which prevents, restricts or distorts competition where this is against the interests of healthcare users.
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. It also prohibits you from offering inducements to clinicians, commissioners and other third parties to refer patients or commission services.
The pricing conditions of the licence require you to comply with the national tariff and to provide us with information on costing.
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.
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.
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 our Risk assessment framework for independent sector providers of NHS services.
If you are a licensed provider but do not provide commissioner requested services, we will ask you to certify that you are compliant with the licence conditions each year. We will also follow up on relevant information from other sources such as third party reports, market analysis and whistleblowers where appropriate
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.
For enquiries relating to the licence application process, please contact our licensing team at nhsi.Licensing@nhs.net.