Health and Social Care Act 2008 (Registration of Regulated Activities) Regulations 2009

Last October we brought into force the legislation to set up the Care Quality Commission—the new single regulator for health and adult social care. The noble Baroness, Lady Young, has given us a daily countdown to CQC kick-off. The draft regulations before us now are part of a package of secondary legislation which will enable the commission to take on its functions from 1 April this year. Part 1 of the Health and Social Care Act 2008 provides for a new registration system for the regulation of health and adult social care. These regulations are the first step in bringing the NHS into a system of registration for the first time, alongside the independent and voluntary sector and social care providers. At present NHS providers are required to comply with the code of practice for the prevention and control of healthcare-associated infections issued under the Health Act 2006. The regulations before us carry forward the essential requirements of the existing code and place them into the new legislative framework. Regulations 3 and 5 require NHS providers of healthcare to be registered with the commission and to meet a single registration requirement on the protection of persons against identifiable risks of healthcare-associated infections. The regulations cover the same providers that are obliged to comply with the existing code. In January we laid an order enabling the registration process to begin. Alongside the regulations there is a revised code of practice which sets out the nine compliance criteria and guidance that the commission will use to judge whether registered NHS providers of healthcare are complying with the regulation on HCAI. It will be an offence to fail to comply with the regulation and registered providers may be prosecuted. On summary conviction, this could result in a fine of up to £50,000 for each offence, as set out in these regulations. The Act also gave the commission a range of other enforcement powers to use where providers are not complying with requirements. These include: the power to suspend or cancel registration, the power to issue a warning notice or a fixed-penalty notice, and the power to attach conditions to a provider’s registration. The greater range of enforcement powers enables the regulator to take a more flexible and proportionate approach to breaches of registration requirements. This will benefit patients by encouraging quicker progress in tackling infections. These regulations set out further details in relation to fixed-penalty notices and set the penalties at between £1,250 and £4,000 depending on the offence. A number of administrative matters are also set out, such as the timescale for payment. Until 2010 the new Care Quality Commission will continue to regulate private and voluntary healthcare providers and adult social care providers under the Care Standards Act 2000. These providers will continue to have to comply with the regulations and national minimum standards under the 2000 Act, which include requirements on infection control. In 2010 the registration system under the 2008 Act will be widened from covering just NHS providers to cover private and voluntary health and adult social care, and with a wider set of safety and quality requirements. If the registration system is to operate effectively and transparently it is important that the public and commissioners have access to information about services and service providers. These regulations make a number of provisions to ensure that information about the commission’s regulatory action is available and they require the commission to keep a register of persons registered as service providers. The regulations also make a number of provisions requiring the commission to make public information relating to certain enforcement action it has taken. The commission is authorised to make certain other information available. The Act requires the commission to notify PCTs, local authorities, strategic health authorities, Monitor and anyone else it considers appropriate when it issues certain notices, such as a notice proposing cancellation of registration. However, to ensure that these requirements are not overly burdensome, Regulation 9 sets out certain exemptions from this requirement, such as where notices relate to certain administrative matters such as the process of considering and granting initial applications for registration. Regulation 10 sets out further details about who must be notified. In carrying out its functions the commission will need to look at documents and information as well as talk to providers and those using the services. The commission will need in the course of carrying out its functions to question people for explanations of any relevant matters. These regulations set out the people who must provide an explanation to the commission if requested to do so. The Act makes it an offence for these persons to fail to comply with a requirement from the commission for an explanation of a matter. The regulations will give the commission a stronger role in relation to the provision of healthcare by NHS bodies and in tackling HCAIs. These are the first in a series of regulations that will be brought before the House to widen the registration system across providers of health and social care services. I commend the regulations to the Committee.