In my last published article, I addressed the issue of CQC registration and doctors’ practising privileges.
If you want to read it, it can be accessed here.
This week I address another statutory exemption from CQC registration that applies to medical practitioners which is less well known and rather more arcane than the one that applies to practicing
privileges.
It is as follows:
- You are an individual doctor or group of doctors
- You carry out treatment in a surgery or consulting room
- You are a registered service provider already in respect of the regulated activity of treatment of disease, disorder of injury or are employed by such a service provider. Employment extends to doctors holding practising privileges.
- You are either on the medical performers list for a designated body or employed by a service provider that is a designated body
- You are not providing any of the following activities listed below.
(a) treatment carried out under anaesthesia or intravenously administered sedation, apart from
(i) nail surgery and nail bed procedures on any area of the foot that are carried out using local anaesthesia or without anaesthesia,
or (ii) curettage (scraping), cautery (burning) or cryocautery (freezing) of warts, verrucae or other skins lesions carried out using local anaesthesia or without anaesthesia
(b) medical services provided in connection with childbirth
(c) the termination of pregnancies
(d) cosmetic surgery, with the exception of
(i) the piercing of any part of the human body,
(ii) tattooing,
(iii) subcutaneous injections of a substance(s) to enhance appearance or
(iv) removal of hair roots or small blemishes on the skin by applying heat using an electric current
(e) haemodialysis or peritoneal dialysis
(f) endoscopy other than using a device which does not have a lumen or other channel for the purpose or design of passing fluid or instruments through, or removing body tissue or fluid or any other item from, a person’s body
(g) the provision of hyperbaric therapy, being the administration of oxygen (whether or not combined with one or more other gases) to a person who is in a sealed chamber which is gradually pressurised with compressed air, where such therapy is carried out by or under the supervision or direction of a medical practitioner
(h) intravenous, intrathecal or epidural administration of medicines or diagnostic agents
(i) the therapeutic or diagnostic use of x-rays, radiation, protons or magnetic resonance imaging
or
(j) invasive cardiac physiology tests
A “designated body” means a body prescribed by regulation 4 of the Medical Profession (Responsible Officers) Regulations 2010 for the purpose of revalidation of doctors. Each designated body will have a Responsible Officer for the purposes of revalidation.
In its published Scope of Registration guidance, CQC says the exemption does not apply to:
- An organisation
- A doctor (or group of doctors) that employs a range of other staff
- To treatment provided outside of the surgery or consulting room, “or to treatment provided remotely over the telephone, by video consultation or by email.”
In practice, based on CQC’s interpretation of this particular exemption, it will have limited application. CQC says it only applies to face-to-face treatment in a surgery or consulting room by the doctor or doctors, and even then, only if they do not employ a range of other staff and do not carry on the service through an organisation. Also, heaven forbid, if a doctor resorts to giving out telephone advice that won’t be covered by this statutory exemption, nor will the use of emails or video consultations.
Conclusion
As I stressed in my last article, before starting work in the private sector, doctors should take legal advice on the legality of the arrangements. Prevention is always better than cure. The CQC exemptions from registration in relation to doctors are technical and obscure and they warrant careful scrutiny by the doctor, ideally before starting work in the private sector.
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