Is CQC Registration Required For Podiatrists Using Class 4 Lasers

Written by Kirsten Sinclair - Podiatrist and Healthcare Demonstrator

Once again the issue of CQC registration for Podiatrists has arisen and once again I have created a formal response based on my best understanding of the guidance given from the CQC. Please note, this response is based on my own reading and understanding of the document ‘The Scope of Registration’ version published May 2022.

Key parts of the document are listed and explained below.

“To decide whether and how you need to register with CQC you may find it useful to ask yourself the following questions: -

Will I be carrying on a regulated activity? If so, which will apply to me?
Who will be responsible for directing and controlling the regulated activity? (called ‘carrying on’ the activity)
Will any exceptions apply?
Where will the regulated activity be carried on at or from? (called location(s))
Is a registered manager required at any or all locations?
If I am intending to provide services to children, do these activities need to be registered with CQC, Ofsted or both?”

(page 2)

The potential regulated activity in question is the use of lasers and intense pulsed light (IPL).

It is important to focus on the activities that will trigger the need for registration. This depends on what regulated activity you provide within your 'service type'.

(page 3)

Podiatric laser therapy does not fall under any of the listed service types.

Who must carry on the regulated activity for it to be in scope.

You will need to register for this regulated activity if your service includes treatment that is carried out by:

a listed healthcare professional, or if this professional supervises the treatment, or
a social worker where the treatment is for a mental disorder, and is intended to treat disease, disorder or injury.

(Pg 30)

Podiatry is NOT listed so NOT in scope for registration

Professionals who are NOT included in the scope of this regulated activity The list of professionals in the regulations does not include:

clinical psychologists
occupational therapists
physiotherapists
pharmacists
opticians
dietitians
nursing associates.

If you are one of these professionals and you run a standalone treatment service, you do not need to register for Treatment of disease, disorder or injury.

(Pg 31)

Podiatry not mentioned in inclusion OR exclusion list – off the radar so presumably, not in scope.

If you provide laser and IPL services that are delivered by listed healthcare professionals, you will only need to register where:

the specific skills of a listed healthcare professional are used, for example where the service is part of a package of clinical care and requires specialist physiological and psychological knowledge such as use of a laser as part of plastic surgery procedures (in this case the regulated activity of Surgical procedures would apply), or
the service is combined with other procedures that require a listed healthcare professional qualification, for example prescribing or
you describe the service as being carried out by someone acting in their capacity as a registered healthcare professional.

(pg 35-36)

Podiatry is not one of the listed healthcare professions (see part 7 below). Therefore, following the decision tree on page 40, when we reach “Is the treatment by or under the supervision of a healthcare professional listed in this guidance?” the answer is NO which takes us to out of scope, no registration required.

(Pg 40)

“The activity does not cover the following surgical procedures if they are carried out using local anaesthesia or no anaesthesia:

nail surgery and nail bed procedures on the foot carried out by any healthcare professional
curettage (scraping), cautery (burning) or cryocautery (freezing) of warts, verrucae or other skin lesions, carried out by a medical practitioner, or another healthcare professional on any area of the foot.”

(Pg 43)

So even for ablative lasers, the procedures above carried out are ‘out of scope’ and don’t require registration. See also, decision tree on Pg 46.

Glossary of terms:

Healthcare professional (other than in relation to the regulated activity of Treatment of disease, disorder or injury)

Listed healthcare professional in relation to the regulated activity of Treatment of disease, disorder or injury For the purpose of this regulated activity only, a listed healthcare professional is defined under Schedule 1 paragraph 4(4) of the 2014 Regulations as a:

medical practitioner –
dental practitioner –
dental hygienist –
dental therapist
dental nurse
dental technician
orthodontic therapist
nurse midwife
biomedical scientist
clinical scientist
operating department practitioner
paramedic
radiographer

(pg 65)

Conclusion

In response to the email I sent them the CQC state, “Ultimately providers are required to make the final judgement as to whether they need to register or not and for which regulated activities, because they know the exact nature of the service and the activities they will provide.”

In summary, based on the points made above, I do not see that podiatrists are required to register to be able to use therapeutic lasers.

What I have written is as mentioned, my own understanding based on through reading and re-reading of the guidance document and decision tree and is shared in good faith. Please read the document for yourself to allow you to make an educated decision based on your own understanding.