Healthcare providers could be shut down for failing to comply with National Institute for Health and Clinical Excellence guidance under plans to make adherence a requirement of the Care Quality Commission's registration scheme.

CQC chair Baroness Young has revealed that organisations from hospitals to GP surgeries will be expected to prove they are complying with national guidelines on clinical effectiveness as part of the new regulator's registration process.

Speaking at NICE's tenth anniversary conference in Manchester last week, Baroness Young said clinical guidance would be "built into" the registration system.

She said: "There's an opportunity for the registration system and the assessments that follow it to raise the profile of NICE guidance, to highlight [its] importance and to track some of that through the assessment process."

The plan is likely to be controversial as clinical guidelines are not currently compulsory and uptake is patchy.

Hardening tone

A CQC spokesman later said providers would be expected to demonstrate compliance with NICE and other national guidance "unless they can show a good reason to vary from them". He said: "The steps that we can take range from a formal warning notice to prosecution and imposition of restrictions, or even closure of a service."

The news marks a hardening in tone at the CQC: in August, Baroness Young told HSJ that health service organisations ignoring guidelines faced marked down annual assessment ratings and lower pay.

Foundation trust network director Sue Slipman said: "The danger here is that we confuse essential entry requirements from providers with gold standards.

"Entry level was never meant to be gold standard - that isn't to say that we don't want everyone to get there, but that's a developmental issue."

Variable quality

And Royal College of GPs chair Steve Field warned that NICE guidelines varied in quality and members had some concerns. He said: "You need to make sure that the guidelines are usable and appropriate."

NICE itself is gathering data on guidance uptake, but is not able to estimate current compliance levels across the board.

Implementation director Val Moore said uptake often varied within hospital trusts, as well as across PCT areas.

She said NICE had been "knocking around themes" on guidance uptake with the new watchdog but added: "For NICE to work with the regulators but not be a regulator is an important strand."

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