Service · Complex & Clinical Care

TDDI registration for complex and clinical care

TDDI — Treatment of Disease, Disorder or Injury — is the CQC regulated activity that applies when a service delivers or supervises clinical treatment through a registered healthcare professional. You can register for it as a new provider, or add it to an existing registration by variation. We prepare and review either route.

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When TDDI applies

Clinical care carries a heavier evidence load than personal care.

TDDI is triggered when treatment of a disease, disorder or injury is delivered or supervised by a registered healthcare professional — for example a registered nurse or doctor. If your staff only provide personal care and support, the "personal care" regulated activity is usually the right one instead.

Because clinical care carries more risk, CQC expects a working clinical governance system behind a TDDI registration: clear clinical oversight and accountability, competency sign-off for clinical tasks, and evidence of how your service would recognise and respond to someone who is deteriorating. Adding children's services is a similar step up — safeguarding, staffing and care planning all have to be evidenced specifically for children, not carried over from an adult service.

Focus

TDDI & complex care registration

Routes

New registration, or a variation to an existing registration

Timing

CQC recommends applying at least 10 weeks before you start the new service

Pairs well with

Registered Manager Support →

What we prepare

The clinical governance evidence a TDDI application is assessed against.

A new or updated statement of purpose that reflects the TDDI regulated activity
A clinical governance framework — clinical oversight, accountability, and clinical lead arrangements
Staff competency, training and supervision records for the clinical tasks your service will carry out
Route-specific clinical policies — medicines, delegated healthcare tasks, and recognising deterioration
For children's services: safeguarding, staffing and care-planning evidence specific to children
The variation application and supporting evidence, where you are adding TDDI to an existing registration

How it works

Our TDDI registration process, step by step.

Scoping call

We confirm whether TDDI applies to your service, and whether your route is a new registration or a variation to an existing one.

Clinical governance build

We help you put the clinical oversight, clinical lead and competency framework in place — the substance CQC assesses, not just the policy.

Policies and evidence

We prepare the route-specific clinical policies and assemble the records CQC expects to see for complex or children's care.

Full review

We check the application or variation is complete and internally consistent before anything is submitted.

Submission and questions

You submit through the CQC provider portal, and we support you through CQC's assessment questions and any registered manager interview.

What to expect

Timing and assessment for TDDI

CQC recommends applying at least 10 weeks before you intend to start the new service. In practice, building the clinical governance evidence beforehand usually takes longer than completing the application itself, so it is worth starting early.

A TDDI application is assessed more closely than a standard personal-care registration, and a variation to an existing registration is held to the same clinical governance expectations. CQC now returns incomplete or inaccurate applications on receipt, so our work focuses on completeness before submission.

FAQ

Frequently asked questions

What is TDDI registration?

TDDI stands for Treatment of Disease, Disorder or Injury. It is a CQC regulated activity that applies when care includes clinical treatment delivered or supervised by a registered healthcare professional, such as a registered nurse or doctor. A service must be registered for it before delivering that care.

Do I need TDDI registration, or is personal care enough?

If your staff only provide personal care and support, the "personal care" regulated activity is usually the right one. TDDI applies once the service delivers or supervises clinical treatment through a registered healthcare professional. We help you work out which applies to your model of care.

What is the difference between new TDDI registration and a variation?

A new provider registers for TDDI as part of a first application. An existing registered provider adds TDDI by applying to vary their registration. Both routes are assessed by CQC against the same clinical governance expectations.

How far in advance should I apply for TDDI?

CQC recommends applying at least 10 weeks before you plan to start the new service. Building the clinical governance evidence usually takes longer than the application, so allow more time than the assessment window alone.

Can you help add children's services to our registration?

Yes. Adding children's services means evidencing safeguarding, staffing and care planning that is specific to children, rather than extending your adult service's policies. We prepare that evidence and the variation application.

Is there a CQC fee for a variation?

CQC does not charge a fee to apply for a variation. Your annual provider fee may change once the variation takes effect, because it reflects the regulated activities and the size of your service.

Related services

Extending into complex care or children's services?

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