Pre-employment checks in health and social care in England
In England, care providers registered with the Care Quality Commission (CQC) must check every person they employ against regulation 19 of the 2014 Regulated Activities Regulations. Everyone employed for the regulated activity must be of good character, have the qualifications, competence, skills and experience the work needs, and be able to do it after reasonable adjustments. The information in Schedule 3 must be available for each of them, and CQC says it must be confirmed before they are employed.
CQC says "person employed" includes volunteers, contractors, agency and bank staff. It expects you to obtain the level of DBS check each role is eligible for, which turns on duties: healthcare and personal care roles can have an enhanced check with barred list checks, while administrators with no patient access can usually only have a basic check. Registered professionals, such as nurses, must be on the relevant register.
What regulation 19 requires
Recruitment procedures must be established and operated effectively so that everyone employed meets the regulation 19 conditions. Where registration with a professional body is required by law for the work or the title, the person must be registered. If someone stops meeting the conditions, you must take necessary and proportionate action and, for a registered professional, inform their regulator.
CQC says providers must regularly review the fitness of employees. It cannot prosecute for a breach of regulation 19, but it can take regulatory action. Where someone else carries out recruitment or checks, providers must assure themselves that all checks are complete and satisfactory.
The Schedule 3 file
Schedule 3 lists the information you must hold for each person:
- proof of identity including a recent photograph
- a copy of the DBS certificate where the role is eligible, with barred list information where applicable
- satisfactory evidence of conduct in previous work in health or social care, or with children or vulnerable adults
- verification, where reasonably practicable, of why any earlier job with children or vulnerable adults ended
- documentary evidence of relevant qualifications, where reasonably practicable
- a full employment history, with a satisfactory written explanation of any gaps
- information about health conditions relevant to capability, after reasonable adjustments
Filling the gaps CQC asks about
CQC's frequently asked questions say a full employment history means a career history from the age of first employment, with start and end dates (actual or approximate month and year). Evidence of conduct may be a reference from a previous employer, but need not be; written appraisals are also acceptable. Where a former employer will only confirm dates, make every effort to get more information about the person's character, skills and experience, then assess the risk and supervise the person until they show competence.
Volunteers need not give a full employment history unless they are service providers, directors or registered managers. If you appoint someone despite information about a Schedule 3 matter, CQC says you should record your reasons.
Which DBS check each role can have
DBS eligibility (England and Wales) depends on what the person does, not the job title. Anyone who provides healthcare as a regulated professional, or under the direction or supervision of one, is in regulated activity and eligible for an enhanced check with the relevant barred list checks for children, adults or both. So is anyone providing personal care to adults, such as help with eating, washing or dressing, and anyone who manages those staff day to day.
In a care home, anyone with the opportunity for contact with residents on more than 3 days in 30, overnight between 2am and 6am, or weekly on an ongoing basis can have an enhanced check without barred lists. Staff with less contact can have a standard check. Health service administrators with no access to patients can usually only be asked for a basic check. The exceptions include every role at Ashworth, Broadmoor and Rampton hospitals (enhanced, without barred lists) and NHS counter-fraud and security roles (standard). If you apply for a level a role is not eligible for, DBS warns you could be in breach of data protection legislation.
CQC expects sound reasons, and a risk assessment, if a person starts before a full DBS check. The Home Office says there are statutory requirements in the health sector for checks on people who have lived abroad; where none is available, gather as much as you can through references.
Since 1 September 2026, in England, Wales and Northern Ireland, people who teach, train, instruct, care for or supervise children often enough, or overnight, can be in regulated activity with children even if someone else supervises them.
Professional registers and agency staff
CQC expects a process to check that staff have appropriate and current registration. The NMC register shows who can practise as a nurse or midwife in the UK, or as a nursing associate in England, including anyone with restrictions on practice or a caution order. The HCPC register covers professions including paramedics, physiotherapists, occupational therapists, radiographers and practitioner psychologists.
In Great Britain, an employment agency or business supplying someone to work with, care for or attend a vulnerable person must normally first obtain copies of relevant qualifications and two references from people who are not relatives, and offer you copies. Your own regulation 19 duty remains, so ask the agency for evidence against each Schedule 3 item.
Records, referrals and the other UK nations
The DBS code of practice says certificate information should usually be destroyed after no longer than 6 months, while Schedule 3 refers to a copy of the certificate. CQC says inspectors will not routinely ask for the hard copy, but expect a record of what you obtained, including whether barred list information was received. Reconcile the two in your retention policy.
Regulated activity providers in England, Wales and Northern Ireland have a legal duty to refer to DBS where the conditions are met. CQC regulates health and adult social care in England only.
Elsewhere in the UK the rules differ. In Wales, providers of regulated services must hold two written references, including one from the last employer, if any, and apply for a new DBS certificate at least every three years, or check the certificate status at least annually where the worker is on the Update Service. In Scotland it is an offence for an organisation to offer a regulated role unless it has received a Level 2 disclosure confirming PVG scheme membership, although an offer made conditional on receiving that disclosure is allowed. In Northern Ireland, AccessNI enhanced checks are normally required for roles providing services to vulnerable adults or children.
Role-based check matrix
England only.
| Role or activity | Check | Basis |
|---|---|---|
| Everyone employed for the regulated activity, including agency, bank and volunteers | Schedule 3 information, confirmed before they start (volunteers need not give a full employment history unless they are providers or registered managers) | Regulation 19(3) and Schedule 3, 2014 Regulations; CQC guidance |
| Every new hire | Right to work check | Legal obligation the ICO cites as justifying vetting |
| Healthcare by or under a regulated professional; personal care to adults; their day-to-day managers | Enhanced DBS with the relevant barred list check | DBS eligibility guidance (regulated activity) |
| Care home staff with frequent contact but no regulated activity | Enhanced DBS without barred lists | DBS adult social care eligibility guidance; CQC expects the eligible level |
| Receptionists and medical secretaries with patient contact | Standard DBS, if the role is involved in providing health services | DBS healthcare eligibility guidance; CQC expects the eligible level |
| Admin roles with no patient access | Basic DBS at most, except at high-security psychiatric hospitals and in NHS counter-fraud or security roles | DBS healthcare eligibility guidance |
| Nurses, midwives, nursing associates, HCPC professions | Professional register check | Regulation 19(4); NMC and HCPC registers |
| Agency workers working with vulnerable people | Agency obtains qualifications and two references and takes other reasonably practicable steps on suitability; provider assures itself | Regulation 22, 2003 agency Regulations; CQC guidance |
What to tell the candidate
- Tell candidates which checks you will run, why, who will see the results and how long you will keep them.
- Ask for a full employment history and let the candidate explain any gaps in writing.
- Ask health questions only to assess capability for tasks intrinsic to the role, after reasonable adjustments.
- If a DBS certificate shows a record, assess the risk with the candidate's input and record your reasons for the decision.
- Candidates on the DBS Update Service decide whether to give you permission to check their certificate.
Sources
- Regulation 19: Fit and proper persons employed · Care Quality Commission
- Provider and CQC Inspector FAQs for meeting CQCs requirements of employment for Regulation 19 · Care Quality Commission
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 19 · legislation.gov.uk
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Schedule 3 · legislation.gov.uk
- Eligibility for healthcare roles · GOV.UK (Disclosure and Barring Service)
- DBS checks for adult social care roles · GOV.UK (Disclosure and Barring Service)
- Eligibility for Enhanced with Adults' Barred List DBS check · GOV.UK (Disclosure and Barring Service)
- Eligibility for roles working with Adults · GOV.UK (Disclosure and Barring Service)
- DBS checks guidance for employers, voluntary organisations and third parties · GOV.UK (Disclosure and Barring Service)
- Making barring referrals to DBS · GOV.UK (Disclosure and Barring Service)
- DBS Update Service · GOV.UK
- Guidance on the application process for criminal records checks overseas · GOV.UK (Home Office)
- Search the register · Nursing and Midwifery Council
- Check the Register · Health and Care Professions Council
- The Conduct of Employment Agencies and Employment Businesses Regulations 2003, regulation 22 · legislation.gov.uk
- The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, regulation 35 · legislation.gov.uk
- The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, Schedule 1 · legislation.gov.uk
- Disclosure (Scotland) Act 2020, section 73 · legislation.gov.uk
- Types of AccessNI checks · nidirect
- About us · Care Quality Commission
- Pre-employment vetting of candidates · ICO
- Change to the definition of regulated activity with children from 1 September 2026 · GOV.UK
General information for employers in the UK, not legal advice. HRjoy advises on screening policy and fair process. We do not run checks ourselves; where you need checks run, we can introduce you to our screening partners. Check the official sources for your situation.
Checks by role
Required or expected
- Everyone employed for a CQC regulated activity, including agency, bank and contract staff: the Schedule 3 information.
- Healthcare and personal care staff, and their day-to-day managers: an enhanced DBS check with the relevant barred list check.
- Cleaning, administration and maintenance staff in care homes: the level of DBS check they are eligible for, enhanced or standard depending on how often they have contact with residents, which CQC expects.
- Nurses, midwives, nursing associates and HCPC professions: a professional register check.
Depends on the role
- Healthcare receptionists and medical secretaries with patient contact: a standard check, if the role is involved in providing health services.
- Public social media checks, only for a documented risk and with notice to candidates.
Rarely justified
- Standard or enhanced checks for administrators with no patient access, who are not eligible.
- Routine credit checks.
Questions
Something else? Ask us.
Do agency and bank staff need the same checks?
Yes, the Schedule 3 information must be available for them. CQC says "person employed" includes agency and bank staff, volunteers and contractors, and where someone else carries out checks, the provider must assure itself that all checks are complete and satisfactory.
Can someone start before their DBS certificate arrives?
CQC says providers must be able to demonstrate sound reasons for not obtaining a full DBS check before a person takes up post, and show they have assessed the risk. This is an exception to the Schedule 3 rule, so record the reasons and the risk assessment.
Does our receptionist need an enhanced DBS check?
Usually not in a general healthcare setting. DBS says receptionists and medical secretaries with patient contact can be eligible for a standard check if their role is involved in providing health services. A care home receptionist with frequent contact with residents, or a receptionist in a children's hospital, can have an enhanced check without barred lists.
How often should we repeat DBS checks in England?
Regulation 19 sets no fixed interval in England, but CQC says providers must regularly review the fitness of employees. In Wales, providers of regulated services must apply for a new certificate at least every three years, or check its status at least annually where the worker is on the Update Service.
Related checks
- Criminal record checks for employers Which criminal record check a role can lawfully have in England, Wales, Scotland and Northern Ireland, and how to run it fairly.
- Employment references: what employers can ask and when When to ask for references, what to ask, the sector rules for care, schools, early years and FCA firms, and how to treat candidates fairly.
- Right to work checks: who to check and how from October 2026 Who needs a right to work check from 1 October 2026, including workers and sub-contractors, how each of the three methods works and follow-ups.
- Social media checks on job candidates When a UK employer can review a candidate's public social media, what to tell them, who should look, and what to do with what you find.
Sector guides
Also covered in our guides for Charities and volunteering, Childcare, Education, Public sector, Recruitment agencies and Security and facilities.
Related answers
- How do employers carry out right to work checks? Before someone starts work, employers should carry out one of three prescribed checks: a manual check of original documents, a Home Office online check using a share code, or a check through a registered right to work digital verification service provider. Done correctly, it gives a statutory excuse against a civil penalty of up to £60,000 per illegal worker.
- When must employers make reasonable adjustments? Under the Equality Act 2010, employers must make reasonable adjustments when they know, or could reasonably be expected to know, that a worker or job applicant is disabled and is likely to be put at a substantial disadvantage by a working practice, a physical feature or the lack of an auxiliary aid. The employer pays for the adjustments.
- How should employers handle an employee subject access request? Employers should recognise the request, which can be made verbally or in writing, confirm the person's identity if needed, make a reasonable and proportionate search and respond without undue delay and within one month. Complex requests can be extended by up to two months. A fee usually cannot be charged, and information about other people may need redacting.
- How should probation periods work? There is no legal requirement to have a probation period, and it can be any length. Acas recommends clear written expectations, regular reviews, support to improve, extension where appropriate, and a fair procedure before any dismissal. Day-one rights such as protection from discrimination apply throughout, and the unfair dismissal qualifying period falls to 6 months from 1 January 2027.