As UK director of two CQC-regulated dental companies for a Turkish dental group, I have been the person on the paperwork for opening a clinic in Chiswick, London. That means company setup, CQC registration, GDC compliance, recruitment, finance and the clinic launch. Before that I had spent years helping companies enter new markets from the marketing side. Doing it as the director, with my name on the regulatory documents, taught me things the marketing side never did.
This is not legal advice, and every case is different. It is the order of work as I now understand it, written for founders and groups who want to open a regulated business in the UK and would rather learn from someone else's sequence than invent their own.
It is a sequencing problem
The single most useful idea I can offer is that opening a regulated clinic is not a list of tasks. It is a sequence. Many steps depend on others being finished first, and some depend on each other in ways that are not obvious from the outside. You cannot register a regulated activity without premises. You cannot finish the premises without knowing what the regulator expects of them. You cannot hire clinical staff easily without a start date, and you cannot give a start date without registration.
Groups that treat it as a checklist try to do everything in parallel and discover the dependencies late. Groups that treat it as a sequence find the critical path early and protect it. The critical path, in my experience, runs through regulatory registration. Almost everything else should be planned around it.
1. The company and the governance
Start with the UK entity, and think harder about governance than you think you need to. Setting up a company at Companies House is quick. Deciding who the directors are, who holds which responsibility, and how decisions made by a parent company abroad translate into accountability in the UK, takes much longer and matters much more.
UK regulation of healthcare assumes clear, local accountability. Someone in the UK must be responsible for the regulated activity, and the regulator will want to know who that is and how they are supported. For an international group used to making decisions centrally, this is often the first cultural adjustment. Authority has to sit where the accountability sits.
2. Banking and finance
Open the bank account early, and expect it to take longer than any other administrative step. UK banks carry out detailed checks on companies with overseas ownership, and the questions they ask about the group structure, the source of funds and the people involved are reasonable but thorough. Have the documents ready: group structure, ownership, identity of the people with significant control, and a clear explanation of what the UK company will do.
Finance is more than a bank account. Payroll, VAT treatment, accounting for transactions between the UK company and the group, and the reporting the parent company expects all need to be designed before the first patient arrives. A good UK accountant who has worked with international groups is worth finding at this stage, not after the first year-end.
3. Premises, designed for the regulator
Choose the premises with registration in mind. A clinic is not just a shop fit-out with dental chairs. Infection control, decontamination, waste, accessibility, and the flow of patients and staff through the building all matter to the regulator, and they are far cheaper to design in than to correct later.
The lease itself needs care. Landlord consent for the use, for the works and for the regulated activity should be clear before the fit-out starts. The fit-out team should understand clinical requirements, and someone on your side should understand what the regulator will ask about the building. In practice that someone is often the director.
4. CQC registration: the critical path
In England, a provider of regulated activities such as dental care must register with the Care Quality Commission. Registration is not a form. It is an assessment of whether the provider can deliver care that is safe, effective, caring, responsive and well-led. The regulator wants to see the policies, the people, the premises and the governance that will make that true from day one.
This is where international groups most often underestimate the work. The policies cannot simply be translated from another country's system; they need to reflect UK requirements and the way the clinic will actually run. The people named in the registration need to understand their responsibilities. And the premises need to be ready enough to be assessed.
Because almost everything else waits for registration, I would start preparing for it at the very beginning, in parallel with the company setup, rather than treating it as a final step once the building is finished.
5. Professional registration and recruitment
Every dentist, dental nurse, hygienist and therapist working in the UK must be registered with the General Dental Council. For clinicians trained abroad, the route to registration depends on where and how they qualified, and it is not always quick. A group that plans to bring its own clinicians from overseas needs to understand the route for each person early, because it can easily become the slowest part of the whole project.
Recruiting locally has its own challenges. Good clinical staff are in demand, and they will ask sensible questions about the clinic, the systems, the support and the start date. Being able to answer them clearly is part of the pitch. So is having the employment contracts, induction, training records and compliance processes ready before people join, not after.
6. Systems before the doors open
The last step before opening is the one most often rushed: the systems that will run the clinic every day. Patient records, booking, consent, payments, follow-up, complaints, audit. A new clinic has no patients and no reputation, so how it answers its first enquiries matters a great deal.
This is where my own work on AI-run systems began. Dental clinics lose a large share of new-patient enquiries to slow replies, so we built CareDental, which follows up enquiries over WhatsApp, qualifies them and books them, first for the clinic I direct and then for others. The broader lesson is that a new clinic has a rare chance to build its operations properly from the start, rather than layering systems on top of habits later.
What I would tell the next group
Find the critical path on day one, and protect it. In my experience it runs through regulatory and professional registration, and most delays elsewhere are tolerable if those are moving.
Put accountability where the regulator expects it. Decide early who in the UK is responsible for what, and give them the authority and support to match. A director who signs the documents but cannot make decisions locally is a risk to everyone, including the patients.
Treat banking and governance as real work, not paperwork. These are the steps that assume local knowledge and punish its absence.
And build the clinic's systems before the doors open. Regulation is not an obstacle to a good business; it is a description of one. A group that builds what the regulator asks for, properly and early, ends up with a clinic that is easier to run, easier to scale and easier to trust.