Published on October 8, 2026 by the Quality Clinic Licensing and health authorizations team, reviewed by the Head of Consulting and Projects. About a 7-minute read. How we write this blog.
In 30 seconds
- Real Decreto 239/2026, a royal decree issued by the Spanish government, has been in force since July 1, 2026 and adds an article 7 to Real Decreto 1277/2003, which regulates the authorization of healthcare centers.
- Every clinic must keep a personal file for all of its healthcare staff, with their official qualification and specialty, whatever their relationship with the center.
- Deadline for centers: January 1, 2027, six months after entry into force. The regions (comunidades autónomas) have one year to adapt the range of healthcare services.
- New hires, departures and changes in the National Registry of Healthcare Professionals (Registro Estatal de Profesionales Sanitarios, REPS) are reported within 7 days at most.
What Real Decreto 239/2026 requires from your clinic
Professionals with different working relationships work in a clinic: employees on an employment contract, doctors who see patients as self-employed practitioners and summer cover. Real Decreto 239/2026, in force since July 1, 2026, requires the clinic to document the qualifications of all of them, regardless of the relationship.
The decree amends Real Decreto 1277/2003, which sets the basic rules for the health authorization (autorización sanitaria) of centers throughout Spain, and adds an article 7 with three obligations.
The three obligations of the new article 7 of Real Decreto 1277/2003
Appropriate qualification7.1
All care must be provided by professionals with an official qualification and with the competencies appropriate to the authorized care unit, for as long as the center operates.
A file for each professional7.2
Up-to-date information on all healthcare staff and a personal file for each professional, with their official qualification and, if they have one, their official specialty.
Safe practices7.3
Inform each professional who joins of the safe practices the center applies.
Article 7.2 expressly includes healthcare staff “whatever their legal relationship and the form and place in which the services are provided.” The doctor who sees patients two afternoons a month counts just as much as the staff nurse.
The decree's preamble explains why. Among the extreme-risk incidents reported in 2024 to the Ministry of Health's patient safety system, 62.5% had professional-related factors as a contributing cause, including training and competence.
The two deadlines the decree sets
The royal decree sets one deadline for the clinic and another for the administration, and both run from its entry into force on July 1, 2026.
Deadlines of Real Decreto 239/2026
Each healthcare centerSix months
Have up-to-date information on all of its healthcare staff (first additional provision, disposición adicional primera). Six months from July 1, 2026.
Each regionOne year
Adapt the centers' range of healthcare services to the amended annexes (second additional provision). One year from July 1, 2026.
The deadline for centers falls on January 1, 2027, six months after entry into force. From that date, information on all healthcare staff must be available and up to date.
The file does not replace the National Registry of Healthcare Professionals (REPS). Real Decreto 640/2014 requires private healthcare centers listed in the registry of centers to report their professionals' data, and the Ministry of Health asks for new hires, departures and changes to be reported within 7 days at most of when they occur.
What each professional's file must contain
Article 7.2 sets the minimum: the official qualification and, if they have one, the official specialty in health sciences. The obligation does not start from scratch. Ley 44/2003, the law on the organization of the healthcare professions (de ordenación de las profesiones sanitarias), already required centers to keep a personal file for each professional and to review, at least every three years, that their staff meet the requirements to practice.
What to document for each healthcare professional and which regulation requires it
Copy of the official degree
Required by Real Decreto 1277/2003, article 7.2.
Specialist degree, when the unit requires it
Required by Real Decreto 1277/2003, article 7.2, and its annex II.
Diplomas, certificates and other professional credentials
Required by Ley 44/2003, article 8.3.
Professional association membership, relationship with the center, place of practice and role
These are REPS data, under Real Decreto 640/2014.
Liability insurance coverage
This is a REPS data item, under Real Decreto 640/2014.
Review that they meet the requirements to practice
Required by Ley 44/2003, article 8.3: at least every three years.
The list is not limited to doctors and dentists. Ley 44/2003 treats technicians in the health vocational training family as vocationally trained healthcare professionals, among them advanced technicians in Dental Hygiene and in Dental Prosthetics and technicians in Auxiliary Nursing Care, and Real Decreto 640/2014 brings them into the REPS. In a dental clinic, hygienists and assistants with that qualification are in the registry: include them in your list as well.
Professionals have the right to access their own file, under the same article 8.3 of Ley 44/2003. That is why the file is kept as staff documentation, easy to locate and up to date.
What competence each unit requires: aesthetics, surgery and dentistry
Article 7.1 measures competence against the definition of each care unit (unidad asistencial) in annex II of Real Decreto 1277/2003. For aesthetic medicine, surgery and dental clinics, these are the definitions in force.
Who is responsible for each care unit under annex II of Real Decreto 1277/2003
U.44 Dentistry/stomatology
A dentist or stomatologist.
U.47 Cosmetic surgery
A medical specialist in Plastic, Aesthetic and Reconstructive Surgery, or in another surgical or medical-surgical specialty within its official program.
U.48 Aesthetic medicine
A doctor, for non-surgical treatments aimed at improving the appearance of the body or face.
In cosmetic surgery, the definition of U.47 itself admits other surgical or medical-surgical specialties only “within the scope and competencies set out in the official program of their specialty.” Article 7.1 applies the same criterion to all care provided by the center.
Your clinic's authorization decision lists its units, and each unit determines which qualification to check. A dental clinic that has added aesthetic medicine treatments checks each unit against its own definition: U.44 for the dental practice and U.48 for aesthetics.
Article 4.2 of Real Decreto 1277/2003 allows each region to add to these minimum requirements for the centers in its territory. Confirm with your regional health department (consejería) whether it asks for additional documentation for the staff file.
Action plan: the staff file in five steps
- Draw up the full list of healthcare staff who provide services in the clinic: employees, self-employed professionals, cover staff and anyone who also works in another center of the group.
- Collect a copy of the official degree of each professional and, when the unit requires it, of the specialist degree.
- Compare each qualification with the unit listed in the clinic's authorization decision, using the list in the previous section.
- Appoint one person responsible for the REPS. Check in the registry's public search that each professional appears under your center, and report new hires, departures and changes within 7 days at most.
- Write the safe-practices onboarding that each new member of staff receives, as article 7.3 requires, and record in their file the date they receive it.
The Ministry of Health warns that the REPS does not yet include every practicing professional: someone missing from the public search does not mean they cannot practice. That is why the clinic's own file, with the copy of the degree, is the proof the clinic controls.
Next step: the staff list
Start with the list from the first step and mark, next to each name, which document is missing. With that list and the clinic's authorization decision on the table, you know what is left to collect before January 1, 2027.
From the list to the complete file: your clinic's authorization, in specialist hands
The staff file is one more piece of your clinic's health authorization. Each time the clinic changes its structure, its owner or its range of healthcare services, it needs a modification authorization, and the regional health department checks again that it meets the requirements.
In our Licensing line of work, we handle health authorizations for clinics anywhere in Spain. We prepare the complete application file, ready to submit in under 60 days. In recent years, the decision on our files has arrived in 8 weeks on average, against a maximum legal period of three months in the Madrid region (Comunidad de Madrid).
We have worked only with clinics since 1999, with 1,017 clinics advised. The initial diagnostic meeting is at no cost and we call you within 48 hours.
Sources
- Real Decreto 239/2026, of March 25, BOE-A-2026-6975 (in Spanish). Accessed September 29, 2026.
- Real Decreto 1277/2003, consolidated text, articles 4 and 7 and annex II, BOE-A-2003-19572 (in Spanish). Accessed September 29, 2026.
- Ley 44/2003, de ordenación de las profesiones sanitarias, article 8, BOE-A-2003-21340 (in Spanish). Accessed September 29, 2026.
- Real Decreto 640/2014, on the National Registry of Healthcare Professionals, articles 4 to 6, BOE-A-2014-8712 (in Spanish). Accessed September 29, 2026.
- Ministry of Health, reporting of data to the REPS by organizations (in Spanish). Accessed September 29, 2026.
- Ministry of Health, REPS public search (in Spanish). Accessed September 29, 2026.
- Ministry of Health, press release of March 24, 2026 (in Spanish). Accessed September 29, 2026.
- Comunidad de Madrid, authorization of healthcare centers: decision period (in Spanish). Accessed September 30, 2026.