In this paper we present a complete reference framework for the provision of quality assured Trusted Third Party (TTP) services within a medical environment. The main objective is to provide all the basic guidelines towards the development of a quality system for a TTP as an organisation, which could be mapped directly to the requirements of ISO-9000 standards. The important results of the implementation of a quality system, are the enhanced trustworthiness of the TTP and the confidence of the medical society in the provided services. Furthermore, the value added certification services conform to customer requirements and are characterised by efficiency, reliability, security, credibility and trust. The internal organisation acquires a clear and strict structure and maximises its effectiveness by establishing quality management, committed to control, assure and improve quality. The TTP requirements for quality are identified and the various elements of the quality system are described illustratively.