CQC to reduce fees for small practices by increasing cost for larger providers

The CQC has announced plans to change the way it calculates GP registration fees to reduce costs for practices with smaller list sizes while charging larger providers more.

The CQC plans to remove its current fee-banding structure that bases the cost of registration on how many locations a provider has.

Under the current system, fees vary based on patient list size for providers with one location, but fees are also based on the number of locations for providers that operate over multiple sites.

The new proposals will instead calculate fees based solely on list size for all providers, which it said should ‘benefit smaller providers and ensure a more equitable distribution of fees’.

This would 'broadly' mean that providers with a below average list size 'could pay a lower fee', while those with a higher list size 'could pay a higher fee'. The DH currently reimburses the cost of CQC fees in full for practices.

The CQC is consulting on which of three different approaches to setting fees in line with this plan. 

CQC fees

The planned change comes after the CQC raised registration fees for GP practices almost seven-fold over the last two years. The regulator said the increase was necessary to ensure it recouped its costs fully through fees income, without relying on government grant-in-aid as it largely did at the time.

As a result of these changes, the watchdog said it had already reached ‘full chargeable cost recovery’ through fees for general practice and all other providers except for adult social care.

The CQC's current proposals to overhaul payments therefore mean the overall contribution paid by GPs as a whole will remain the same, it said, with only the proportional amount paid by individual providers subject to change.

It said it was reviewing the structure of its fee scheme in light of changes to how the sector is run and following the large increases in fees it had already introduced.

Setting fees based on how many locations a provider has is no longer appropriate, the CQC said, because more practices now collaborate in formal ways as part of super-partnerships and other multi-site organisations.

The consultation document says: ‘As demonstrated, the current fees structure does not fit the way the sector is structured, and it will become increasingly outmoded as the way services are organised and delivered develops further.

‘Bearing this in mind, we are proposing to adjust the structure of the fees scheme so that it measures size in what appears to us to be a fairer and more equitable way. The changes will benefit smaller providers and ensure a more equitable distribution of fees.’

The consultation will run until midday on Thursday 18 January 2018. GPs can respond to the consultation here.

Read more: Most practices face simpler CQC checks from April

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