GPs face seven-fold increase in CQC fees by 2017/18

GP practices could be hit by a seven-fold increase in CQC fees by 2017/18 under radical plans proposed by the watchdog to claw back its full chargeable costs from providers.

Funding: GP CQC fees to rise sharply over coming years

CQC fees for a GP practice with 5,000-10,000 registered patients that operates at one location must rise from £725 to £4,839, the watchdog has said. This could happen over two years – by 2017/18 – or over four years.

The DH has pledged a £15m funding boost for GPs in 2016/17 intended to mitigate the rising costs practices will face, although officials are not yet able to confirm whether further funding will be made available in subsequent years.

The CQC is currently funded through grant-in-aid from the DH in addition to provider fees, but government policy dictates that fee-setting regulators must recuperate their costs fully through fees income. Fee income for providers this year will account for under 51% of the £224m a year the CQC spends on its registration functions.

Map: GP CQC ratings by CCG

The watchdog is now holding a consultation to decide on which of two ‘timescale’ strategies it will adopt to recover full chargeable costs from providers, which will see it attaining full recovery over two years or over four years.

Under the two-year plan, fees will leap 3.5-fold from £725 to £2,574 in April next year for the average GP practice, followed by a further increase to £4,839 – almost seven times more than the current charge. The four-year strategy would see fees almost double to £1,341 in April next year, and rise each year until the £4,839 target is reached in 2019/20.

The huge spike in provider fees will go in part to cover the costs of the watchdog’s overhauled inspection regime and the ‘substantial organisational restructuring’ this entailed, which contributed to the CQC's costs rising by £180m compared to two years ago in 2013/14.

This meant that ‘the rise in costs out-stripped increases in fees’, causing CQC to rely on additional grant-in-aid from the government during this time, it said.

David Behan, chief executive of the CQC, said: ‘Our commitment is to make sure that people receive safe, effective, compassionate and high-quality care and we can see that our new inspection model is allowing us to support providers to do exactly that. The fees providers pay enables this important work to happen.

‘We are required to move to full cost recovery and are consulting on how we do this. We recognise the financial pressures faced by many providers, and do not underestimate the impact of any changes to their fees. We developed our proposals with an expert panel; including representatives from the providers we regulate.

CQC costs for GPs

‘We are committed to ensuring that we continue to monitor the costs of our regulatory work closely, as well as seek to improve our efficiency, evaluate our effectiveness and demonstrate the value of our approach to the public, as taxpayers and as people who use services, and to the sectors we regulate.

‘We welcome feedback on these proposals.’

A DH spokeswoman said: 'We want the NHS to be the safest healthcare service in the world and the CQC plays a vital role. We have always been clear that we expect the CQC to recover its costs through fees.

'These fees allow CQC’s tough inspection regime to drive up standards across the country and ultimately make sure patients get safe and compassionate care.'

GP funding

The spokeswoman told GPonline that it was not the government's intention for GP practices to bear the brunt of the increased CQC charges.

The £15m cash injection the DH has pledged for GP practices in 2016/17 amounts to an average of around £2,000 per GP practice in England. This looks likely to cover the bulk of increased fees practices could face in 2016/17 under the two-year strategy proposed by the CQC.

However, it would not cover the full seven-fold rise practices face, and the DH was unable to comment on potential subsequent new funding to support practices with the rising costs.

CQC increased fees to practices this year by 9%, described at the time as a ‘financial blow’ to practices by the GPC. 

The CQC is accepting feedback from providers as part of the consultation, which will be open until midday on 15 January 2016. The final decision on fees for 2016/17 must be made by health secretary Jeremy Hunt, and will be finalised in March 2016.

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