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CQC fee hike slammed by GPs and health providers

Plans for fee rise 'damaging to patient care'

Jo Carlowe

Tuesday, 03 November 2015

Doctors and health managers have slammed proposals to increase CQC fees, almost seven fold. 

This week, the Care Quality Commission (CQC), announced proposals to increase its fees to start in 2016. In its consultation document, it states its aim is to achieve full chargeable cost recovery over a defined timescale of either two years (2016-18) or four years (2016-2020).

Under proposal one (two year timescale), a single location GP practice with up to 10,000 registered patient, would see its fee increase from £725 to £2,574 for 2016/17, with an estimated fee of £4,839 by 207/18. For GPs in multiple locations (with 5 locations), the fee would go from £2,681 to £9,518 by 2016/17, with an estimated fee of £17,893 by 2017/18. 

Dr Chaand Nagpaul, British Medical Association GP committee chair, said: “GPs will be staggered at the consultation proposals from the CQC for an unprecedented increase in practice fees at a time when many are struggling financially.

“These changes, if adopted, will see fees for GP practices increase seven fold and will lead to practices collectively paying £40 million a year for CQC's activity. It is an inexplicable move given the CQC is itself reviewing its inspection programme with a stated aim of introducing a scaled down process with fewer inspections."

He added: “The BMA had already called for end to the disproportionate, bureaucratic nature of CQC inspections, which currently has a focus on pointless box ticking that takes GPs and staff away from caring for patients. Requiring GPs to pay more for an imposed system they do not have confidence in adds insult to injury and will do nothing to repair the poor standing of the CQC with the GP profession at large."

And he warned the move, could damage patient care.

"This significant financial burden could be the final straw for many GPs and practices with many already having to cope with swingeing cuts to their core budgets and escalating costs of keeping a practice open. These proposals could have a damaging effect on patient care by further shrinking practice resources for frontline services.

“While we understand and recognise that the government has indicated resourcing GP practices for this expense, this provides no assurance that the costs will be fully met, nor that it will be recurrently available.

“The BMA’s GP committee has been consistently raising concerns about this process in our discussions with the CQC and during the consultation we will robustly challenge these wholly unjustified and damaging proposals.”

Dr Maureen Baker, Chair of the Royal College of GPs, said: “The last thing that GPs and our practice staff need is further charges whilst we are under intense resource pressure.

“We are pleased that the Department of Health has stepped in to address this situation, so that practices will not suffer financially as a result of these changes – but practices need assurances that these will cover all costs.

“The College has been expressing concerns for a long time about the burden of CQC inspections on practices. What we really need is for the GP inspection regime to be halted and a less resource-heavy and bureaucratic process be put in place, so that GPs are not taken away from frontline patient care whilst inspections are underway.”

Responding to changes to the CQC fees and regulation, Rob Webster, Chief Executive, NHS Confederation, warned the fee hike would jeopardise relations between the health watchdog and health providers.

“Increasing fees by at least a further 40% next year will add a considerable burden on trusts. It comes as providers forecast a deficit of around £2 billion this year and face £1 billion of increased pension payments from 2016/17. The goodwill of providers towards CQC and its new approach to inspections could be jeopardised by this fee increase.

“Further change is needed if CQC inspections and regulation are to be sustainable. Progress in regulation has to mean greater alignment and an elimination of duplication between the national arms-length bodies. Our members cannot afford the time or the disruption of multiple interventions by multiple organisations." 

He added: "The CQC must also look beyond individual organisations to local healthcare systems and NHS Confederation members want a much stronger voice in how the CQC further develops its regime – particularly given they will be contributing so much of its funding. Providers will also be looking to CQC to demonstrate that it is delivering value for money, especially as it will soon start to assess their use of resources.”

In the CQC’s consultation foreword, Michael Mire, interim chair, and David Behan, CQC chief executive stated: “We do not underestimate the impact on providers of paying fees, and we will continue to look carefully at our costs relating to regulation. We have a responsibility to cover our costs by charging fees, but we are also accountable for demonstrating that we are fair, efficient, effective and proportionate. In this context, it should be noted that the budget for CQC in relation to the overall spending on health and adult social care in England is 0.16%.”

The CQC's consultation on its fees proposals ends on 15th of January.

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