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DH unable to guarantee 76% CQC fee hike will be fully reimbursed

The Department of Health has been unable to guarantee it will reimburse practices for the 76% hike in CQC registration fees, stating that it is under negotiation.

The GPC said it expects practices will be reimbursed, after the CQC proposed to increase all GP practice fees by three quarters next year, with the biggest practices having to pay more than £100,000, and the total fee burden reaching almost £40m.

Under the proposals, an average-sized GP practice with 5,001-10,000 patients will see their fees increase by almost £2,000, to £4,500.

The Department of Health put £15m into the 2016/17 GP contract to cover rises in fees for GP practices. It previously said it would ‘review’ future years’ costs, although a BMA spokesperson said the GPC is expecting rises to be fully reimbursed.

But when asked, the DH was unable to guarantee that this was the case.

A spokesperson said: ‘The Government has made extra funding available for general practice this year to reflect a number of increasing cost pressures, including CQC fees.

‘Negotiations between NHS Employers and the GPC on the 2017/18 GMS contract continue.’

The GPC said the proposed fee hike was ‘scandalous’, even if it were reimbursed to practices.

It said fee rises would divert funding which would otherwise have been spent on frontline patient services – as the total annual cost of inspections for general practice was due to rise from £21.3m to £37.5m.

GPC CQC lead Dr Mark Sanford-Wood said that since the CQC is ‘planning to significantly reduce the scale of its GP inspections’ this ‘should lower the cost of regulation’. He said that ‘makes the proposal to increase its fees inexplicable and wholly unjustified’.

He said: ‘This is a scandalous proposed increase in fees that could see GP practices being charged an extortionate 76% rise in their CQC costs.

‘While NHS England has promised to reimburse GP practices for the increase in fees, it nevertheless will divert overstretched NHS funds from other budgets from frontline patient services to maintain a system of regulation and inspection in which the majority of GPs have little confidence.

He said these increases ‘need to be halted so that precious NHS resources are spent on providing care to patients and not feeding the bureaucracy of the current regulation and inspection programme’.

When asked whether GP practices will be reimbursed for this hike in fees, GPC Dr Chaand Nagpaul said: ‘That’s what they have said they will do and we will expect them to honour it.’

The CQC said the proposed fee rises were the second step in its two-year trajectory to cover all of its costs via charges rather than relying on Government grants, as ordered by the Treasury.

But CQC chief executive David Behan said that ‘protecting the public’ comes with a cost.

He said: ‘We know that our work is leading to better care – providers tell us our reports help identify areas for improvement, and we regularly see improvements when we re-inspect.

‘Protecting the public in this way has a financial cost. The fees paid by providers enable us to fulfil our purpose of making sure health and social care services provide people with safe, effective, compassionate, high-quality care.’

The CQC is consulting on the fee increases until 11 January 2017 and will make a final proposal to health secretary Jeremy Hunt in March. The new fees will come into force on 1 April 2017.

Proposed CQC fee increases

Single location providers Current fee Proposed 2017/18 fee

list size up to 5,000 patients

£2,187

£3,845

list size between 5,001 and 10,000 patients

£2,574

£4,526

list size between 10,001 and 15,000 patients

£2,978

£5,237

list size over 15,000 patients

£3,365

£5,918

     

Multiple location providers

   

2 locations

£4,761

£8,371

3 locations

£6,347

£11,161

4 locations

£7,934

£13,951

5 locations

£9,518

£16,736

between 6 and 10 locations

£11,900

£20,924

between 11 and 40 locations

£23,799

£41,848

More than 40 locations

£59,494

£104,614

Source: BMA