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Independents' Day

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 providersCurrent feeProposed 2017/18 fee

list size up to 5,000 patients



list size between 5,001 and 10,000 patients



list size between 10,001 and 15,000 patients



list size over 15,000 patients




Multiple location providers


2 locations



3 locations



4 locations



5 locations



between 6 and 10 locations



between 11 and 40 locations



More than 40 locations



Source: BMA

Readers' comments (49)

  • That's okay, because we all really appreciate and value the work done by the CQC....

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  • The entrenchment of the academic-regulatory complex in the medical profession and the diversion of funds away from patients towards itself continues.

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  • this will help recruitment and retention a lot. Well done.

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  • Pay the commissars more, doesn't make the NHS more productive, probably less.Collectivization in action comrades.

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  • This is an absolute joke at a time when all Practices are feeling the pinch. I really don't see how they can justify an annual charge increase of this significance for 1 in 5 yearly inspections. That will mean any one inspection for even the smallest practice will cost them night on £20,000 for the privilege. How on earth can that be right and just?! The process is a shambles, practices doing exactly the same thing getting different ratings from different inspectors; 6 months or more to get a report, so where is the patient confidence there, if there's something picked up its likely not to be tackled for another year.....

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  • this is an outrage- we have recently had a CQC inspection at a huge personal and organisational cost- both financial, time and stress and given that we anticipate being re-inspected in 5 years- the cycle admin cost of this for our large practice will be £30,000 !!! How can that possibly be justified ?

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  • I'm a full time locum GP; news like this makes me wonder if I will ever become a GP Partner or go abroad?

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  • we have just been inspected at significant personal and organisational cost in terms of money, time and stress . we are a single site practice of 16000 so if- as anticipated, we receive another visit in 5 years- then that cycle of inspection will be £30,000 before we even consider the cost above - this is an outrage.

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  • Hahahahahahaha! Sorry, is this not a joke?

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  • We are a two site practice but during our recent CQC inspection they just visited the one site. Why, oh why, do we have to almost pay double for the privilege. We are not anticipating that they will be back for 5 years, it just doesn't seem right...

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