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Gold, incentives and meh

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)

  • If the DOH really want to help patients, they can just scrap this useless organisation and get the GPs there to help out and see some patients for a change. It will be an improvement to recruitment.

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  • this is a small price to pay for patient safety. David Behan said it best that 'protecting the public' comes with a cost.

    the CQC does an amazing job monitoring patient safety - this is something that patients and the taxpayers want - to know that their hard earned money is being well spent on good safe health care. the taxpayer already spends a giddy 7% or so of GDP on the NHS. The last thing we should expect is that the public should pay to monitor their own health service. No - GPs are best placed as always to shoulder the burden. If anything the CQC should get a gong for the work that they have put in. Do you know how much clinical harm can occur for not having the right colored buckets? or not having a mission statement? Critics will argue that the CQC doesn't care if a practice is understaffed due to shortages and may have poor care due to starving of funds and that the CQC (and GMC) turn a blind eye to the the political initiatives that have caused practices a lot of problems in delivering quality care as they are in the pockets of said politicians. Such slurs are misplaced as the CQC has a clear remit to tick a long list on non-clinical and irrelevant politically driven initiatives and they are doing a fantastic job in doing so. Long live the CQC - please can i have a job as it sure beats seeing 50 + patients a day.

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  • Let's call a spade a spade. The DoH are liars if they say they have allocated anything at all to Practices for 2016-17 to compensate for CQC fee rises.
    If the total uplift of 3.2% and this
    so-called contribution of DoH has resulted in only a 2 pence per patient per month increase for my Practice, can I be expected to believe in this stupid assertion.

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  • I am NOT a GP but any regulatory body that thinks it can raise its fees by more that the rate of inflation should have its contract cancelled IMMEDIATELY. They should be replaced by a public body rather than yet another barely accountable arms length body that government deny all responsibility for when they get it wrong.

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  • What can they do if we all refuse to pay ????

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  • A charge on Practice of more than £20k for one inspection in 5 years. Grotesque takes on a new meaning and just reflects the intent of this government to liquidate general practice as a profession. It's worthwhile for the young colleagues to try and go back into hospital medicine as in 5-7 years you will be Consultants with guaranteed jobs, 6-8 weeks of holidays, covered indemnity and no CQC charges as this demon will not stop at present increase of fees. In GP you have funding cut every year with pseudo-uplifts accompanied by exorbitant rise in costs and no family life.
    Time to consider. If you are above 40 - try to get a diploma and develop SI so you can work with the hospital on their payroll. If your 50 don't lose hope - time to travel the world as a locum - or trudge on to 60 and take early retirement.
    If you are above 55 and entitled to retirement, what are you doing on this website - Well that's a question I am asking myself:)

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  • Of course, before treasury started to cap DDRB payments, this would have been picked up automatically as a business expense.

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  • Why should you have to pay for inspections at all?
    Surely this is just stealing money from practices that need the money fro patient care?
    If they want to inspect premises that is fine, but it should not be at the GP's expense, what a nice way to make money fro the CQC, when some of the inspections miss the most obvious issues around patient privacy and dignity!
    The CQC is a joke!

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  • Why don't we all refuse to pay ???. Would the shut us all down ?

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