The CQC has launched a consultation on changes to fees for GP practices, expected to result in increased costs for one-site practices with large list sizes.
Those with a below average (around 7,800 patients) list size are likely to see their costs come down under the CQC’s new formula, which it said would better account for practices working across multiple sites.
Announcing the consultation, the CQC said that more than 90% of practices currently operate out of a single site, but the trend is towards multi-site working, often with community or secondary care providers.
The new system would set fees based on the list size per location, rather than charging bands based on the total patient list size.
The CQC told Pulse it will be collecting the same amount of fees from GPs overall, but a provider with three locations and a small list size would be likely to see fees reduce, while a provider with one location and a large list size will see fees increase.
Currently practices with three sites are paying triple the cost for regulation, which the CQC says does not reflect the true costs.
The consultation says: ‘Broadly, NHS GP providers with one location, who represent 90% of the sector, who have a below average list size (estimated at 7,785) will pay a lower fee, while those with a higher list size will pay a higher fee.’
It adds: ‘The current fees structure does not fit the way the sector is structured, and it will become increasingly outmoded as the way services are organised and delivered develops further.
‘Bearing this in mind, we are proposing to adjust the structure of the fees scheme so that it measures size in what appears to us to be a fairer and more equitable way.’
‘The changes will benefit smaller providers and ensure a more equitable distribution of fees. This addresses the above point on the changes in the way primary care is organised.’
However practices will be insulated against any change because the 2017/18 GMS contract introduced direct reimbursement for CQC fees.
This was done in order to offset the financial blow of the six-fold increase in costs from the withdrawal of Department of Health subsidies.
Currently practices claim back their costs, which increased by more than £4,000 for the average 7,000 patient practice, from NHS England.