GP practices will be expected to front a £6m bill towards the cost of CQC registration in the first year of the process, the regulator has revealed.
Subject to consultation, the CQC’s proposals mean that most GP practices will be paying between £550 and £850 for registration in the first year, with the maximum fee set at £15,000. However this could rise in the second year when the CQC is intending to recover more of its funding through fees.
The regulator has estimated the cost of registering primary care at a total of £12m during the first year, out of which it has committed to the Treasury to recover 50% in fees.
But the CQC said the future goal is cover the majority of costs through fees, with the percentage covered intended to rise to about 75% in the second year then incrementally rising year-on-year.
It added that since £12m is merely a cost estimation, and the real figure could fall either above or below the number, it is currently unclear how that will affect individual practices’ fees.
The news comes as the CQC has today (28 September) launched a consultation on the model under which it will recover fees from GP practices, presenting three separate models, including a recommended option that has been worked out in collaboration with the BMA.
The first model option sees fees based entirely on list size, ranging from £300 to £1,600, the second only on number of locations, with fees ranging from £600 to £50,000.
Under the recommended model, a practice with just one location would pay between £550 and £850 depending on list size. If a practice has more than one location, the fees will be determined by the number of locations at a climbing ratio, with a two-location practice to pay £1,200.
The consultation will run until the 21 December with all stakeholders. The result will then be examined and the Secretary of State for health will make a final decision in March 2013. The fees system will then go live from 1 April.
Maureen Campbell, CQC fees policy design team leader, said: ‘The Treasury says we have to recover the costs of our registration services which we do through fees. We are being cautious in the first year and the fees are probably lower in the first year, then we will need to move towards cost recovery. We estimate that most GPs will register with one location but their practice may stretch further and that is where the list size model comes in.’
Glyn Barker, CQC investment appraisal manager, added: ‘We will consult on the fees scheme each year and this will decide what we do about fees doing forward. The intention is that we do move towards full cost recovery and it is fair to say that we will go to 75% next year. We don’t think it is viable that will ever go to 100% recovery through fees.’
The CQC estimates that around 7,500 primary care providers will register as a one-location practices and less than 1,000 as two or three-location practices. It expects only eight to register with more than 40 locations.
Dr John Canning, who led the GPC work with the CQC to develop a fair model, said the hybrid model was the best out of three bad options for GPs.
He said: ‘We don’t back any structure, but some are fairer than others. Almost all GPs are in a single location and a list size would be a problem with larger cliff edges so pure location or pure list size are potentially worse.’
He added that the GPC did not think it was fair that GPs should bear the burden of this cost.
He said: ‘We object to any fees [and rising fees year-on-year] has been the pattern, I see no reason it will be different for us. Again this is unfair as we have no route to increase income or fees so have to pay out of our pockets.’
The CQC recommended proposal in detail
For GP practices operating out of just one location:
- Small practice (less than 5,000 patients): £550
- Medium practice (5,000+ up to 10,000 patients): £650
- Large practice (10,000+ up to 15,000 patients): £750
- Very large practice (15,000+ patients): £850
GP practice with two locations: £1,200;
- 3 locations: £1,600
- 4 locations: £2,000
- 5 locations: £2,400
- 6-10 locations: £3,000
- 11-40 locations: £6,000
- 40+ locations: £15,000