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21.10.16

CQC opens consultation on ‘concerning’ provider fees increase

Healthcare providers could pay significantly more for CQC inspections from next year, under new proposals set out by the regulator.

Under the plans, which the CQC published as it opened a consultation, some NHS trusts could see their inspection fee go up from £136,864 to £202,329.

A single-location GP practice would see its fee increase from £2,574 to £4,526, and a specialty service’s fee would increase from £6,704 to £6,958.

The consultation document says: “Our organisation needs to be properly resourced for it to be effective, but this needs to be achieved against a background of a reducing budget. We are also fully aware that we regulate providers that are operating within a demanding financial environment, and that funding for providers is increasingly challenging. Providers face pressures to control costs at a time when demand for care is increasing and care needs are becoming more complex.

“Not only does this mean that we have to review how we regulate effectively, but that we have to achieve this while our own resources are reducing and while responding to innovations and changes within the health and social care sectors. In order to pursue this, we are obliged to ensure that the majority of our funding comes from fee income from the providers we regulate.”

The CQC is required to achieve at least £32m in savings over the four years of the Spending Review. Its budget for 2017-18 will be £230m, £6m lower than in 2016-17, £196m of which will come from provider budgets.

Amber Davenport, head of policy at NHS Providers, said: “The CQC plays an important role in regulating all care providers against core standards of quality and safety, and it is right that they are properly funded to do that well.

“But with pressures on frontline health and social care budgets intensifying, we remain concerned with the funding approach.”

The latest NHS Improvement figures show that 153 trusts are in deficit, with the total shortfall currently at £461m.

Simon Stevens, chief executive of NHS England, told the Health Select Committee this week that the funding challenges facing the NHS over the next five years will be made worse because the DH didn’t meet its funding demands.

Within the consultation document, the CQC proposes to increase fees for all sectors, except community social care and dental providers, as the second year of the two-year trajectory to reach full chargeable cost recovery (FCCR).

Social care providers, which are on the second year of a four-year trajectory, will see fees increase from £1,369 to £2,192.

Dental providers’ fees will decrease in order to maintain FCCR levels. Fees for a single location provider will go from £850 to £749, while fees for a multiple location provider will go from £3,200 to £2,819.

Davenport said that under the two-year trajectory, which was overwhelmingly opposed by healthcare providers, the sector would face a total fees increase of £18m, or the wages of 700 nurses for a year.

She said the increase could “have a particularly destabilising impact on GPs and adult social care providers”, with NHS trusts then absorbing the extra demand.

“The government urgently needs to address how best to fund providers to pay for these fee increases through the national tariff, CCG budgets and other payment mechanisms, so that more of providers’ already stretched resources are not diverted away from frontline care,” added Davenport. “With performance against access standards at an all-time low, and funding set to plummet further in 2017-18 and 2018-19, this is now critical.”

But David Behan, CEO of the CQC, said: “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.”

A Department of Health spokesperson said: "It has always been the case that CQC, like other regulators, recovers its costs via fees. These fees allow CQC's tough inspection regime to drive up standards across the country."

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