The Care Quality Commission (CQC) are seeking views on new proposals for how they should calculate the fees that providers of health and adult social care must pay in order to be registered.
These proposals are based on what we have learnt and on changes to the health and care sectors, such as the creation of larger NHS trusts through mergers and acquisitions, and GPs collaborating in large-scale general practice.
Over the last two years (2016/17 and 2017/18), the CQC have been increasing the fees that providers of health and adult social care in England must pay for being its register, so that the CQC can fulfil the government’s commitment to reduce grant-in-aid funding to public regulatory bodies.
The CQC have now reached ‘full chargeable cost recovery’ for most providers they regulate, including NHS trusts, care homes, general practices and dental services, as planned.
The exception is providers of community adult social care (which includes care in people’s own homes), and the consultation sets out the third year (of four) towards ‘full cost recovery’ for this sector, which will reach this point by 1 April 2019, as agreed following our previous consultation.
This means that no sector apart from community adult social care will see any increases overall to their regulatory fees.
However, the CQC are reviewing the structure of our fees scheme to ensure that fees are charged and distributed proportionately. The options that we are consulting on over the next three months could result in changes to what individual providers and services in three sectors are required to pay. Based on its own calculations, the CQC are proposing changes to the fees structure for the following sectors:
- For NHS trusts, by moving away from the current fee bandings, the proposals could see 75% of individual trusts paying reduced fees and the largest 25% seeing an increase.
- For NHS general practices, the proposals could see fees being calculated by registered patients (list sizes) rather than number of ‘registered locations’. Broadly, NHS general practice providers that have a below average list size could pay a lower fee, while those with a higher list size could pay a higher fee.
- For community adult social care providers, we are seeking views on the most appropriate metric that should be used to calculate fees. This could see around 70% of (mainly smaller) providers paying lower fees and around 30% higher fees.
The consultation will run until midday on Thursday 18 January 2018.