ICBs face £5.5m cost for CQC assessments

The regulator has launched a consultation – closing on 21 December – on how it will fund the integrated care system inspections and assessments which it has been asked to carry out.

It is proposing to charge integrated care boards an annual fee in proportion to its ‘running cost allowance’, which is broadly linked to its population size.

The Care Quality Commission said it is proposing a “short-term approach only” and has calculated each board’s fees based on 2024-25 as an example year.

It estimates that carrying out the assessments will cost it £5.5m from 2024/25 in total, while the total running cost allowance for all 42 ICBs for that year will be £908.76m. Government and NHS England are in the process of cutting the running cost allowance by 30 per cent over two years, leading many ICBs to carry out restructures and cut posts.

The CQC said fees represented a “relatively small” 0.6 per cent of the running cost allowance, and argued that it already charges some health and social care organisations a fee for their regulation, which could rise if it does not also charge ICBs.

According to CQC draft calculations, the largest ICB – North East and North Cumbria – which has a running cost of over £48m, would pay a regulatory fee of £289,368. The smallest, Shropshire Telford and Wrekin, with a running cost of £7.7m, would pay £46,620.

The CQC has published early details of how it will assess ICSs, and begun some pilot inspections, but it is unclear when all will be complete, and if and when they will be given CQC ratings.

The consultation states: “Our forecasted regulatory cost for 2024-25 is based on us undertaking our initial assessments within a two-year period. We will continue to consider how to mitigate costs, including what impact a longer delivery timeline would have on them.” This suggests all ICSs may get a first assessment by April 2026, but that this timescale could be extended.

It adds that its approach to charges for all providers could be changed “to align with our new regulatory approach, and to future-proof it for a changing provider landscape”, but said this would be “subject to a separate consultation”.

Covered by government

The NHS Confederation’s ICS network said the fees should be covered by government, either directly or by allocating it to ICBs. 

Network director Sarah Walter said: “The cost of inspection should really be met by central government.

“Whether funding goes through ICBs or directly from DHSC, government should meet the cost of running the inspections it’s introduced, otherwise the cost to local systems will ultimately affect the delivery of patient care.”