• CQC fees for smaller trusts to increase by £58,656 next year
  • Fees for GP practices to triple but government will cover extra cost
  • CQC chooses most bullish of the options it consulted on, moving to “full cost recovery” from providers over two years

The Care Quality Commission will increase the fees paid to it by NHS trusts by 75 per cent next year.

The regulator has chosen the most bullish of the scenarios it consulted on – moving to “full cost recovery” from trusts over two years – despite requests from providers that the increase should be phased over four.

David Behan

David Behan

David Behan: ‘The fee paid by providers is the charge for entering and remaining in a regulated sector’

The CQC’s government grant is to be cut by about 25 per cent over the next four years, resulting in a reduction to its overall budget of at least £32m.

At the same time it is expected to follow a government policy requiring public bodies with fee setting powers to charge fees that will cover the full costs of their “chargeable activities”.

This move to full cost recovery will be a big shift in the CQC’s funding, which is currently split almost equally between fees and direct government funding.

When the CQC launched its fees consultation in November it outlined two scenarios: the first for full cost recovery to be achieved in two years, the second for it to happen in four.

The CQC’s choice of the two year option means a small NHS trust with an income of £125m-£225m will see its fees increase next year by £58,656, from £78,208 to £136,864 – a 75 per cent increase.

According to figures in the CQC’s consultation document, the fee would then increase to £215,835 in 2017-18 – a 176 per cent increase on the 2015-16 fees.

A single location GP practice with 5,001-10,000 patients will have a £1,849 increase from £725 in 2015-16 to £2,574 in 2016-17 – a more than threefold increase.

The Department of Health has said it will provide an extra £15m through the GP contract to cover the expense to GPs’ of the rise. A DH spokeswoman said the funding will be recurrent in future years and any funding additional to that will be assessed at a later date.

A care home with 26-30 residents will see its fees increase by £451.

The exception to the two year trajectory is the dental and home care sectors. Home care providers are the furthest sector from full cost recovery, and so will see their fees increase on the four year trajectory. General dental practices will continue to pay the same fees next year because the full costs of regulation in their sector have already been recovered.

The CQC said that for the majority of providers fees would be no more than 1 per cent of their turnover.

It admitted that the responses it received in its consultation “expressed a strong preference for the four year option”.

“However, following the government’s spending review, the level of grant in aid available to the CQC for 2016-17 is such that in order to fulfil its statutory options, the CQC has had to recommend the two year option to the secretary of state,” it said.

David Behan, the CQC’s chief executive, said: “We understand that the scheme that has been put forward is not the one the majority of those who took part in our consultation would have preferred.

“In order to achieve our requirement to the government and commitment to the taxpayer, we need to work towards reaching full cost recovery while reducing our overall budget by at least £32m.”

He added: “The fee paid by providers is the charge for entering and remaining in a regulated sector. The public deserves nothing less than safe, high-quality and compassionate health and adult social care, and we must continue to act in their best interests.”

NHS Providers said the increase would be equivalent to two senior nurses per NHS provider over two years.

Miriam Deakin, NHS Providers’ head of policy, said it had “yet to be persuaded of the benefits” of charging the costs of regulation to the frontline, especially when providers were facing “unprecedented financial challenge”.

Rob Webster, chief executive of the NHS Confederation, said the decision would “leave a sour taste for our members”.

A DH spokeswoman said: “These fees allow CQC’s tough inspection regime to drive up standards across the country and ultimately make sure patients get safe and compassionate care.”

This story was updated at 9.45am on 31 March with the DH spokeswoman’s comments.