Small practices will pay a lower registration fee, while larger ones will pay more, the Care Quality Commission (CQC) has revealed.
The CQC proposes to calculate fees based on patient list sizes rather than number of registered locations, from April 2018.
Structure ‘doesn’t fit’
The CQC said: ‘The current fees structure does not fit the way the sector is structured, and it will become increasingly outmoded as the way services are organised and delivered develops further.’
Removing the current banding system and charging fees in proportion to the size of a provider, using patient list size per location as measure of size, will ensure fees are charged and distributed fairly and proportionally.
Over the past eight years, fees have been organized using bandings.
Practice providers with one location are banded by list size, while those with more than one location are banded by locations.
Under this system, providers with two or three registered locations pay more fees than those with one location — up to more than double for two locations and triple for three locations—even if they have a smaller number of patients.
But with the rise of practices merging, with some keeping their independent status, using locations as a measure of the size of a GP practice is inappropriate.
The CQC said: ‘Changes can result in larger organisations paying lower fees than the individual practices prior to reorganization.
‘Using locations as a measure does not produce a fee that reflects the costs incurred by CQC for regulation or is commensurate with the complexity of the provider.
‘As fees have increased this has produced ‘cliff edges’, where a provider moving to a higher band might incur a sudden increase in fees or a provider moving to a lower band can see a sudden decrease.’
The CQC started increasing registration fees in 2016 to reduce the Government’s grant-in-aid funding to public regulatory bodies. Now that ‘full cost recovery’ has been reach, the fees scheme can be reviewed.
Health and care providers and stakeholders can reflect on the proposed changes, through the CQC consultation, until 18 January 2018.