Our response covers the following key messages:

• Any increase in fees is difficult for our members to accept at a time when they are being asked to make unprecedented efficiency savings as demand for services continues to rise. A 9% uplift represents an unacceptable cost to the sector.
• The CQC faces a significant challenge in balancing a proportionate and risk-based approach to quality regulation for the benefit of patients in an environment where providers face challenges which may impact upon quality, but often extend beyond their control.
• The combined budget for Monitor, the CQC and the NHS Trust Development Authority makes up a substantial proportion of the NHS budget and all the regulators need to be held to account for providing the public with value for money and ensuring the long-term sustainability of the regulatory framework.
• We understand that the CQC has been required by HM Treasury to move towards full cost recovery and we welcome the regulator’s commitment to measure its costs and benefits on an ongoing basis.
• Given that the costs of the new approach are not yet fully understood, and the current financial position of our members, we would urge the CQC to avoid imposing any increase for 2015/16 and to adopt a much more gradual pace towards full cost recovery.