• The Care Quality Commission has launched a consultation on proposed changes to regulatory fees for NHS providers from April 2018
• Under the proposals each trust will pay a different fee, charged in proportion to trusts’ turnover levels, and the existing bandings will be removed
• While the fees for around three quarters of trusts will reduce under these proposals, one quarter of trusts will see a big increase.

The Care Quality Commission has published its consultation on the changes to fees that it proposes to charge providers in 2018/19.

The proposals are based on developments in the provider sector as a result of mergers and transactions, as well as the intention to remove the ‘cliff edges’ when trusts move up or down a band in the current fee scheme.

The proposed approach, whereby individual trusts would pay a specific amount in proportion to the size of their annual turnover, aims to be more proportionate and allow the CQC to respond appropriately to small and large changes among providers.

On average, trusts with a turnover of £350m – £400m would see fees decrease from an average to £288,912 to £261,930 or £260,300, while a trust with a turnover of £1bn - £1.1bn would, on average, see fees increase from around £330,000 to £687,426 or £736,512.

Responding to the publication of the consultation, NHS Providers head of policy Amber Jabbal said:

“The Care Quality Commission’s (CQC) role in regulating the quality and safety of care is fundamental to ensuring that national standards are met.

Some trusts could see a huge fee hike at the same time as the CQC reduces the number of inspections it carries out. In these instances, it does not feel proportionate for all trusts.

“While we welcome the fact that the majority of trusts will see a reduction in their fees under the CQC’s proposals, some trusts could see a huge fee hike at the same time as the CQC adopts a more targeted approach to inspections which may in turn reduce the number it carries out. In these instances, it does not feel proportionate for all trusts and will add great pressure at a time when providers are already operating in a climate of significant financial challenge.

“As providers begin to bear more of the costs of regulation directly, it is essential that they are appropriately funded through the tariff and other payment mechanisms to pay for fee increases.

“As the CQC moves towards a more targeted, risk-based approach to inspection, it is inevitable that these changes will have an effect on the costs of regulation and should ultimately bring down fees for providers over time. In the meantime the CQC must focus on operating an efficient inspection regime that provides value for money, as highlighted by the National Audit Office.”