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Care Quality Commission fees consultation – have your say

25 October 2018


Dear colleague,

Care Quality Commission fees consultation – have your say 

Today we have published a consultation document about the fees we propose to charge registered providers in 2019/20 and we are inviting you to have your say.

We are required to consult widely on any proposed changes to the fees we charge and we will continue to give providers and their representatives the opportunity to review, comment upon and be able to plan for any changes that will affect them. The fees paid by providers enable CQC to fulfil its purpose of making sure health and social care services provide people with safe, effective, compassionate, high-quality care.

The consultation proposals we have published today follow the plans we set out in previous consultations to meet the Treasury’s requirement to recover our chargeable costs in full from providers. In 2015/16 our budget was agreed at £249 million. We spent £239 million and have continued to drive down our costs so that our planned expenditure for 2019/20 is £217 million. 
This is a result of the controls we have exercised over our spending and increased efficiency in our inspections and other operational activity. We will continue to look carefully at our costs, and to demonstrate that they are is fair, efficient, effective and proportionate.

We are constantly refining our costing model to ensure we are better able to assess whether the fees we charge match the cost of regulation. Our assessments tell us that we need to rebalance the overall fees charged to ensure one sector does not subsidise the cost of us regulating another. 

Our proposals for the coming financial year reflect the move to a position to recover all our costs for our chargeable activities through fees, as well as a desire to address sectors where we have identified the need to adjust the cost of regulation and fees recovered. We are therefore making specific proposals for: 
  • the community social care sector (which includes domiciliary care services), where we propose a fee increase, as the final year of the planned four-year trajectory to full chargeable cost recovery
  • the dental sector, where we propose a fee increase to better align against our costs
  • the residential social care sector, where we propose a fee decrease to better align against our costs.
The following examples are based on our calculations of an average provider in each sector and the proposed change to their fee:
  • We estimate that for community social care locations supporting up to 22 service users their fee increase would be no more than £144 per annum. This represents half of all locations.
  • We are proposing that all providers will see the same flat percentage increase. Representing almost two-thirds of dental providers, single location dental practices with between one and three dental chairs would see their fee increase by no more than £97 per annum.
  • The average residential social care provider with 26-30 beds at one location would see a fee reduction of £64 under the new proposals.
Most NHS trusts and NHS GPs will see a small change to their fees from April 2019 because of the changes we made to their fees structure last year. This is because each provider’s fee is calculated by looking at their size against the total size of the sector, both of which change year-on-year. However, this will not alter the total fees collected overall for these sectors. Community social care providers will also be affected by the structural changes made last year, as well as the overall increase mentioned above.

We recognise the financial challenges that providers face, and we do not underestimate the impact of fees on providers. We believe that our proposals for 2019/20 will rebalance fees across the sectors, while preventing fees from fluctuating unreasonably year on year. They also reflect our strategic ambitions to continue to use data more effectively in assessing the costs of regulation.

Full details and descriptions of each of our proposals are given in the consultation document and draft regulatory impact assessment.
When we have analysed the feedback from this consultation in January 2019 we will prepare a response and a final fees scheme. CQC’s Board will recommend the final fees scheme to the Secretary of State for Health and Social Care, whose consent is required in order for the scheme to come into effect. We expect to publish our response and our final fees scheme in March 2019, for implementation on 1 April 2019.

You can find the consultation document and respond using our online form by visiting www.cqc.org.uk/feesconsultationThe consultation is open for responses until midday on 17 January 2019.

Yours sincerely,
 
Ian Trenholm
Chief Executive
Care Quality Commission
                                              

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