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GP Practices Lose Out in the Financial Battle between Government and CQC

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According to CQC’s Chief Inspector of General Practice Steve Field, the inspection regime is paying dividends. With more than 3,000 GP practice inspections completed, the results are more than encouraging:

- 132 are rated as outstanding

- 100 Practices have been found to be inadequate

- 33 GP practices have exited special measures

- More than 90% of practices that have been re-inspected have improved

Commenting after publication of the results of the latest round of inspections, Steve Field said, “…over 1 million patients in England currently receive care from practices which we have rated Outstanding.” However, he also notes that,”… there were over half a million patients in England who were not receiving the basic standards of care that they should be able to expect from their GP practice. I am glad to say that we have increasingly found that most practices that are placed in special measures use the support that is on offer to meet those standards.”

So the message from the CQC to GP practices is basically, “You’re doing well, but there is still room for improvement.”

We now know just how much the measurement of improvement will cost every practice in England.

You may remember our article of November 2nd 2015 – “A bad week for the CQC and the impact on inspections” – in which we described how the CQC was months behind its target of inspecting every adult social care, general practice, and out-of-hours care service in England to December 2016. After telling everyone that lack of funds were no excuse for poor performance, the CQC was directly tested on this hypothesis when the government cut funding for CQC inspections.

So it is about money, after all

Having been told by government that it would have to fund its inspections through fees, the CQC has indeed pushed up its GP fees. To help compensate this, GP practices have been given a 3.2% rise on their funding. However, when this increase was announced, the extra CQC fee was unknown.

Having consulted with practices last year, the preference was for the fees to be increased over four years. The CQC suggested two levels of increase: an average of £1,342 or £2,187 (no surprises for guessing which was the most popular with GP practices). What might surprise GP practices is that the CQC has chosen to:

- Make the full increase over a two year period

- Make the maximum increase that it suggested

The CQC CEO David Bevan has explained this decision by saying that, “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.”

Dr Chaand Nagpaul believes the CQC increase to be “wholly disproportionate and unwarranted.” We have to agree. The Department of Health points out that it has increased payments under the GP contract by £220 million. But with CQC fees now rising by around 250% this year, and then doubling again next year (see below), the extra funding will already have had a huge chunk taken out of it.

Meanwhile, the CQC will have fully funded its inspection regime at a time when it is suggesting the number of inspections should fall (because of the improvements seen). Between the rock of government and the hard place of the CQC lies GP practices, and it is these that continue to be squeezed.

How the CQC fees decision affects your practice:

Number of registered patients 2015/16 fee 2016/17 fee 2017/18 fee
Up to 5,000 £616 £2,187 £4,111
5,001 to 10,000 £725 £2,574 £4,839
10,001 to 15,000 £839 £2,978 £5,599
More than 15,000 £948 £3,365 £6,327

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If you have any questions or feedback, please do not hesitate to contact me -alex.henman@esuppliesmedical.co.uk - 01865 261451

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