• The Care Quality Commission has confirmed its changes to regulatory fees for NHS providers from 1 April 2018
• Under the new fee structure, fees will be set in proportion to the size of the trust in relation to the sector, and CQC will continue to use annual turnover as the measure of size. The existing banding structure will be removed
• CQC has decided not to set either a maximum or a minimum fee for NHS trusts.

The Care Quality Commission has published its approach to fees for 2018/19.

The new fee structure is based on developments in the trust 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 existing fee scheme.

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

In 2018/19, trusts with a turnover of £350m – £400m will, on average, see fees decrease from an average of £288,912 to £261,930 or £260,300, while a trust with a turnover of £1bn - £1.1bn will, on average, see fees increase from around £330,000 to £687,426 or £736,512.

The deputy chief executive of NHS Providers, Saffron Cordery said:

“We are pleased that the CQC has chosen not to introduce a maximum or minimum fee for NHS trusts, which trusts have argued is the approach that is most equitable and fair. While we welcome the reduction of fees paid by around 75% of providers, we are concerned that others will see their fee rise substantially.

While we welcome the reduction of fees paid by around 75% of providers, we are concerned that others will see their fee rise substantially.

“This increase will add extra pressure at a time when providers are already operating in a climate of significant financial challenge. Therefore it is disappointing that CQC has not taken up our recommendation of adopting a transitional period and more phased approach towards implementing these changes. A cap on the maximum fee will be increasingly important in the future to restrict the highest fees paid by trusts.

“The CQC’s plans to continue to engage the sector and consult again in the autumn are welcome. We look forward to continuing to work with CQC to review the impact of the new fee structure and as it considers developments to the fee scheme in 2019/20.”