Why we’re consulting on registration fees

I want to explain why Council believes now is the right time to begin a conversation about the changes that are needed to registration fees, what has led us to this point, and why I believe it is important that every osteopath takes part in the consultation.

Osteopathy is one of the few health professions to benefit from its own dedicated regulator. That matters. It means patients and osteopaths are supported by a regulatory system designed specifically for osteopathic practice. As your regulator, we can focus our attention on the issues that matter most to osteopathy while maintaining our independence and our overriding responsibility to protect the public.

It is Council’s responsibility to ensure that the GOsC remains able to protect patients, uphold professional standards and regulate osteopathy effectively, to support high quality osteopathic care, both now and in the future. It is against that backdrop that we are launching this consultation on registration fees.

Nobody welcomes increased costs. I understand that. But I also believe it is important to have an honest conversation about what it takes to maintain an independent and sustainable regulator that protects patients, upholds standards and maintains public confidence in osteopathic care.

This consultation is an opportunity for all of us to have that conversation together.

The value of a single-profession regulator

Before explaining the financial context, it is worth reflecting on what registration fees pay for. Your registration fee helps fund a regulator dedicated solely to osteopathy, and the issues that matter most to patients and osteopaths. We reinvest every registration fee back into osteopathy through the regulation and development of the profession.

Your fees help protect patients, assure the quality of education for new osteopaths entering the profession, uphold and develop profession-specific standards and guidance, and protect the osteopathic title. Your fees help ensure that osteopathy continues to benefit from regulation that understands and reflects the realities of contemporary osteopathic practice.

As a single-profession regulator, we can continue to involve osteopaths directly in making decisions at Council and in our Committees, and these decisions are informed by a deep understanding of osteopathy and the environment in which it is practised.

It also allows us to invest in areas that increasingly matter to both patients and practitioners, including supporting safe, high quality practice; improving understanding of professional boundaries; strengthening patient involvement; supporting newly registered osteopaths and those entering practice; ensuring that regulation remains relevant in a changing healthcare environment and embedding equity, diversity, inclusion and belonging.

In short, profession-specific regulation allows us to focus all of our attention and resources on maintaining confidence in osteopathy and protecting those who rely on osteopathic care.

Registration fees have never increased

In fact, they came down between 2012 and 2014 (from £750 to £570) and have remained unchanged ever since.

Council reviews fees annually and, each year until now, Council members decided not to seek an increase to fees as they were keen to minimise the impact on osteopaths. Those decisions were taken by Council despite rising inflation, rising operating costs and increasing demands on healthcare regulators.

Had our fees increased in line with inflation over that period, the current standard fee would be £918 rather than £570.

Any changes we make to our fees requires an amendment to our legislation (called Fee Rules) through a formal government process. We’re only able to change the amounts of the fees (the numbers) in the legislation rather than the wording or more substantive changes due to the limited amount of government time available to support the legislative change.

This is why we are not able to make small changes each year to the annual fee such as increasing with inflation, or introducing new categories of fees such as for people who work part time, which is why these sorts of options have not been considered by Council.

Even though we are only changing the amounts, this will take time to be reflected in the fees legislation. We are launching a consultation in August 2026 but the changes to registration fee levels will not come into effect until the summer of 2027.

We are now spending more than our income

From 2023 to 2026, the money we spent was more than our income by around £540,000 and forecasts show that this gap will continue to grow if no action is taken.

Council has a duty not only to ensure that public protection is maintained today, but also to take responsible decisions that safeguard its long-term sustainability.

One of the main reasons our costs have increased is the significant growth in fitness to practise activity, something which is not unique to our profession and is being seen across healthcare regulation as a whole. Compared with 2018, our fitness to practise caseload has increased by 74%, with a significant proportion of cases relating to professional boundaries concerns. These cases are often complex and lengthy and require greater investment in investigations, hearings and case management.

We have considered other options to reduce costs

Over recent years we have taken many significant steps to reduce our costs and improve efficiency. These include bringing the quality assurance of osteopathic education in-house rather than using an external provider, reducing fitness to practise costs where possible to secure better value for money, reviewing how much we spend on research, introducing a new and more efficient database and, more recently, agreeing the sale of our headquarters building. Combined, these actions have helped us reduce our regular outgoing costs by over £500k each year.

These decisions have not always been easy, but they reflect Council’s commitment to ensuring that registrants’ fees are used carefully and responsibly.

And it’s important that we don’t reduce our costs to the extent that we compromise on what we are here to do. For example, the funding we provide for osteopathic research and giving free access for osteopaths and some students to research journals helps the profession to develop and innovate, and demonstrates to patients and the public that osteopathy is a safe and credible practice.

So Council has concluded that while our cost-reducing measures have delivered savings and efficiencies, they will not address the long-term funding gap on their own.

Making responsible use of our assets

The sale of our headquarters building is an important part of our broader approach to long-term financial sustainability.

In addition to helping to reduce our annual outgoings, most of the money from the sale will be used to strengthen our reserves, which Council has increased to the equivalent of eight to nine months of operating costs (£2.4 million). These reserves provide financial resilience and help ensure that the GOsC can continue to fulfil its statutory responsibilities in the face of unexpected pressures or future risks.

Reserves are important, but they are not a substitute for sustainable annual income. Council’s role is to ensure that the GOsC has both a stable financial foundation and enough reserves to responsibly manage uncertainty. The proposed fee consultation is therefore one part of a broader approach to securing the long-term future of osteopathic regulation.

Looking ahead

We left our headquarter building at the end of July and moved to a much smaller location that better reflects how we work today. The building sale also creates opportunities for the GOsC to be more visible and engaged across the UK. Later this year, Council will consider how some of the remaining funds might be used to support engagement with osteopaths, students, educators and patients in different parts of the country. This could include creating more opportunities for osteopaths and students to attend Council meetings in person, strengthening engagement with regional groups and supporting learning and engagement activities alongside those events.

Healthcare and regulation continue to evolve. Patients rightly expect regulators to respond to changing risks, developments in professional practice and increasing expectations around transparency, inclusion and patient involvement.

Making sure the GOsC can continue to meet those expectations, while remaining proportionate, effective and focused on public protection, is an important part of our responsibility and requires a sustainable financial foundation.

Your voice matters

I encourage every osteopath to engage with the fees consultation and share their views when it launches in early August. We are consulting on the level of the increase; whether the increase should be applied equally across fee categories and; if it is not applied equally, whether there should be differences for practising, newly registered and/or non-practising osteopaths.

Please do take part. As well as submitting a response you are welcome to attend one of the series of webinars we are planning throughout the consultation. Our aim with the webinars is to give osteopaths an opportunity to ask questions and discuss the proposals directly with us. We genuinely want to understand the impact of our proposals and hear different perspectives before Council reaches a final decision.

Consultation timeline

The consultation will run for 12 weeks and responses will be considered carefully by Council before any final decision is made. Subject to legislative approval, fee changes won’t take effect until 2027.

A final reflection

This consultation is about more than fees.

It is about safeguarding the future of your profession and ensuring that it continues to benefit from effective regulation.

I hope you will take the opportunity to share your views and help Council shape the future of that regulation.

Matthew Redford

Chief Executive and Registrar

General Osteopathic Council