The Care Quality Commission (CQC’s) annual assessment of the state of health and adult social care in England has been released.
The assessment has highlighted that the country is running a ‘two-tier’ system. A system where those who can afford to pay for treatment, do so and those who can’t, facing longer waits and reduced access.
The report also highlights issues with local authority budgets which have failed to keep pace with rising costs and the increase in the number of people needing care. And this imbalance in authority budgets is also affecting adult social care. Local authority funded adult social care places are often less profitable which is leading to people who live in more deprived areas unlikely to get the care they need.
Challenges within the workforce have also been worse this year with industrial action disrupting the wider system which in turn has affected waiting lists, which over the last year have risen to record levels. Research has shown that patients, who can afford to are turning to the private healthcare.
Research by YouGov shows that 8 in 10 of those who used private health care last year would previously have used the NHS, with separate research showing that 56% of people had tried to use the NHS before using private healthcare.
"It’s important to say that we have also seen staff and leaders across all sectors mitigating risks arising from staffing shortages and working hard to deliver good care in very challenging conditions.”
— Care Quality Commission (@CareQualityComm) October 20, 2023
-Ian Trenholm -
CQC’s Chief Executive#StateOfCare pic.twitter.com/baQEW3GUbv
Ian Trenholm, CQC’s chief executive, said: “The combination of the cost-of-living crisis and workforce challenges risks leading to unfair care, with those who can afford to pay for treatment doing so, and those who can’t facing longer waits and reduced access.
“And the impact of unresolved industrial action on people can’t be ignored – it’s crucial that both parties work towards an agreement so strikes do not continue into the winter, when disruption will have to be managed alongside increased demand for urgent care and staff sickness.”
Attention has also been paid to maternity care in the report. CQC has worked on a focused programme of maternity inspections. The report found ten per cent of maternity services are rated as inadequate overall, while 39% are rated as requires improvement. Safety and leadership remain particular areas of concern, with 15% of services rated as inadequate for their safety and 12% rated as inadequate for being well-led.
Access to and quality of mental health care also remain a key area of concern. Gaps in community care continue to put pressure on mental health inpatient services, with many inpatient services struggling to provide a bed, which in turn leads to people being cared for in inappropriate environments – often in A&E.
Ian Dilks, chair of CQC, said: “The challenges described in this year’s State of Care are to some degree caused by a lack of joined-up planning, investment, and delivery of care.
“Integrated care systems present the opportunity of bringing together local health and care leaders with the populations they support to understand, plan, and deliver care at a local level.
“This would in time move some of the focus of care away from big institutions and towards local and self-care provision, with autonomy to act on local population needs and an increased focus on preventing poor health, not just treating it.”
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