The Care Quality Commission (CQC) has published its annual assessment of health and social care in England. It looks at the trends, highlights examples of good and outstanding care, and identifies factors that maintain high-quality care.
It shows that quality ratings have largely been maintained overall, but people’s experience of care is determined by whether they can access good care when they need it.
This year’s State of Care report considers the pressures faced by health and social care as a whole, with a focus on mental health and learning disability services where CQC is seeing an impact on quality, particularly in inpatient services.
The report finds that there is pressure on all health and care services in England. Waiting times for treatment in hospitals have continued to increase, while the stability of the adult social care market remains a particular concern.
In all sectors, there is pressure on the availability of services to maintain people’s health and wellbeing. CQC has heard about the increasing concerns regarding getting care and support in the community – a lack of prevention services, early stage or low-level support, community-based NHS services and social care.
Where patients struggle to access non-urgent services in their local community, including GP and dental services, this can have a direct impact on secondary care services. Figures for emergency admissions after attending the emergency department are continuing to rise year-on-year. This peaked at 31.2% of attendances in December 2018, and in July 2019 it was 28.9% – the highest figure for July in at least the last five years. There has also been an increase in referral to treatment times over the last year, with 4.4 million people at the end of June 2019 waiting to start treatment – an increase of 40% since June 2014.
The challenge for government, Parliament, commissioners, national organisations and providers is to change the way services work together so that the right services are being commissioned to deliver what people need. Leaders need to have a more urgent focus on delivering care in innovative, collaborative ways.
Innovation is at the heart of some of the high-quality care the CQC sees and it encourages and supports innovation that improves the quality of care for people and puts their safety first.
CQC says that providing the right access to the right care at the right time is increasingly key to the sustainability of health and social care as services struggle to cope with increased demand. When people can’t access the services they need, the risk is that they are pushed into inappropriate care settings. Difficulties in accessing the right care can mean that people with a learning disability and or autism end up detained in unsuitable hospitals.
The regulator adds that a better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments.