The Care Quality Commission has published its annual assessment of health and social care in England. The report shows that most people are still getting good care, when they can access it.
The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England shows that overall, quality has been largely maintained, and in some cases improved, from last year.
However, people’s experience of care varies depending on where they live; and that these experiences are often determined by how well different parts of local systems work together. Some people can easily access good care, while others cannot access the services they need, experience ‘disjointed’ care, or only have access to providers with poor services.
The challenge for all local health and social care services is to recognise the needs of their local populations and find sustainable solutions that put people first. In this context, we have considered 5 factors that affect the sustainability of good care for people:
Access to care varies from place to place across the country. Some people cannot access the services they need, or their only reasonable access is to providers with poor services.
The overall quality of care in the major health and care sectors has improved slightly. At the same time, too many people are getting care that is not good enough.
Workforce problems have a direct impact on people’s care. Getting the right workforce is crucial in ensuring services can improve and provide high-quality, person-centred care.
Each sector has its own workforce challenges, and many are struggling to recruit, retain and develop their staff to meet the needs of the people they care for.
Demand is rising, not only from an ageing population but from the increasing number of people living with complex, chronic or multiple conditions, such as diabetes, cancer, heart disease and dementia.
Providers face the challenge of finding the right capacity to meet people’s needs. Services need to plan – together – to meet the predicted needs of their local populations, as well planning for extremes of demand, such as sickness during winter and the impact this has on the system.
Care providers need to be able to plan provision of services for populations with the right resources, so good funding and commissioning structures and decision-making should be in place to help boost the ability of health and social care services to improve.
Funding challenges of recent years are well known, and in June 2018 the government announced an extra £20.5 billion funding for the NHS by 2023/24. However, at the time of publication, there is no similar long-term funding solution for adult social care.
Ian Trenholm, Chief Executive of the Care Quality Commission, said:
“This year’s State of Care highlights both the resilience and the potential vulnerability of a health and care system where most people receive good care, but where access to this care increasingly depends on where in the country you live and how well your local health system works together. This is not so much a ‘postcode lottery’ as an ‘integration lottery’.
“We’ve seen some examples of providers working together to give people joined-up care based on their individual needs. But until this happens everywhere, individual providers will increasingly struggle to cope with demand – with quality suffering as a result.
“There need to be incentives that bring local health and care leaders together, rather than drive them apart. That might mean changes to funding that allow health and social care services to pool resources; for example, to invest in technology that improves quality of care. Like the digital monitoring devices for patients’ clinical observations that have saved thousands of nursing hours, the e-prescribing in oncology that’s helping people directly, and the electronic immediate discharge summaries that have improved patient safety.
“The challenge for Parliament, national and local leaders and providers is to change the way services are funded, the way they work together and how and where people are cared for and supported. The alternative is a future in which care injustice will increase and where some people will be failed by the services that are meant to support them, with their health and quality of life suffering as result.”