Annual ‘State of Care’ assessment released by CQC

The Care Quality Commission (CQC) recently released its annual assessment of health and social care in England.

Entitled ‘State of Care’, the report reveals trends, examples of good practice, and areas for improvement.

In a foreword delivered by the CQC Chief Executive, Ian Trenholm and the Chair, Peter Wyman, it’s noted that, “new models for urgent and emergency care are needed” but that, “in the medium to longer term, integrated care systems must set out plans for how social care and all parts of the health and care system work better together to respond to the needs of their local community.”

Success, the introduction states, will “involve making sure people get the right treatment in the right place at the right time, managing activity away from acute services where possible to where people can be better cared for.”

“The future must be focused on outcomes for people – all people – who need care, supported by transformational changes to workforce, funding, commissioning and oversight. Rather than attempting a return to business as usual, we must grasp this opportunity to build something better – a health and care system that works for everyone,” it concludes.

The assessment is focused on four main umbrella areas, dedicating a specific sections to people’s experiences of care, flexibility to respond to the COVID-19 pandemic, ongoing quality concerns, and the challenges for systems.

Key points are summarised for every area, taken from individual chapters of sub-topics within those four themes, which focus on a range of factors.

These are different for each area and cover everything from increased challenges for people with disabilities, the rising demand for mental health care, and the impact of the pandemic, through to workforce stress, access to GPs and dental care, ambulance handovers, tackling inequalities, and recovery of services.

Some of the main takeaways from the report include that, “the strain on carers has intensified” with the CQC citing Carers UK in June 2020, when it estimated that “an additional 4.5 million people had become unpaid carers since the pandemic began.”

It’s also added that, for the healthcare workforce, “the negative impact of working under this sustained pressure, including anxiety, stress and burnout, cannot be underestimated.”

The CQC noted that it has “serious concerns” about “ambulance handover delays at hospitals, which puts the safety of patients at risk”, while another area of concern was that “urgent action is needed to tackle staffing issues” in adult social care.

Other areas highlighted were that improvements in maternity care are “far too slow”, while “collaborative working was varied among the local systems“” reviewed, with a “lack of integration of adult social care providers into system-level planning and decision-making.”

Meanwhile, “most systems had some understanding” of “inequalities in care that existed in their areas before the pandemic, as well as how they had worsened or changed due to the pandemic.” However, “tackling these inequalities was often not a main priority.”

Despite these areas of note, there were also aspects of health and care that were praised, with the CQC mentioning that, “despite the widespread disruption caused by the pandemic, surveys have shown that, when people were able to access the care they needed, they were often positive about that care.”

While, of the acute NHS areas the CQCs had examined – cancer, cardiovascular, A&E, and mental health services – it stated that “cancer services have achieved the best response and recovery.”

The CQC also singled out that the “‘discharge to assess’ model for managing transfers of care has helped to support services in both health and social care”, calling it a “good step towards helping people after they leave hospital,” although there needs to be “greater consistency in how it is implemented.”

Within the section on access to GP care, the roll-out of the COVID-19 vaccination programme was called a “remarkable achievement”, with with GP practices and primary care networks described as being “at the forefront of this critical task”. It added that “many different local services have worked together at speed on a programme that has shown the NHS at its most versatile and patient-centred.”

To read the key points from the CQC report, or download the findings and assessment in full, click here.