How the independent regulator sees the state and future of health and social care services

Last month the Care Quality Commission (“CQC”) published its annual State of Care Report for 2016/2017. The report describes the future of the health and social care sector in England as the “greatest unresolved public policy issue of our time”.

Last year’s CQC report warned that the adult social care sector was approaching a “tipping point” where deterioration in quality would outpace improvement and there would be a substantial increase in people whose needs were not being met.

Despite this stark warning, this year the CQC has found that overall the quality of health and social care in England has been maintained even though the entire system is stretched to its limit. The question that looms is: how much longer can it be stretched?

We highlight the key points from the report below:

Adult Social Care

  • Ageing population with complex health concerns:

The CQC acknowledged that delivering adult social care is becoming more challenging due in part to the increasingly complex demand of an ageing population. It warned that the number of people aged 85 or over in England is set to more than double over the next two decades. Yet, at the present time, it estimates that 1 in 8 older people are not receiving the care they need.

  • Different levels of pressures in different areas:

The report concludes that, “While in some areas, social care has moved further away from a tipping point, in other areas it has moved closer”. In the adult social care sector the CQC found there was no national picture but rather that pressures were being felt at a local level and to different degrees.

  • Finance:

The report cites a budget survey of directors of adult social care which found that 79% believed that providers are facing financial difficulty in 2017/18. The CQC inferred from this that there is a definite need for a sustainable long-term solution to the issue of social care-funding.

It is perhaps cold comfort to many care-providers that the CQC acknowledges that without a holistic long-term funding plan in place, and against the current background of increased demand, “improvements may be difficult to sustain”.

  • The value of good leaders:

The predominant message within the report is that good leaders have a big influence on the quality of care that people receive. The CQC reports that it has seen “improvement achieved by consistent managers who are supported by the provider to bring about fundamental change” or by “recruiting new registered managers”.

  • CQC action:

Where improvement is not made and there is poor care, the CQC will not hesitate to take action to stop unsafe care and protect people from abuse or avoidable harm.

Hospitals, community health services and ambulance services

The CQC raises multiple concerns about staff shortages, hospital bed shortages alongside rising occupancy rates and the number of patients with preventable illnesses. The report details how the NHS is struggling to deal with 21st century problems such as obesity, diabetes, dementia and heart disease.

The quality of the NHS service has been maintained but the CQC warns that standards were likely to drop.

Mental Health

Overall the CQC found some improvements in mental health services but also highlights areas of concern and challenges that services must overcome relating to high demand, workforce shortages, unsuitable facilities and outdated services. Basic ward safety issues in mental health services remain a major concern, despite being raised in previous reports.

Registered Providers must keep abreast of all regulatory requirements

The CQC Care Report shines a light on the positive impact care sector leaders and personnel have made over the last year, by maintaining the quality of health and social care provision.

Highlighting the extent to which our current health and social care services are stretched, the State of Care Report also reiterates the necessity for registered care providers to comply with increasingly complex regulations. The CQC sets out the action it will take to prevent unsafe care and protect people from avoidable harm.