Heath and social care services crippled by disjointed approach

Annual CQC State of Care report reveals local systems are failing to work together, with major shortfalls in patient satisfaction

The report provides an overview of health and care services

Disjointed health and care services are one of the main bugbears for NHS patients, a new report has revealed.

Regulating body, the Care Quality Commission, has recently released its annual State of Care report, which found that, while most people receive a good quality of care, their experiences are often determined by how well different parts of local systems work together.

By looking at local health and care systems, we found that it was harder for people to access services in the community in places where services failed to work well together

The report explores trends, shares examples of good and outstanding care, and highlights where care needs to improve.

And this year’s document found that, while some people can easily access good care, others cannot access the services they need, experience disjointed care, or only have access to providers with poor services.

Particularly worrying is that a third of NHS acute core services are rated by the CQC as ‘requiring improvement’.

“By looking at local health and care systems, we found that it was harder for people to access services in the community in places where services failed to work well together,” said a CQC spokesman.

“In turn, this can lead to unnecessary admissions to hospital, putting extra pressure on acute and mental health services.”

The report outlines five factors affecting the sustainability of good care:

  • Access to care and support
  • Quality of care for people
  • Workforce to deliver care
  • Capacity to meet demand
  • Funding and commissioning

And the challenge for all local health and social care organisations is to understand the needs of local people and to work together to find sustainable solutions that put patients first.

The report also reveals that:

  • The number of older people living with unmet care needs continues to rise, currently at around 1.4 million
  • People who need inpatient mental health care often have to travel long distances to get it
  • Access to GP appointments is variable and the workforce is increasingly stretched
  • ‘Good’ ratings for quality of care are slightly up on last year – 91% for GP practices; 79% for adult social care locations; 70% for NHS mental health core services; and 60% for NHS acute hospital core services.
  • While some services have improved, thanks to the hard work of staff, others have declined in quality and safety remains a concern in NHS acute hospitals and mental health services
  • A third of NHS acute core services are rated as ‘requiring improvement’
  • One in six adult social care services need to improve
  • 20% of mental health services need to improve

Staffing is key to overcoming many of these problems, claims the report, which reveals there are currently more than 110,000 vacancies in adult social care.

Providers are starting to embrace new technology, which is having a positive effect on improving people’s quality of care, and the way services work together

It states: “Many services struggle to recruit, retain and develop their staff to meet the needs of the people they care for.

“Low staffing levels are the most-common reason for delayed access to children and young people’s mental health services.

“Recruiting and retaining newly-qualified GPs is also a problem in a profession with an ageing workforce.”

It adds: “Services face the challenge of finding the right capacity.

“They need to plan together to meet the predicted needs of the people in their local area.”

Commenting on the ongoing issue of funding, the report states that care providers ‘need to plan the right services for people with the right resources’.

It adds: “Funding challenges in health and social care are well documented.

“The government has announced £20.5billionextra funding for the NHS by 2023/24, but there is not yet a similar long-term solution for adult social care.

The report concludes: “Good, sustainable care is no longer just about whether individual organisations can deliver good care, but whether they can successfully collaborate with other services as part of an effective local system.

Good, sustainable care is no longer just about whether individual organisations can deliver good care, but whether they can successfully collaborate with other services as part of an effective local system

And technology will be central to this.

“Providers are starting to embrace new technology, which is having a positive effect on improving people’s quality of care, and the way services work together,” says the report.

“Digital monitoring, e-prescribing and assistive technology are all examples that are making a difference to people’s lives and the way they are cared for.”

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