Future quality of NHS and social care is ‘precarious’, says CQC

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The future of the health and social care system is in peril as it struggles to cope with the increasingly complex needs of a 21st century population, the Care Quality Commission has warned.

In its latest State of Care report, the watchdog commends the efforts of staff and emphasises that the majority of people are currently receiving good, safe care, but stresses that the system is now at full stretch and facing unprecedented pressure.

Following an inspection of services, the CQC found that 78 percent of adult social care services were rated good as were 55 percent of NHS acute hospital core services, 68 percent of NHS mental health core services and 89 percent of GP practices.

However, there were clear signs that the system is buckling under pressure. In acute hospitals there is a growing number of people waiting more than four hours at A&E, while the number of planned operations being cancelled is also on the rise and patients are having to wait longer for their treatment.

In social care, the number of beds available in nursing homes is on the decrease, and domiciliary care contracts being handed back to councils because providers say the funding is insufficient to meet people’s needs, creating a bottleneck of patients waiting to be transferred from hospitals.

These problems will only by magnified by increasing demand, caused by a growing number of people with complex, chronic or multiple conditions and an ageing population, while service providers are also grappling with growing staff shortages and financial constants, all of which means that the future quality of services is “precarious”, the regulator warns.

“As people’s health and care needs change and become more complex, a model of care designed for the 20th century is at full stretch and struggling to cope with 21st century problems,” said Sir David Behan chief executive of the CQC, and stressed that “the future of care for older people and the adult care system is one of the greatest unresolved public policy issues of our time”.

“It would be a tragedy if the NHS’s 70th birthday was remembered as the year England’s care system collapsed, but [the] report reveals real concerns that mental health and social care services are not sustainable,” said Niall Dickson, Chief executive of the NHS Confederation, commenting on the CQC’s findings.

“The inescapable conclusion has to be that without further government funding today’s perilous state will become tomorrow’s tragedy”.

Also responding to the report, Nuffield Trust director of research Professor John Appleby said: “The CQC’s warnings must be seen in the context of the unsustainable financial squeeze. The NHS ended last year with an underlying deficit of £3.7bn and faces an even greater challenge this year.

He went on to say that “perhaps the most worrying parts of this report touch on social care for older people,” given that “one in eight are not receiving the care that they need in the community, and costs have already been pushed so low that companies are giving up contracts.

“We agree that the future funding and organisation of social care is becoming one of the greatest unresolved policy issues of our time, and action on this is now an important priority.”

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