Hospital Dr News

Social care crisis compromising NHS services and creating postcode lottery for care

The continuing crisis in social care is having significant effects on hospital services, encouraging people to swamp A&E departments.

The CQC’s annual assessment of the quality of health and social care in England shows ineffective collaboration between local health and care services can result in people not being able to access care services in the community that would avoid unnecessary admissions to hospital.

The most visible impact of this is the pressure on emergency departments as demand continues to rise, with July 2018 seeing the highest number of attendances on record.

Emergency departments are the core hospital service most likely to be rated requires improvement (41%) or inadequate (7%).

A less visible impact when health and care services do not work well together is on people who use mental health services, who may already have more difficulty accessing support or to have to travel unreasonable distances to get it.

For example, inappropriate out of area mental health placements – with some people being placed hundreds of miles from their homes – vary considerably by region.

The report concluded that 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.

Posing a threat to effective collaboration between health and social care is the continued fragility of the adult social care market, with providers closing or ceasing to trade and contracts being handed back to local authorities.

Unmet need continues to rise, with Age UK estimating that 1.4 million older people do not have access to the care and support they need.

In two years, the number of older people living with an unmet care need has risen by almost 20%, to nearly one in seven older people.

While the government made a welcome NHS funding announcement in June 2018, the impact of this, and last week’s short term crisis funding for adult social care, risks being undermined by the lack of a long-term funding solution for social care, the report says.

Ian Trenholm, Chief Executive of the CQC, 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.”

On the positive side, the report found that overall quality has been largely maintained, and in some cases improved, from last year.

Read the full report.

Bookmark and Share

Post a Comment

Enter this security code

Submit Comment for Moderation