11.10.18

State of Care: ‘The tipping point has already been reached’

This year’s CQC State of Care report has found that most people in England receive a good quality of care, but that, much like the situation last year, quality remains inconsistent and access to care is very much dependent on where you live.

The CQC’s ratings showed that since last year, quality of care has generally been maintained and, in some areas, improved – which the inspectorate puts down to the hard work of care staff, despite the many challenges faced by providers.

But this wasn’t the case everywhere, and access to this good-quality care increasingly depends on where in the country you live and how well an area works together as a system.

The report said that the “fragility” of the adult social care market poses a threat to the effective collaboration between health and social care, with many providers closing and contracts being handed back to local authorities.

It is estimated that 1.4 million people do not have access to the care they night and the number of people with an unmet care need has risen by 20% in the last two years to nearly one in seven older people.

The lack of a long-term funding solution for adult social care, the report says, runs the risk of undermining the NHS funding settlement.

Ian Trenholm, chief executive of the CQC, said: “There needs to be incentives that bring local health and care leaders together, rather than drive them apart. That might mean changes to funding that allow health and social care services to pool resources.”

Peter Wyman, chair of the CQC said: “Our other big concern is the fragility of the adult social care market. Two years ago, we warned that social care was ‘approaching a tipping point’ – as unmet need continues to rise, this tipping point has already been reached for some people who are not getting the good quality care they need.

“It is increasingly clear that without a long-term funding settlement for adult social care, the additional funding for the NHS will be spent treating people with complex conditions for whom care in the community would have been more effective both in terms of their health and wellbeing and use of public money.”

Maisie Borrows, research manager at Reform, said: “Whilst the report sheds light on an unwelcome 'integration lottery' in local health and care systems, it also highlights the positive role of technology in accelerating joined up care. Integrated care records enabling effective data sharing are fundamental to this, improving care quality and reducing unnecessary admissions - a win-win for service users and providers, which we need to see more of.”

Also responding to the report, Cllr Ian Hudspeth, chairman of the LGA’s Community Wellbeing Board, said: “Over recent years, councils have protected adult social care relative to other services. But the scale of the overall funding picture for local government as a whole means adult social care services still face a £3.5bn funding gap by 2025, just to maintain existing standards of care. The likely consequences of this are more and more people being unable to get quality and reliable care and support, which enables them to live more fulfilling lives.

“The government must use the Budget and Spending Review to inject desperately needed funding into adult social care and use the green paper to secure the long-term sustainability of the system.” 

 

Top image: Dean Mitchell

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