Public facing a growing ‘care injustice’

A new report from the Care Quality Commission has warned that the public is facing a growing ‘care injustice’ as people are finding it more difficult to get help in England.

The State of Care paper highlights growing hospital waiting lists, delays at A&E and record dissatisfaction levels with GPs, while also detailing how mental health and old-age care were also becoming harder to access.

While the CQC states that the majority of services were rated as good or outstanding and the quality of care was being maintained, the annual review pinpoints examples of a lack of out-of-hours GP care, rising rates of preventable admissions to hospitals, overcrowding on wards and worsening A&E waiting times, a growing waiting list for routine operations and mental health patients being made to travel long distances for treatment.

Specifically, the Isle of Wight, Kent, Wirral and Portsmouth have been singled out as the four areas where access to good hospital and social care is problematic, with poorer-than-average care services and struggling hospitals leaving inspectors unsure about the likelihood of future improvements. This is because the Isle of Wight's only hospital has an inadequate rating, there are seven local hospitals in Kent that are all judged to be not good enough, while nearly half of home care services in Portsmouth and its main hospital are not up to scratch.

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. That might mean changes to funding that allow health and social care services to pool resources. Like the digital monitoring devices for patients’ clinical observations that have saved thousands of nursing hours, the e-prescribing in oncology that’s helping people directly, and the electronic immediate discharge summaries that have improved patient safety.

“The challenge for Parliament, national and local leaders and providers is to change the way services are funded, the way they work together and how and where people are cared for and supported. The alternative is a future in which care injustice will increase and where some people will be failed by the services that are meant to support them, with their health and quality of life suffering as result.”