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Health & care system 'straining at the seams'

WebMD UK Health News
Medically Reviewed by Dr Rob Hicks

10th October 2017 -- The quality of NHS health and social care in England is 'straining at the seams', according to a regulator's annual report.

In its State of Care report the Care Quality Commission (CQC) says most people are getting good, safe care but future quality is "precarious".

'At full stretch'

More people in the UK are living longer - but not always with healthier lives – they may be frail, have dementia, or a combination of long-term health conditions needing more complex care.

The NHS runs health services like GPs, clinics, and hospitals but care homes (social care) are funded or run by local authorities in England.

The CQC describes the health and social care system as being "at full stretch" and "struggling to meet the more complex needs of today’s population, meaning that maintaining quality in the future is uncertain."

Health and care staff and services "are under huge pressure", the report says, with a greater demand and unfilled vacancies, staff are "working ever harder to deliver the quality of care that people have a right to expect. However, there is a limit to their resilience."

The report did find many services classed as 'good', including:

  • 78% of adult social care services
  • 55% of NHS acute hospital services - such as A&E
  • 68% of NHS mental health services
  • 89% of GP practices

'Outstanding care' was achieved by 2% of adult social care services, 6% of NHS acute hospital and mental health services, and 4% of GP practices.

'Inadequate' care was found in 1% of adult social care and NHS mental health services, 3% of NHS acute hospital services, and 2% of GP practices.

Inspectors found some services had improved while others had become worse, and there were regional differences in quality.

It also raised concerns about:

  • More people waiting over 4 hours in A&E
  • More planned operations being cancelled
  • More people waiting longer for treatment
  • In cancer treatment, more people are being treated after a GP referral, but they are having to wait longer for treatment to start
  • A decrease in adult social care beds in nursing homes
  • Funding problems meaning some private care contracts were handed back to councils

Fragmented care

The regulator highlighted problems when patients need help from different parts of the NHS and social care services, saying: "Better care is often where providers are working together to provide a more seamless service, one that is built around the often multiple, or complex, needs of individuals."

It warns: "Too many people receive fragmented care – care that is built around the priorities or targets of the services, rather than people’s needs.

"To deliver good, safe, well-coordinated care that is sustainable into the future, providers will have to think beyond their traditional boundaries and reflect the experience of the people they support."

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