People experience different care depending on where they live and how well different parts of the healthcare system work together, a new report from the has concluded.
The CQC’s The State of health care and adult social care in England 2017/18report, published on Thursday, found that the overall quality of health and care services has been maintained but a large number of patients are still not receiving good care.
Having analysed CQC ratings data covering the period between 31 July 2017 and 31 July, 2018, the CQC found that around one in six adult social care services and one in five NHS mental health core services needed to improve.
The report also acknowledged the ongoing workforce pressures and funding constraints that providers have to cope with, and praised the efforts of staff to provide good care under these circumstances.
‘Integration lottery’
Ineffective collaboration at a local level between health and care services had an impact on patients’ experience, the report found.
This meant that patients were in some instances not able to access care in their community that would otherwise have prevented them from adding extra pressures on the acute service.
Around 41% of emergency departments were rated as requires improvement and 7% of them as inadequate, according to the data analysed.
The report said: ‘A struggling local hospital can be symptomatic of a struggling local health care system. This indicates that – although good and outstanding primary care is more evenly distributed – there are parts of the country where people are less likely to get good care.’
CQC chief executive Ian Trenholm 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”.’
Social care at breaking point
The fragility of adult social care services hinders closer collaboration between the health and care sectors, the report suggested.
Around 32% of directors of adult social services said they witnessed the closure of home care providers in the last six months, according to a recent survey by the Association of Directors of Adult Social Services (ADASS).
Responding to the CQC report, LGA’s Community Wellbeing Board chairman Cllr Ian Hudspeth said:
‘Councils across the country are working closely with their counterparts in health for the benefit of people requiring services, however with people living longer, increases in costs and decreases in funding, adult social care is at breaking point and its potential for helping people to live the lives they want to lead is at risk.’
The social care service, which was given an extra £240m last week to cope with winter pressures, faces a £3.5bn funding gap by 2025, according to the LGA.
