Integrated care systems (ICSs) must be supported to own and deliver ‘system level’ workforce plans, the Care Quality Commission (CQC) has said.
The call comes as part of its major annual report – assessing the state of health care and adult social care in England – which has claimed the NHS is in a ‘gridlock’, stifling patients’ access to services.
The CQC today called for central support for ICSs to ensure they can develop their own workforce plans that acknowledge the staffing crisis in social care as a national issue.
It said these plans must offer staff better pay, rewards and training linked to career progression, encouraging ‘investment in long-term solutions rather than short-term sticking plasters’.
During its research, the CQC found examples of care homes having ‘significant’ spare capacity which could be used to support patients leaving hospital, and clearing up the gridlock.
However, staffing shortages in social care in some areas – such as Gloucestershire – restricted system leaders’ ability to use this capacity.
It said: ‘This shows how vital workforce planning at a system level is, and how all partners within health and care need to be involved.’
Health and care staff want to provide good, safe care but are struggling to do so in a gridlocked system, it said, noting that this is mirrored in staff dissatisfaction levels and record-high vacancy rates.
Today’s report also made a series of major criticisms on the state of access to healthcare in England.
The CQC warned that too often patients were unable to access the care they needed, although it noted care was good when it was provided.
The regulator highlighted that only two-in-five people are able to leave hospital when they are ready to do so, contributing to record-breaking waits in emergency departments, while the capacity in adult social care has reduced and unmet need has increased.
It also said that worsening access to primary care was leading to record drops in patient satisfaction and ‘exacerbating pressure’ on urgent and emergency services.
Without action now, staff retention will continue to decline, placing increasing pressure across the system and leading to worse outcomes for people – particularly in areas of economic deprivation – the CQC warned.
It also suggested local leaders need to bring together ‘better data’ and information to better plan to tackle inequalities in people’s experience of and access to care.
The CQC also confirmed it would begin assessing ICSs from April 2023.
Kate Terroni, chief inspector of adult social care, integrated care and interim chief operating officer, said: ‘Through our inspection activity we see much good and outstanding care – as well as issues with culture and leadership which can lead to increased risk for people, as we’ve highlighted in maternity services and services for people with learning disabilities and autistic people.
‘However, through our work on local areas and systems and our oversight of the whole health and care system, we also see increasingly clearly how a lack of investment in one part of the system has consequences for the whole, and the impact this has on whether people get good care.’
Responding to the report, Hugh Alderwick, director of policy at the Health Foundation, said: ‘Chronic staffing gaps, now standing at around 130,000 in the NHS and 165,000 in social care, are holding the system back and putting even more pressure on people providing care.’
He added: ‘Improving health and care services will require additional investment and a long-term plan for recruiting and retaining staff. But a public sector spending squeeze is looming instead – and the new prime minister will need to be honest about the consequences for local services and the people who rely on them.’
