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On 21 October the CQC published its 2021 State of Care report, which provides its annual assessment of the health and social care system in England.
As was the case this time last year, there is a heavy focus on the impact of the pandemic. Pre-existing difficulties in accessing care have been exacerbated. The waiting list backlog continues to rise, with the most optimistic estimate being that it reach 9m in 2022 (from a current figure below 6m) and reach pre-pandemic levels by 2025.
The CQC found that many people are deciding not to see their GP, which is causing a potential bottleneck in the system as onward referrals are not made.
"When asked whether, at any time in the last 12 months, they had avoided making a GP appointment for any reason, 42% of respondents confirmed that they had. The top two reasons were because people were worried about the burden on the NHS (20%), and because people were worried about the risk of catching COVID-19 (17%)."
Staffing issues continue to be felt across the sector and the CQC called for urgent action to be taken. The number of qualified GPs is 3% lower now than it was in June 2017. 50% of doctors surveyed were found to be more likely to reduce their working hours over the course of 2021 and into 2022. New models of care and tech, such as remote consultations, may help to alleviate these issues, but clearly there is a need to improve the number of GPs and access to them.
In residential care, the vacancy rate jumped from 6% in April 2021, to 10.2% just 5 months later. Detail on these issues was set out in the May 2021 House of Commons Health and Social Care Select Committee report on workforce burnout and resilience in the NHS and social care.
The CQC also flags the need for greater transparency and openness to identify flaws in service delivery and continually improve quality, moving away from a "cover up culture" with poor reporting.
The report shines a light on many issues that we have become familiar with for some time now, but concludes with an acknowledgement that whilst the pandemic did not cause these issues (but rather exacerbated them) it should act as a turning point for much-needed change. The report flags the unprecedented levels of joint working between the public and private sectors - such as the use by the NHS of private hospital services across the UK - as one of the key lessons learned.
Overall there was a view that the pandemic prompted improved system working, and that this shouldn’t be lost during recovery; instead it should be strengthened and embedded. We heard how general practice has worked closely with adult social care providers, and the independent sector with the NHS, to deliver care. The successful delivery of the vaccination programme is a good example of the kind of effective system working providers would like to see more of.
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