‘Fragile' care sector needs immediate reform

The Care Quality Commission has warned that an under pressure social care sector is ‘fragile’ heading into a second wave of coronavirus infections.

The inspectorate said that overdue reform of the care sector ‘needs to happen now – not at some point in the future’, warning that the coronavirus pandemic risks turning inequalities in England’s health services from ‘faultlines into chasms’.

The annual State of Care report unveils serious problems with mental health, maternity services and emergency care before the pandemic, and says that these areas must not be allowed to fall further behind.

For example, in routine inspections carried out before March, 41 per cent of maternity services were found to require improvement for safety, while more than half of urgent and emergency care services were also rated as requiring improvement or inadequate.

On the second wave of the virus now striking hospitals, the CQC argued that the health system’s response to the pandemic needs to change. After focusing on protecting NHS services from being overwhelmed, health leaders must now adapt to prevent people who need help for non-coronavirus reasons from being left behind, stressing the need for greater local leadership of health systems.

Ian Trenholm, chief executive of CQC, said: “Pre-Covid, the health and care system was often characterised as resistant to change. Covid has demonstrated that this is not the case. The challenge now is to maintain the momentum of transformation, but to do so in a sustainable way that delivers for everyone – driven by local leadership with a shared vision and supported by integrated funding for health and care.

“There is an opportunity now for government, Parliament and health and care leaders to agree and lay out a vision for the future at both a national and local level. Key to this will be tackling longstanding issues in adult social care around funding and operational support, underpinned by a new deal for the care workforce. This needs to happen now – not at some point in the future.

“Covid is magnifying inequalities across the health and care system – a seismic upheaval which has disproportionately affected some more than others and risks turning fault lines into chasms. As we adjust to a Covid age, the focus must be on shaping a fairer health and care system – both for people who use services, and for those who work in them.”

Saffron Cordery, deputy chief executive of NHS Providers, said: “CQC’s state of care report provides a valuable, objective assessment of the way health and care services have performed in what has been the most challenging year in the history of the NHS.

“The report highlights the way that trusts and frontline staff have adapted and innovated successfully in response to the pandemic. CQC rightly concludes that progress in transforming the delivery of services has been extraordinary. We agree with CQC about the importance of ensuring that non Covid-19 patients are not left behind as we enter a second wave of the pandemic.

“Trusts are working flat out to maintain and restore services, while keeping people safe and preventing the spread of Covid-19 within hospitals. “It will be important as they do that to keep in mind the unequal impact of the pandemic, and to develop their work to tackle health inequalities.

“The emphasis in the report on effective provider collaboration in developing system wide responses contains valuable lessons for the year ahead, and we welcome the call for local leaders to be empowered to respond to the needs of their population as the impact of Covid-19 on different parts of the community becomes apparent We agree that the pandemic exposed the longstanding neglect of social care, which in turn impacted on the NHS. It is vital for the whole health and care system that social care is put on a sustainable and secure footing.”

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