Care Quality Commission State of Care report: investigation finds a ‘concerning gridlocked system'

Service quality for people with a learning disability, autistic people, and people with a mental health condition are at risk of workplace cultures which are causing harm and breaches of human rights, find the Care Quality Commission (CQC).

The annual CQC State of Health and Care in England report has assessed the current pressures faced in the health and social care sectors. The independent body found that, too often, people are not accessing the care they need and highlighted workplace shortages across all sectors that need to be addressed.

Over the last few years, the CQC has taken action to improve standards of care in inpatient mental health settings. However, services are still struggling to meet the pressures of increased demand and symptom complexity and severity as especially more children and young people reach crisis point.

This problem of accessibility was detailed in the report by one case study, ‘Joseph’, aged 10, has been diagnosed with depression and anxiety. He had struggled to gain a referral for services and has been on a waiting list for treatment for two years. During this time, his grandfather passed away, severely impacting his wellbeing. Joseph has recently been prescribed medication to manage his symptoms, but he is still waiting to see a therapist.

The CQC said in a statement that many of the challenges services are facing are related to historic underinvestment. Adding that solutions to the problems are therefore only going to come from long-term planning and investment, with local areas taking a whole system approach to recognise the relationship between health and social care and address the root causes behind the immediate and ‘obvious’ problems.

Ian Trenholm, Chief Executive of CQC, said:

“The health and care system is gridlocked and unable to operate effectively. This means that people are stuck – stuck in hospital because there isn’t the social care support in place for them to leave, stuck in emergency departments waiting for a hospital bed to get the treatment they need, and stuck waiting for ambulances that don’t arrive because those same ambulances are stuck outside hospitals waiting to transfer patients.”

“The fact is that it’s hard for health and care staff to deliver good care in a gridlocked system. There are no quick fixes, but there are steps to be taken now on planning, investment and workforce that will help to avoid continuing deterioration in people’s access to and experience of care.”

A Government strategy to grow the psychiatric workforce is urgently needed, says the Royal College of Psychiatrists

In response to the report’s findings, the President of the Royal College of Psychiatrists, Dr Adrian James, highlighted the pressures facing mental health services. He followed by repeating the Royal College of Psychiatrists calls for a well-funded multiyear Government recruitment strategy to grow and incentivise retention in the current psychiatric workforce.

Dr James said:

“The CQC annual state of care report makes it undeniably clear the pressures facing mental health services. Services are struggling to cope, and there are simply not enough psychiatrists to meet the current demand.”

“We know that nearly a quarter of mental health patients wait more than 12 weeks to start treatment, and more than three-quarters of those are in a hidden waiting list and were forced to use emergency services or a crisis line in the absence of mental health support.”

“There is a crucial need for a funded multiyear workforce strategy that outlines how the government will grow and retain the psychiatric workforce, and how it will consistently monitor progress so that it can change course where necessary.”

“It takes 13 years to train a consultant psychiatrist, so there is no excuse for a lack of longer-term planning, planning which is needed now.”