On The Pulse | 22nd November 2024

Your weekly round up of the major health and social care news stories from PLMR's expert team. Nathan Hollow | Lucy Taylor | Jessica Peddie | Michela Bandilla

Winter is Coming: A&E and Social Care Systems Under Icy Strain??

As the cold weather starts digging its heels in across the UK, this week, two major reports highlighted the deepening challenges across England’s health and care system. From the alarming findings of a Care Quality Commission (CQC) survey on A&E services to warnings from the Nuffield Trust about the unsustainable pressures facing the social care market, the forecast for winter is increasingly worrying. ?

The findings serve as another reminder of the urgent need for coordinated action to safeguard patient care and prevent a cascading crisis across both acute and social care.?

A&E: Long Waits, Poor Communication, and Insufficient Pain Relief?

The CQC’s survey of more than 45,000 NHS urgent and emergency care (UEC) patients reveals a stark picture of overcrowding, long waits, and poor patient experiences in A&E departments.?

Key findings include:?

• 64% of A&E patients waited over four hours to be admitted, discharged, or transferred, while over a quarter waited more than an hour to be assessed by a nurse or doctor.?

• More than a quarter (27%) of patients in A&E and 26% in urgent treatment centres reported receiving no help for their pain.?

• One in three patients discharged from A&E said they were not given sufficient information on how to manage their condition at home, and 21% were left unsure of who to contact if problems arose post-discharge.?

Dr Adrian Boyle, President of the Royal College of Emergency Medicine, described the findings as evidence of a “system in crisis.” He warned that winter pressures—including seasonal illnesses and increased demand—will only exacerbate existing issues such as bed shortages, workforce constraints, and delays in discharging patients who are medically fit to leave.?

Social Care: A Sector on the Brink?

The pressures on A&E are not happening in isolation. The social care system—essential in part for supporting hospital discharges and preventing unnecessary admissions—faces its own escalating challenges.?

A report from the Nuffield Trust warns that private and non-profit social care providers could face additional costs of ￡2.8 billion in the next financial year due to wage increases and a hike in employers’ National Insurance Contributions (NICs).?

Key drivers of these costs include:?

• The Chancellor’s recent Budget increased employer NIC rates, costing the adult social care sector an estimated ￡940 million.?

• A 6.7% increase in the national living wage from April 2024 will add approximately ￡1.85 billion to the sector’s wage bill.?

The Nuffield Trust’s Natasha Curry warned of a “catastrophic” impact on providers already weakened by years of cuts, inflation, and the lingering effects of the pandemic. ?

Without government support to offset these pressures, Curry cautioned that “swathes of the social care market” could collapse, with care homes forced to close and vital services disappearing.?

A System at a Crossroads?

Both the CQC survey and the Nuffield Trust report point to a critical need for systemic reform and investment across health and social care. Addressing these issues will require more than funding announcements: it will need a coordinated strategy to tackle workforce shortages, improve patient flow, and stabilise the social care market.?

And as with every year, as winter looms, the stakes become increasingly higher. If action isn’t taken to shore up A&E and social care services, the system risks reaching a breaking point—with devastating consequences for patients and staff alike.?

The months ahead will be a critical test of whether the new Government can rise to meet these challenges or whether the cracks in the system will deepen further.?

Here’s what we’re reading this week:?

Healthcare Leader: Cross-party action to ‘fix’ social care needed, Darzi tells MPs??

Lord Ara Darzi called for political unity to address the social care crisis, warning that failure to act will worsen the strain on the NHS. He criticised past government proposals and stressed the need for comprehensive reform, not just funding. Darzi also expressed concern over children’s health and advocated for a greater role for pharmacies in easing healthcare pressure.??

Caring Times: National Insurance rises could cause 10% care fees rise???

Changes to national insurance contributions are expected to strain social care providers, with rising wage bills potentially forcing some businesses to close. Experts warn that the policy will suppress wage growth and increase costs, especially for providers reliant on local authority funding. A petition to exempt care providers from the NIC rise has gained support, but the government is unlikely to make changes.?

The Guardian: Large parts of adult social care market in England face collapse, thinktank warns??

The Nuffield Trust warns that England's adult social care market could collapse due to rising tax and wage costs, with an additional ￡2.8bn burden from April. Many providers may face financial collapse, reduce staff, or freeze pay, disrupting care for vulnerable people.? The Trust urges urgent government action to prevent this, but critics argue the government’s promised funding is insufficient.???

Caring Times: Report reveals critical gaps in care access??

Birdie's report reveals that only 6% of older adults receive formal home care, with 60% relying on family and friends. It highlights issues like financial barriers, lack of awareness, and caregiver burnout, which are expected to worsen with an ageing population. The report urges improved care coordination through digital platforms, better support for informal carers, and stronger integration between NHS and social care systems.??

BBC News: Social care sector ‘will struggle’ to cover costs???

Community Integrated Care warns that rising National Insurance and minimum wage costs could force some care providers to close. The charity estimates a ￡12 million impact, with smaller providers at risk.? CEO Jim Kane calls for more funding and a national debate on supporting social care.??

?Thank you for reading! We'll see you back here next week.