Care Quality Commission State of Care report 2021

State of Care report

Key points

  • The impact of the pandemic on many who use health and social care services has been intensely damaging. Many people have struggled to get the care they need, and there is also evidence that some people have not sought care and treatment as a result of COVID-19.
  • We have previously highlighted the ongoing issues that people from some groups have faced in accessing and receiving high-quality care. Over the last year, the pandemic has further exposed and exacerbated these inequalities.
  • People with a learning disability have faced increased challenges as a result of the pandemic.
  • The need for mental health care has increased, with children and young people particularly badly affected.
  • The strain on carers has intensified. Carers UK estimated in June 2020 that an additional 4.5 million people had become unpaid carers since the pandemic began.
  • Health and social care staff are exhausted and the workforce is depleted. People across all professions, and carers and volunteers, have worked tirelessly to help those who needed care. The negative impact of working under this sustained pressure, including anxiety, stress and burnout, cannot be underestimated.
  • Despite the widespread disruption caused by the pandemic, surveys have shown that, when people were able to access the care they needed, they were often positive about that care.

 

Flexibility to Respond to the Pandemic

Key points

  • After the initial prioritisation of urgent care, there was a gradual push to bring systems back in line with pre-pandemic levels. Of the NHS acute areas we examined (cancer, cardiovascular, A&E, and mental health services), cancer services have achieved the best response and recovery.
  • The NHS was able to expand its critical care capacity to respond to the needs of the patient population at a time of crisis, although it put extra pressure on staff and other types of care and treatment.
  • We have serious concerns about ambulance handover delays at hospitals, which puts the safety of patients at risk.
  • The ‘discharge to assess’ model for managing transfers of care has helped to support services in both health and social care. It has been a good step towards helping people after they leave hospital, although there needs to be greater consistency in how it is implemented.
  • The vital role of adult social care was made clear during the pandemic, but urgent action is needed to tackle staffing issues and the increased pressures and stresses caused by staff shortages.
  • GP practices had to rapidly move to a more remote model of care in the pandemic – this was welcomed by many people needing GP care, but it did not benefit everyone and some struggled to get the appointments they wanted.
  • Access to NHS dental care was an issue since before COVID-19, and there are clear signs that this has been compounded by the pandemic.