Care regulator the CQC issued a stark warning - Social care cuts take English service to tipping point.
Care
Quality Commission says level of cuts to service is affecting A&E units,
causing bed blocking and failing elderly at-home patients. The number of patients unable to leave
hospital due to the unavailability of social care has risen 70% since 2012
A&E units are struggling to cope because social
care services that help elderly people have been cut so much that they are
reaching a “tipping point”, England’s care regulator is to warn.
Hospitals are ending up dangerously full and have
seen “bed blocking” hit record levels because of a widespread failure to give
elderly people enough support to keep them healthy at home, says the Care
Quality Commission.
A worsening lack of at-home care services and beds
in care homes are forcing hospitals to admit more patients as emergencies,
which deepens their already serious financial problems. “What’s happening, we
think, is that where people aren’t getting access to [social] care, and we are
not preventing people’s needs developing through adult social care, is that
they are presenting at A&E,” said David Behan, the CQC’s chief executive.
Figures contained in the commission’s annual report
show that the number of hospital bed days lost through patients being unable to
leave because social care was not available to allow them to be discharged
safely soared from 108,482 in April 2012 to 184,199 in July this year – a 70%
rise.
The fact that growing numbers of mainly frail,
elderly people are being left without the help they need with basic chores such
as washing, dressing and cooking “creates problems in other parts of the health
and care system, such as overstretched A&E departments or delays in people
leaving hospital,” he added. GP surgeries are also having to treat patients who
became unwell or suffered an injury because they did not receive help they
needed.
Behan urged ministers to give social care a higher
priority and urgently find extra money for it to prevent its ongoing
deterioration causing even worse problems. “We are becoming concerned about the
fragility of the adult social care market, with evidence suggesting that it
might be approaching a tipping point,” he said.
The CQC’s assessment of health and social care,
called State of Care, adds that: “The difficulties in adult social care are
already affecting hospitals. Bed occupancy rates exceeded 91% in January to
March 2016, the highest quarterly rate for at least six years, and in 2015-16
we saw an increase in the number of people having to wait to be discharged from
hospital, in part due to a lack of suitable care options,” the CQC’s annual
report says.
The number of people in England receiving local
council-funded social care services fell by 26% from 1.1m in 2009 to about
850,000 in 2013-14, at a time of Whitehall-driven cuts to town hall budgets.
The number of people with unmet needs has risen from 800,000 in 2010 to more
than 1 million last year, according to Age UK.
Growing unavailability of social care was a key
driver of the 3% rise in emergency admissions to hospital last year and 11%
rise in bed days lost to bedblocking. That was mainly due to patients having to
wait for a package of care to be put in place to let them return home or for a
place in a nursing home to become available. “The effect of these delays on the
NHS
is significant, costing hospitals £820m a year,” the National Audit Office
says.
NHS bodies, health thinktanks and charities urged
government to use next month’s autumn statement to inject extra funding into
social care.
Simon Stevens, the chief executive of NHS England,
has already called for any extra funding for the health service to instead be
used to prop up social care. Jeremy Hunt, the health secretary, is understood
to privately agree. On Monday Stephen Dorrell, the ex-Conservative health
secretary, said that the government’s policy of giving social care less and
less money was “insane economics and bad social policy” and undermined its
claim to be backing the NHS.
Cuts to social care and also mental health and
public health mean “the NHS is being stretched to the limit,” said Stephen
Dalton, chief executive of the NHS Confederation, which represents hospitals.
“Relying on political rhetoric that promises to protect the NHS but fails to
acknowledge that a cut in social care results in a cost to the NHS, is an
economic deception.”
The CQC also disclosed that about 800,000 patients
are registered with a GP practice that its inspectors have judged to be
inadequate on safety grounds. It is concerned that some surgeries deliver
“unacceptable standards of care”. Safety failings include poor management of
medicines, inappropriately trained staff and premises that are unsuitable.
The Department of Health
welcomed the CQC’s findings that “the majority of the NHS, 72% of adult social
care services and 87% of GP practices inspected are good or better – and that
improvement is taking place all over the country”.
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