Report: Care Quality Commission – State of Care 2019/20 – Full Report
For the services we regulate – as for the rest of the world – the past year is divided into two parts.
Pre-COVID, care was generally good, but with little overall improvement. In the NHS, improvement in some areas – for example, emergency care, maternity and mental health – was slower than others. The social care sector was fragile as a result of the lack of a long-term funding solution, and in need of investment and workforce planning. In primary medical services, the fact that the overall ratings picture remained broadly unchanged masked a more volatile picture of deterioration and improvement.
Since the arrival of COVID-19, we inhabit a different world, in which all these things remain true, but so much else has changed. As we take stock of the health and care system’s initial response to the pandemic in order to learn lessons for the future, there are elements to build on – and elements to reassess.
The professionalism and dedication of the people who work and volunteer in health and care has always been the system’s key strength – and from March onwards, this was more obvious than ever, as staff went to extraordinary lengths to protect those they cared for. This is cause for celebration – as well as for reflection on how to ensure that all staff are recognised for their work, regardless of the sector in which they deliver care.
The progress achieved in transforming the way care is delivered is also deeply impressive. In a matter of days, services developed new procedures and ways of working, often taking advantage of technology. Changes that were expected to take years – like the switch to more flexible GP consultations by phone and online – took place almost overnight. This report highlights many examples of how collaboration among services has made a real difference to people’s care.
The challenge now will be to keep and develop the best aspects of these new ways of delivering services while making sure that no one is disadvantaged in the process. COVID-19 has magnified inequalities across the health and care system – a seismic upheaval that risks turning fault lines into chasms.
At the start of the pandemic, the focus on acute care was driven by the urgent imperative that the NHS should not be overwhelmed. Decisions were made in order to ensure capacity as quickly as possible – but as we move past the initial peak of the pandemic, priorities need to be reset in a more sophisticated way to ensure that the longer-term response includes everyone, regardless of what type of care they need or where they receive it.
This resetting of priorities starts with local leaders being empowered and having the capacity to respond together to the needs of their area. The fact that the impact of COVID-19 has been felt more severely by those who were already more likely to have poorer health outcomes, including people from Black and minority ethnic backgrounds, people with disabilities and people living in more deprived areas, makes the need for health and care services to be designed around people’s needs all the more critical….