‘Fragile' care sector needs immediate reform

The Care Quality Commission has warned that an under pressure social care sector is ‘fragile’ heading into a second wave of coronavirus infections.

The inspectorate said that overdue reform of the care sector ‘needs to happen now – not at some point in the future’, warning that the coronavirus pandemic risks turning inequalities in England’s health services from ‘faultlines into chasms’.

The annual State of Care report unveils serious problems with mental health, maternity services and emergency care before the pandemic, and says that these areas must not be allowed to fall further behind.

For example, in routine inspections carried out before March, 41 per cent of maternity services were found to require improvement for safety, while more than half of urgent and emergency care services were also rated as requiring improvement or inadequate.

On the second wave of the virus now striking hospitals, the CQC argued that the health system’s response to the pandemic needs to change. After focusing on protecting NHS services from being overwhelmed, health leaders must now adapt to prevent people who need help for non-coronavirus reasons from being left behind, stressing the need for greater local leadership of health systems.

Ian Trenholm, chief executive of CQC, said: “Pre-Covid, the health and care system was often characterised as resistant to change. Covid has demonstrated that this is not the case. The challenge now is to maintain the momentum of transformation, but to do so in a sustainable way that delivers for everyone – driven by local leadership with a shared vision and supported by integrated funding for health and care.

“There is an opportunity now for government, Parliament and health and care leaders to agree and lay out a vision for the future at both a national and local level. Key to this will be tackling longstanding issues in adult social care around funding and operational support, underpinned by a new deal for the care workforce. This needs to happen now – not at some point in the future.

“Covid is magnifying inequalities across the health and care system – a seismic upheaval which has disproportionately affected some more than others and risks turning fault lines into chasms. As we adjust to a Covid age, the focus must be on shaping a fairer health and care system – both for people who use services, and for those who work in them.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “Social care was already facing severe financial and demand pressures prior to the pandemic, which have since been exacerbated further, as this report highlights. Despite this, it should be recognised that service quality still improved slightly prior to the outbreak.

“The unequal impact of Covid-19 on people using and working in social care needs to be addressed as part of future reforms, as well as building on the importance of closer working and local approaches.

“Social care deserves parity of esteem with the NHS, with the pandemic highlighting the incredibly valuable role of social care in its own right. In particular, action is needed urgently on the care workforce including on pay, professionalisation, skills and training. The upcoming Spending Review must urgently provide councils with the extra funding they need to help shore up social care ahead of winter and get through the second wave of Covid-19, while also using this as the basis for future reform of social care to place it on a long-term, sustainable footing.”