The CQC has been reviewing how those aged over 65 access and move between health and care services in targeted local authority areas. With their findings in a third of the areas they are reviewing now published, the CQC has taken time out to step back and look at the bigger picture.
Whilst they commended those working within health and adult social care services, finding them passionate about providing the best possible experience to the older people within their care, they did find systemic problems. Their efforts were too often compromised by the competing priorities, performance measures and accountabilities of each organisation, resulting in limited choice and difficulties when moving between services, with the system appearing confusing and fragmented.
- the ‘whole system approach’ that focuses on integrated and person-centred care is not being realised as best as it could.
- how providers and commissioners work together could be improved
- lack of capacity is a real issue.
- market supply and workforce issues are also barriers to achieving a seamless whole system approach.
- Service commissioners and providers need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing.
Prof Steve Field, chief inspector of general practice and integrated care, who is the executive lead for this work, said: “In too many instances, older people find the experience of moving between health and social care services confusing. Too often, care is fragmented, choice is limited and people are uncertain about who is coordinating their care needs. Many people are worrying about what support will be in place when they return home from hospital, or who will be there to give their carer a break from looking after them full-time.
“In response, we encourage all system partners to have a clearly communicated health and social care offer that responds to people’s local needs, to provide a stronger focus on wellbeing initiatives that can help people to stay out of hospital and to address variation that can inhibit people’s access and choice.
“These are our interim findings and suggestions for improvement at this stage. We will report to the Secretaries of States for Health and Communities & Local Government again in the summer once we have completed all 20 reviews.”
The final report, following the completion of all 20 reviews, is due to be published in the summer of 2018.