CQC says the health and care system is gridlocked and unable to operate effectively

The report found that, due to a lack of available social care, only two in five people are able to leave hospital when they are ready to. This is leaving large numbers of people stuck in hospitals.

As a result, others are then stuck in emergency departments waiting for a hospital bed to get the treatment they need, and stuck waiting for ambulances that don’t arrive because those same ambulances are stuck outside hospitals waiting to transfer patients.

People's inability to access primary care services is further increasing pressure on urgent and emergency care services.

At the heart of these problems are staff shortages and struggles to recruit and retain staff right across health and care. As capacity in adult social care has reduced, unmet need has increased.

The CQC have concluded that health and care staff want to provide good safe care but are struggling to do so in this gridlocked system.

Disabled people, those with a long-term health condition and people living in more deprived areas are less satisfied with being able to access services when they need them. Older people living in the most deprived areas are more likely to report that they have a long-term condition, disability or illness compared with those living in less deprived areas.

The State of Care report highlights that the Covid-19 pandemic continued to disproportionately affect people from some minority ethnic backgrounds in 2021 to 2022. In addition, research has shown continuing ethnic inequalities in mental health, maternity care and in the NHS workforce.

The report found that ethnic minority-led GP practices are more likely to care for populations with higher levels of socio-economic deprivation and poorer health, increasing the challenges they have around recruitment and funding.

CQC also state that health and social care providers need to do more to make their services accessible, especially to people with different communication needs.

Notably, improvements are also needed in the recording and use of demographic data by services generally.

The repercussions of the Covid-19 pandemic on the healthcare system are leading to frustrations in people accessing services. The impact ranges from difficulties in accessing regular appointments to delays in life-saving treatments.

In a CQC survey of people aged 65 and over who had recently used health or social care services, 37% were on health waiting lists and did not feel well supported those services.

There has also been a significant reduction in the availability of NHS dental care, particularly for children and young people.

Health and social care staff across the country are working tirelessly to ensure people are kept safe . At 31 July 2022:

• 83% of adult social care services were rated as good or outstanding.
• 96% of GP practices were rated as good or outstanding.
• 75% of NHS acute core services were rated as good or outstanding.
• 77% of all mental health care services (NHS and independent) were rated as good or outstanding.

Maternity services: need improvement. CQC found that action to ensure all women have access to safe, effective and truly personalised maternity care has not been sufficiently prioritised.

In addition, women from ethnic minority groups continue to be at higher risk of dying in pregnancy and childbirth than White women.

CQC has responded to these findings by focusing its inspection programme on supporting improvements in maternity care at both a local and national level.

Care for people with a learning disability and autistic people: despite multiple reviews and reports over decades, people with a learning disability and autistic people continue to face huge inequalities in terms of accessing and receiving health and social care.

CQC's 2021 report Home for Good illustrated that bespoke homes in the community, that are tailored to meet people’s individual needs, can transform people’s lives.

And the Supported Living Improvement Coalition means that people with lived experience, their relatives and representatives can tell their stories to a range of organisations to embed the improvements that are needed.

Mental health services: are struggling to meet needs of children and young people.

Services are struggled to meet demand, increasing the risk of children and young people’s symptoms worsening and reaching crisis point, and being cared for in unsuitable environments.

In response to concerns around increasing demand, NHS England announced in July 2022 that 4,500 more NHS staff are working in children’s mental health services.

Deprivation of Liberty Safeguards: ongoing problems with the Deprivation of Liberty Safeguards process mean that some people are at risk of being unlawfully deprived of their liberty without the appropriate legal framework to protect them or their human rights.

Workforce: in the first three months of 2022, 2.2 million hours of homecare could not be delivered because of insufficient workforce capacity, leading to unmet and under-met needs.

More than 9 in 10 NHS leaders have warned of a social care workforce crisis in their area, which they expect to get worse this winter.

CQC concludes that more needs to be done to maintain and develop the workforce, especially in adult social care, and that system-wide workforce planning must be a priority.