A damning new report lifts the lid on the state of our NHS after nine years of Conservative-led governments. After years of cuts and a staff crisis, it shows that there’s a “perfect storm” in mental health services. The report also highlights rising pressure on Accident and Emergency departments (A&E) where services have “deteriorated”. One thing shines through though: it’s testimony to the incredible NHS staff working in increasingly difficult situations that this crisis isn’t even worse.
The Care Quality Commission’s (CQC) annual report evaluates “health care and social care in England”. It highlights examples of good and outstanding care but also points to areas for improvement.
In 2019, the State of Care report looked at pressures on “health and social care as a whole”. But it focussed particularly on “inpatient mental health and learning disability services”. Because, as it noted:
When people can’t access the services they need, the risk is that they are pushed into inappropriate care settings – ending up in emergency departments because they can’t access the care they need outside hospital, or in crisis because they can’t access community based mental health and learning disability services.
The report revealed that:
- “10% of inpatient services for people with learning disabilities and / or autism were rated inadequate”. Compared to 1% in 2018″
- “7% of child and adolescent mental health inpatient services rated inadequate”. This was 3% in 2018.
- “8% of acute wards for adults of working age and psychiatric intensive care units” rated inadequate. Compared to 2% in 2018.
Access to mental health services is particularly difficult for children and young people, especially those with an eating disorder. The report also noted that “21% and 10% of community-based mental health services for children and young people” required improvement or were inadequate.
One of the most concerning findings of the report was that some people were “detained in mental health services” yet this “might have been avoided” if they’d been helped sooner. Other people, meanwhile, spent too long in unsuitable services.
One man described spending over three years in a secure mental health unit as “like a prison really”. Jack, told the BBC that his experience was “really horrible. Terrifying”.
CQC chief executive Ian Trenholm noted “a deterioration” in services since 2018. He also said that the inspection highlighted:
staff shortages, or care delivered by staff who aren’t trained or supported to look after people with complex needs, as a reason for this.
The report also noted that there are now “8% fewer learning disability nurses registered with the Nursing and Midwifery Council in 2019 than 2015”.
Increased demand combined with challenges around workforce and access [risks] creating a perfect storm – meaning people who need support from mental health, learning disability or autism services may receive poor care, have to wait until they are at crisis point to get the help they need, be detained in unsuitable services far from home, or be unable to access care at all.
In response to the report, national director of Healthwatch England Imelda Redmond said:
Unfortunately, the CQC’s findings come as no surprise to us and confirm that this is a nation-wide problem. We agree that urgent action is required, particularly on staffing levels, to ensure that people can get the help they need.
Accident and Emergency
The CQC also found that there’s pressure across the entire NHS. Hospital waiting times increased overall. At the end of June 2019, 4.4 million people were waiting to start treatment in NHS services. This is a 40% increase since June 2014.
Meanwhile, there’s a growing demand for “elective and cancer treatments”. This, it said, “risks making things worse”.
In A&E departments, the CQC found that performance got worse yet attendances and admissions continued to rise. The report stated:
July 2019 saw the highest proportion of emergency patients spending more than four hours in A&E than any previous July for at least the last five years. What used to be a winter problem is now happening in summer as well. While other hospital services improved slightly this year, the quality of care in NHS urgent and emergency services in hospitals has deteriorated.
That the CQC found any improvement at all in services is testimony to the incredible people working in increasingly difficult situations. As the chief inspector of adult social care Kate Terroni noted:
It is testament to our social care workforce and innovative providers that 4/5 services are rated as Good and there is an increase in the number providing Outstanding care despite the workforce and funding challenges #StateOfCare pic.twitter.com/HQ5BTjarum
— Kate Terroni (@KateTerroni) October 15, 2019
People trying to access all these services are incredibly vulnerable. This report is a shocking indictment of what Tory destruction has done to our NHS.
Featured image via Wikimedia
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