Quality and safety at risk in NHS funding gap

The Government must increase spending on NHS and social care services if quality of care is to be maintained in a health service "straining at the seams", according to the safety and care inspectors.

The chief executive of the Care Quality Commission Sir David Behan told Sky News adult social care required more funding and that the NHS will have to finance new ways of working to protect "precarious" levels of patient care.

Speaking as the CQC’s annual review for 2016-17 found that the NHS is under pressure from rising demand while facing staff shortages and a reduction in hospital and nursing home beds, Sir David called on the Government to develop a sustainable plan for social care and provide the funding to implement it.

"Our report will be laid before Parliament and it is for Parliament to debate how they respond," he said.

"The future funding of adult social care, I think, is one of the unresolved policy issues. We have a system that is designed in the middle of the 20th Century which is struggling to accommodate the needs of the 21st century. We need a solution.

"Adult social care requires more funding and in relation to the NHS we need new ways of working and that change needs to be supported by finances."

Local authority spending on social care has been under pressure because of funding cuts over the last seven years. The Government is planning to issue a consultation on social care by the end of the year but there are reports a Green Paper will not be published until next summer.

Sir David also warned that the NHS is "struggling to cope with 21st century problems", with a system designed in the 20th century now having to cope with soaring levels of obesity, diabetes, heart disease and, most pressing of all, a rise in the number of elderly patients with complex multiple conditions.

After conducting 29,000 inspections the CQC concluded that the majority of services are good or outstanding, but highlighted concerns over safety.

The CQC rated 55% of NHS acute services as "good", but found that 67% of acute Trusts required improvement when it came to patient safety.

It also found 66% of NHS urgent and emergency services were not safe enough, with 60% "requiring improvement" and 7% "inadequate".

Some 78% of adult social care services were rated "good", Sir David warned that the system is in urgent need of a "long-term sustainable solution" from the government.

The report also highlighted a 16% increase in the number of staff vacancies across health and social care, and bed occupancy running at 91%, above the "safe" level of 85%, and a fall in the number of GPs per 100,000 people, down to 62 from 67 in three years.

Sir David said social care was under pressure from a 2% fall in the number of nursing home beds; an increase in the number of people with "unmet need" to 1.2m; and evidence that care companies are handing back contracts to local authorities because they are uneconomic.

"From 2014 to 2034 we are going to see an increase in people aged over 85 from 1.5 million to 3.2 million people," he said.

"We are living longer but are not living healthier so I think what we are signalling is that the system now and into the future has got to deal with those increased numbers of older people who are going to have more than one condition.

"We are going to see a fall in the quality of services that are offered to people and that may mean that the safety of some people is compromised."

(c) Sky News 2017: Quality and safety at risk in NHS funding gap