The state of UK health and social care 2014/15
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The document summarizes the state of health care and adult social care in the UK in 2014/15. It finds that while the majority of services were rated as good, there is significant variation in quality across different regions and sectors. Safety continues to be the biggest concern, and strong leadership is crucial for delivering high quality care. The report also encourages further improvements in care through factors like better staff training and recruitment, learning from mistakes, and increased transparency.
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The state of UK health and social care 2014/15
- 1. The state of health care and adult social care 2014/15 David Behan Chief Executive Care Quality Commission #StateofCare
- 2. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve This year’s report is the first time such a national assessment has been possible following the introduction of our rigorous ratings system 2 Our purpose
- 3. A challenging environment 3 Despite challenging circumstances, the majority of services have been rated as good, with some rated outstanding
- 4. There is significant variation in quality - and safety continues to be the biggest concern 4 Safety
- 5. Strong leadership is emerging as more crucial than ever to delivering good care 5 Leadership Effective planning Focus on delivering for people Culture of openness and staff engagement Willingness to collaborate with partners
- 6. Evidence increasingly shows that CQC’s work is leading to improvements in care 6 Encouraging improvement
- 7. 7 Adult social care A registered manager consistently in post has a crucial influence on quality Staff recruitment and retention remain a serious challenge
- 8. 8 Hospitals Creating the right culture for staff to work with autonomy and confidence Patients must feel confident to complain
- 9. Access to beds continues to be a problem 9 Mental health 8 trusts rated so far: 4 are good 3 require improvement 1 is inadequate Attitudes of all staff can have a big impact
- 10. Room for improvement in safety culture Strong link between the quality of leadership and collaborative working, and the quality of care 10 Primary medical services GPpracticesand GPout-of-hoursservices
- 11. Everyone should have the right information Everyone should be treated with dignity and respect Providers should ensure equality for their staff 11 Equality Significant variation in access, experience and outcomes
- 12. 12 The future Strong leadership Good communication with staff and people using services The skills, experience and visibility of management A strong, positive and open organisational culture Learning when things go wrong Strong governance Cross-sector collaboration New models of care Better data transparency Looking to the future together Putting quality of care at the centre of change and innovation
- 13. •Focusing on quality •Providing better information •Encouraging innovation •Becoming a more efficient regulator •Working with partners to encourage improvement Our new strategy for 2016-2021 will help us to achieve these goals 13 What is CQC’s role?
Editor's Notes
- Welcome to today’s launch of CQC’s State of Care report 2014/15 This a live debate, we’re streaming live on Youtube You can also follow the debate on Twitter via the address on the screen, #StateofCare
- The health and care system in England has come under increasing pressure during 2014/15, driven by changing care needs and financial demands Providers and staff are being asked to deliver significant efficiency savings Many services have responded well - managed to improve or maintain quality The environment will become even more challenging - the effective use of resources will be a vital component of success But some people get care that is not acceptable Seven per cent of services are inadequate The level of variation in quality that we see is also of great concern
- Safety is a fundamental expectation for people, but it is our biggest concern Our inspections over 2014/15 found that: 13% of hospitals are inadequate 10% of adult social care inadequate 6% of primary medical services inadequate Safety is affected by a failure to investigate incidents properly and learn from them, ineffective safety and risk management systems and inadequacy of staffing numbers and mix, alongside skills, training and support
- 94% of services rated good or outstanding overall were also good or outstanding for leadership 84% of services rated as inadequate overall were inadequately led Importance of leaders who are visible, engage widely with people who use services and staff, promote a strong culture of safety, put in place robust governance systems and plan their resources well Having the right number and mix of staff, with the right skills, at all times is integral to providing safe, high-quality care
- Where we see poor care, we will respond and challenge providers to improve Re-inspections so far - 50% of services have improved ratings within 6 months Providers find our reports useful in identifying what they need to do to improve Where necessary we will take enforcement action to protect the people who use these services In 2014/15 we took 1,179 enforcement actions including: 63 non-urgent cancellations of registration 27 urgent suspensions of registration or urgent variations or imposition or removal of conditions
- Sector under pressure - issues around the sustainability of provision due to cuts to LA budgets, increasing costs and high vacancy rates Despite this, inspections showed that almost 60% of services were providing good or outstanding care However, 7% of services were rated inadequate: safety being the biggest concern Contributory factors were staffing levels, understanding and reporting safeguarding concerns, and poor medicines management Having a consistent registered manager in post has a positive influence- outstanding leaders demonstrate passion, excellence and integrity, collaborate with staff and the provider, and ensure people’s views and wishes are at the centre of their care
- Too much variation in the standards of care provided within and between trusts Difference between trusts that are rated outstanding and those rated inadequate are their ability to monitor and act on issues that are identified, share learning from incidents, have a strategy that is communicated and understood by all staff, and promote a culture of openness Consistent, good care can only be achieved by excellent leadership and inclusive staff engagement Safety remains our biggest concern for the sector Staffing levels and skill mix remain an issue in many hospitals
- Across the trusts we inspected, we rated individual core services mostly as good (65%) or requires improvement (31%) Excellent examples of local leadership (for example ward managers), but some boards unaware of whether their decisions were having any impact on frontline services Our biggest overall concern is the safety of care environments, particularly wards - not good enough and creating risks to patients Right here, right now found that attitudes of all staff can have a big impact, particularly for those in crisis Access to beds, particularly in child and adolescent mental health services, continues to be a problem
- Most of GP practices and out-of-hours services are providing good care but we have been shocked at the very poor care provided by 4% of practices we have rated inadequate Strong link between good leadership and good care Room for improvement in the safety culture in GP practices: poor incident reporting, a lack of learning from significant events, and poor medicines management GP practices deliver a better quality of care when sharing learning and providing joined-up care through multi-professional networks There is a need for GP practices to review access to medical advice and treatment to ensure they are in line with patients’ needs
- Across all sectors there is a significant variation in access, experience and outcomes for different groups of people using health and care services Challenge to ensure everyone has the right information in order to access services Whether people say they are treated with dignity and respect is closely linked to their overall experience of care Important that providers also ensure equality for their staff While almost all services say that they have equality policies in place, far fewer say that they have carried out work in the last year on equality
- Put quality of care at the centre of change and innovation - to survive and thrive will require resilience, innovation and creativity, supported by great leadership We encourage services across health and social care, together with their local and national partners, to focus on: Building a collaborative culture - reaching out to people who use services and staff Being open, transparent and learn from mistakes - information and data to make good decisions and to learn from the best Ensuring the right staff and skill mix in place to ensure that care is always safe Continue to put quality of care at the centre of change – don’t fall into the trap of seeing innovation as only driven by the need to save money We encourage all partners in adult social care to come together and set out a plan to address the fragility of the market and ensure the continuity of good care CQC has an important role in working with national and local partners to support sectors and providers in building resilience to maintain their focus on quality We have started to promote transparency - conversations about quality are becoming more open and honest across all stakeholders We are looking at the way we register and inspect, particularly new models of care, and at the quality of the data and providers collect to help understand the experiences of people who use services better This work should help us support innovation while ensuring people who use services receive high-quality care
- CQC has an important role in working with national and local partners to support sectors and providers in building resilience to maintain their focus on quality We have started to promote transparency - conversations about quality are becoming more open and honest across all stakeholders We are developing a new strategy for 2016-21 in consultation and co-production with our stakeholders We are keen that our approach leaves room for providers to innovate and develop how they provide care, as long as it remains safe and of good quality The new strategy will focus on being more efficient by considering the right balance between registration, inspection, monitoring and information from providers; and building stronger relationships with our partners to encourage improvements for people who use services