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CQC State of Care report 2021/22

The Care Quality Commission (CQC) recently published its annual ‘State of Care’ report – a detailed and comprehensive assessment of health and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. And the overwhelming message is that the health and social care system is in gridlock, which is having a hugely negative impact on people’s experiences of care at all levels.

The health and care system is gridlocked and unable to operate effectively
Ian Trenholm, Chief Executive of the CQC

The report states that people are struggling to access care, with large numbers of people stuck in hospital longer than they need to be due to a lack of available social care. And people’s inability to access primary care services is exacerbating the high 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.

Ian Trenholm, Chief Executive of the CQC, said about the report: “The health and care system is gridlocked and unable to operate effectively. This means that people are stuck – stuck in hospital because there isn’t the social care support in place for them to leave, 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.”

The report shows that when people have been able to actually access the care they need, the quality of care at the point of delivery is mostly good – and health and social care staff across the country are working relentlessly to ensure people are kept safe.

At 31st 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 core services (NHS and independent) were rated as good or outstanding

However, across all health and social care services, providers are struggling desperately to recruit and retain staff with the right skills and in the right numbers to meet the increasing needs of people in their care. Despite their efforts, in many cases providers are losing this battle, as staff are drawn to industries with higher pay and less stressful conditions. Sickness, vacancy and turnover rates are having a deep impact; continuing understaffing in the NHS poses a serious risk to staff and patient safety, and shortages in social care are even worse than they are in the NHS. 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.