Health and care system “gridlocked”

ONLY two in five people are able to leave hospital when ready to do so, which is contributing to record-breaking waits in emergency departments and dangerous ambulance handover delays, according to the Care Quality Commission.

The CQC’s annual assessment of the state of health and social care in England considers the quality of care over the past year based on inspection activity, information received from the public and those who deliver care alongside other evidence. It concludes that that the health and care system is "gridlocked" and unable to operate effectively.

Part of the work included a series of coordinated inspections across the urgent and emergency care pathway in 10 integrated care systems (ICSs) and also discussion with a group of 250 health and care leaders, who described the system they work in as "in crisis" and shared their fears that the risk of people coming to harm represents a “worrying new status quo”.

Ian Trenholm, Chief Executive of CQC, said: “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.

“There’s lots of great care out there… However, the fact is that it’s hard for health and care staff to deliver good care in a gridlocked system. There are no quick fixes, but there are steps to be taken now on planning, investment and workforce that will help to avoid continuing deterioration in people’s access to and experience of care."

Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “The Urgent and Emergency care system is failing patients and failing in its core function. Emergency Medicine staff and paramedic colleagues face unthinkable and distressing decisions every day, many are burned out and exhausted, doing all they can to keep patients safe and mitigate harm.

“Patients face long waits for an ambulance to arrive, long waits in Emergency Departments and long waits for a bed. Demand is not driving these long waits. Attendances are not higher than pre-pandemic levels, these long waits are symptomatic of exit block and patients being unable to be discharged from hospital due to lack of social care support.

“The government must urgently bolster the social care workforce to help with the provision of care in the community and with the discharge of patients in a timely way."