10 November 2017

The recently published State of Care report – the CQC’s annual report on health and social care in the England – reports positively that the quality of care provided in England is generally good. However (and this comes as no surprise) the system is under considerable strain as it struggles to cope with the weight of increasing demand and is sustained by the resilience of a workforce stretched beyond capacity.

Key findings

Demand is not only increasing – it is increasingly complex

  • The number of people in England aged over 85 is set to double in the next 20 years and the number of years in which people can expect to live in poor health continues to rise.
  • As well as living longer, the “baby boomers" are experiencing increasingly complex health problems such as obesity, diabetes, cancer and long-term degenerative conditions – all of which are on the rise.

Bridging the health and social care gap

  • There is a complex patchwork of health and social care across the country. The need for greater integration between health and social care is a long-debated matter. Real problems are occurring when providers do not communicate effectively. Investment in technology has a key role to play here.
  • To encourage joined up thinking, rather than looking at the performance of individual care providers, the CQC will increasingly focus on the quality of care and the coordination between different providers.

Good leadership and innovation are essential

  • Providers rated as "Outstanding” are marked by their excellent leaders who focus services on the needs of individuals and harness new innovations and technology.

The need for public debate and the shadow of Brexit

  • The future of care needs to be discussed. The £2 billion of central funding for social care announced in the Spring Budget was a welcome but short-term measure. Many NHS trusts are in substantial deficit. We need a long-term plan that provides sustainable quality and finance.
  • The anticipated government green papers on adult social care and child and adolescent mental health could be a much needed catalyst for Parliament, the public and the profession to discuss and implement transformational change.
  • Whilst Brexit dominates the agenda, Parliamentary consideration of these issues has been delayed and there is little appetite or time to discuss the essential but potentially controversial policies required.


The overwhelmingly positive message from “State of Care” is that despite the challenges the care sector is facing, most services have improved since their last inspection. That itself is a testament to leaders within the sector and their staff. But the word of warning is that “staff and leaders can’t work any harder" and that there is an ever-growing need for effective collaboration “to create a sustainable and effective health and care system for the third decade of the 21st century.”

The sector is evolving to meet demands – through efforts to integrate health and social care through accountable care systems and other models, social care market consolidation and investment in health tech. It is the pace of change and how effective these changes are in improving outcomes that will be key.

This article was written by Patrick Parkin and Sam Charkham.

Key contact

Patrick Parkin

Patrick Parkin Partner

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