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Social care crisis is crippling A&E leading to record overcrowding

Social care crisis is crippling A&E leading to record overcrowding with vulnerable patients denied help at home, watchdog warns

  • The Care Quality Commission rated half of casualty departments ‘inadequate’
  • Its annual audit of the NHS found most A&E units were overwhelmed by patients 
  • Many patients end up in A&E because they have been denied social care 
  • Vulnerable patients are much more likely to have a fall or contract infections if they are not assisted with meals, taking medication or washing 

Failings in social care are driving unprecedented levels of overcrowding in A&E units, the care watchdog warns today.

Its annual audit of the NHS rated half of casualty departments as ‘inadequate’ or ‘requiring improvement’, with most overwhelmed by record numbers of patients.

According to the Care Quality Commission, many patients end up in A&E because they have been denied social care.

Vulnerable patients are much more likely to have a fall or contract a severe infection if they are not assisted with meals, taking medication or washing.

Failings in social care are driving unprecedented levels of overcrowding in A&E units, the care watchdog warns today. Stock photo

The CQC says many patients are suffering a ‘care injustice’ due to a lack of social care provision.

The watchdog calls for the Government to come up with a funding plan for ailing social care services.


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It warned that without proper investment in social care, the Government’s £20.5billion cash injection for the NHS over four years would be wasted.

The Department of Health is due to publish a Green Paper later this Autumn to outline how social care should be paid for and services improved.

But many healthcare experts are worried the proposals will be pushed back.

Vulnerable patients are much more likely to have a fall or contract a severe infection if they are not assisted with meals, taking medication or washing. Stock photo

The CQC also warns that overcrowding in A&E units is worsened by ‘inadequate GP access’, with patients waiting weeks for a routine appointment.

Elderly patients end up in casualty unintentionally, when a preventable health condition deteriorates, while younger generations go there in the hope of being seen more quickly.

The report is based on inspections of almost 30,000 hospital trusts, care homes and home help services, surgeries and ambulance trusts in England.

One of the CQC’s biggest causes of concern is the performance of A&E units.

The watchdog has rated 41 per cent of England’s 197 casualty departments as ‘requires improvement’ and another 7 per cent as ‘inadequate.’

But in terms of safety, 54 per cent are ‘requires improvement’ and 7 per cent ‘inadequate’, which is nearly two thirds.

HALF OF MATERNITY UNITS ARE ‘FAILING’

Half of maternity units are ‘inadequate’ or ‘require improvement’, the Care Quality Commission’s report said.

Inspectors uncovered ‘dysfunctional’ relationships between midwives and consultants and staff not recognising births were going wrong. 

The ratings for maternity services are far worse than most other hospital departments. 

Overall, 3 per cent were rated ‘inadequate’ for safety and 47 per cent as requiring improvement.

The findings will add to concerns over hospital maternity services, which are overstretched and understaffed. 

CQC officials stressed that the problems would get worse without major improvements to the provision of social care.

The report highlights how more than 15.4million patients showed up in casualty in 2017/18, a 9 per cent rise in 2011/12. Julywas the busiest month on record with nearly 1.4million patients.

The watchdog highlighted four health and social care ‘blackspots’, regions where the provision of residential care and home visits is particularly poor.

This has a knock-on effect on hospitals which are overwhelmed by patients who then cannot be discharged.

The blackspots are Kent, the Isle of Wight, Portsmouth and the Wirral, in Merseyside.

In its annual ‘State of Care’ report, the CQC warns that the problems will only get worse.

Ian Trenholm, CQC chief executive, said: ‘The challenge for Parliament, commissioners and providers is to change the way services are funded and work together, and how and where people are cared for.’

Barbara Keeley MP, Labour’s shadow cabinet minister for mental health and social care, said: ‘No amount of plaster sticking from this Government will plug the deep holes.’

Caroline Abrahams, charity director at Age UK said: ‘The crisis in social care is a national problem that requires a national solution.’

A Department of Health and Social Care spokesman said: ‘It is testament to our staff that the vast majority of patients continue to receive good, safe care.’ 

 

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