Older People Using Services Affected By Fragmentation Across Local Health And Care Systems, Warns CQC

Those working within health and adult social care services are passionate about providing the best possible experience to the older people within their care.

However, their efforts can be compromised by the competing priorities, performance measures and accountabilities of their employing organisations. Collectively, this can limit choice and can make movement between services seem confusing and fragmented.

This is one the key themes we have found, having completed a third of our Government-commissioned reviews that explore how well local systems work together to support and care for people aged over 65.

Following the Government’s additional investment of £2bn for local authorities to spend on adult social care as part of the Spring Budget announcement, the Secretaries of State for Health and for Communities and Local Government asked us to review how those aged over 65 access and move between health and care services in targeted local authority areas.

We have published our first six local system reviews already covering the following areas: Halton, Bracknell Forest, Stoke-on-Trent, Hartlepool, Manchester and Trafford.

Today (Tuesday 19 December) and based only on these six reviews, we have summarised our emerging findings in an interim report. Our Board of executive and non-executive directors will discuss this in the public session of their meeting later this morning.

Prof Steve Field, chief inspector of general practice and integrated care, who is the executive lead for this work, said: “From the six local systems we have reviewed in our report, we appreciate that many leaders are embracing and steering programmes of complex transformation already that are focused on improving integration and personalisation. Also, we have found staff who are passionately committed to providing the best possible experience of older people within their care.

“However, despite these good intentions, the ‘whole system approach’ that focuses on integrated and person-centred care is not being realised as best as it could. We have identified three themes that could act as a barrier to integration: how providers and commissioners work together; capacity, market supply and workforce issues; and, the need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing.

“In too many instances, this means that older people find the experience of moving between health and social care services confusing. Too often, care is fragmented, choice is limited and people are uncertain about who is coordinating their care needs. Many people are worrying about what support will be in place when they return home from hospital, or who will be there to give their carer a break from looking after them full-time.

“In response, we encourage all system partners to have a clearly communicated health and social care offer that responds to people’s local needs; to provide a stronger focus on wellbeing initiatives that can help people to stay out of hospital; and to address variation that can inhibit people’s access and choice.

“These are our interim findings and suggestions for improvement at this stage. We will report to the Secretaries of States for Health and Communities & Local Government again in the summer once we have completed all 20 reviews.”

Once we have completed the 20 reviews from across the country, we will publish a national report for the Secretaries of State for Health and for Communities and Local Government in the summer.









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