'Care injustice' means some patients have no access to good quality NHS and social care, watchdog warns

Tory Austerity creating social care 'deserts' and overwhelmed A&Es, Labour says

Black spots for NHS funding and soaring patient demand in England are fuelling "care injustice" where patients cannot access good quality hospital, GP or social care because of where they live, the health regulator has warned.

The Care Quality Commission (CQC) said hardworking staff were responsible for standards being maintained overall, but improvements in some areas are being offset by deterioration elsewhere.

A&E departments are the part of the system most under strain, and 48 per cent have been rated either "Inadequate" or "Requires Improvement" on inspection by the regulator.

This pressure is being driven by "ineffective collaboration" and often "symptomatic of a struggling local health and care system", it concluded in its annual State of Care report.

Labour said that patients are turning up at emergency departments because nearly a decade of underfunding has hamstrung social care, and swamped GP surgeries.

Less than a third (31 per cent) of NHS acute hospital services were rated as requires improvement, compared to 37 per cent in 2017 and often the worst performing hospitals are alongside the struggling social care and GPs​

"It means a struggling acute hospital can be symptomatic of a struggling local health and care system," the report said.

A&E departments in July saw the highest number of A&E attendances ever as a summer heatwave hit, and there is now little difference between summer and winter pressures.

Health service chiefs are trying to address this by investing in out of hospital services which can prevent a serious admission, but the report reveals a gaping hole in the number of nurses working in the community who are vital to making this a success.

"The 44 per cent drop in district nursing numbers highlighted in this report is concerning, as adequate staffing in the community is needed for safe, high quality care, and to help people remain in their own homes where appropriate," said Jennifer Dixon, chief executive of the Health Foundation think-tank.

"More staff are needed across health and social care, and a comprehensive strategy to do this is urgently needed."

Ian Trenholm, chief executive of the CQC, said barriers between NHS and social care groups need to be swept away.

"The alternative is a future in which care injustice will increase and where some people will be failed by the services that are meant to support them, with their health and quality of life suffering as a result," he said.

While £20bn in additional funding for the NHS has been announced, its not clear if any of this will help support social care which is creating many of the health services' woes.

Peter Wyman, chairman of the CQC, said: "It is increasingly clear without a long-term funding settlement for adult social care, the additional funding for the NHS will be spent treating people with complex conditions for whom care in the community would have been more effective both in terms of their health and wellbeing and use of public money."

A Department of Health and Social Care spokeswoman said the government has pledged £420m for this winter to redevelop A&Es and shore up social care so patients can get home quicker.

"It is testament to our hardworking, dedicated NHS and social care staff that the vast majority of patients continue to receive good, safe care and many parts of the NHS have improved since this time last year. We want the NHS to be the safest healthcare system in the world - and this starts by ensuring every single patient in this country receives the highest quality of care, no matter where they live.

"This is backed by our long term plan to guarantee the future of the NHS with an extra £20.5 billion a year by 2023/24."

However Labour's shadow care minister Barbara Keeley said: “No amount of plaster sticking from this Government will plug the deep holes in our health and care services."

“Repeated hammer blows to health and care services from this austerity-obsessed Tory Government has led to unsafe mental health wards, social care "deserts" and emergency departments which have become overwhelmed. Cuts to council budgets, which have seen £7 billion leached away from social care funding, combined with the continued underfunding of front-line mental health services have led to a deluge of unsafe services."