England’s health care services ‘have worrying black spots across the country where patients do not receive fitting care’

Poor community services in certain areas mean hospitals are failing to cope with overwhelming demand – and safety is being put at risk.

Half of the country’s over-stretched emergency departments are failing – with 41 per cent rated as in need of improvement and seven per cent as ‘inadequate.’

Demand for acute services was at an all-time high with a staggering 15.4 million A&E attendances in 2017/18, a rise of nine per cent since 2011/12.

Two years ago, the same State of Care report, compiled annually by the Care Quality Commission, warned that adult social care was near ‘tipping point’.

The 2018 version, released today, admits: “As unmet needs continue to rise, this tipping point has already been reached for some people who are not getting the care they need.”

One of the biggest issues raised is the postcode lottery of care across England.

The report states: “Two things are clear – that people’s experience of care varies depending on where they live and what services they use; and that these experiences are often determined by how well different parts of local systems work together. Some people can easily access good care, while others cannot access the services they need, experience ‘disjointed’ care, or only have access to providers with poor services.

“Our review of local health and care systems found that ineffective collaboration between services affects access to care and support services in the community, which in turn leads to demand for acute services.

“It means a struggling acute hospital can be symptomatic of a struggling local health and care system. This indicates that, although good and outstanding primary care is more evenly distributed across the country, there are geographical areas where people are less likely to get good care.

“Some people may experience geographic disparities particularly acutely – people who use mental health services, for example, who are already more likely to have difficulty accessing support and who may have to travel unreasonable distances to get it.”

In some areas, “people with suspected dementia or an eating disorder had to wait months for specialist assessment,” the report states.

And many children and young people with mental health issues were at ‘crisis point’ before they got the help they need and waiting times for treatment varied significantly.

A worrying 37 per cent of mental health trust core services were rated as requiring improvements on safety and one in four people receiving NHS mental health services did not feel they got services often enough for their needs.

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Overall, general practice appeared to be performing better with 84 per cent of patients claiming their surgery was very good or fairly good.

Only one per cent were rated inadequate and four per cent as in need of improvement.

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