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Found 125 results
  1. Content Article
    The Health Foundation has published new analysis estimating the funding needed for social care in England over the next 10 years. They have analysed the latest data on social care spending, which compares public spending levels over time and analyses if current spending is enough to meet pressures on the system. The analysis estimates that an extra £3.4bn would be needed in 2028/29 to prevent further deterioration of services - rising to £9.1bn in 2034/35. To go further and improve people’s access to care and boost care workers’ pay, we estimate an additional £8.7bn would be needed in 2028/29, rising to £15.4bn in 2034/35.  
  2. Content Article
    In February the HSCIT hosted a webinar for adult social care services about what we can all do to keep antibiotics working. The webinar aimed to raise awareness of antimicrobial resistance and antimicrobial stewardship across adult social care and to explore what they mean in practice. The webinar featured presentations from two antimicrobial stewardship nurses and a principal educator from NHS Education for Scotland, as well as a question and answer session.
  3. Content Article
    Dementia is caused by different diseases, including Alzheimer’s disease and vascular dementia, which affect memory, thinking and the ability to perform daily tasks. The number of people being diagnosed with dementia is increasing. In February 2025, nearly half a million people in England had a dementia diagnosis. The likelihood of developing dementia, becoming an informal carer or both in a lifetime in the UK is 55% (around 1 in 2). This Care Quality Commission (CQC) report looked at people's experiences of living with dementia when using health and adult social care services, including the experiences of families and carers. It sets out the main themes that influence whether an experience is good or poor, and what health and care services are doing to improve these experiences. CQC will use the findings in this report to help shape their work to define what good care looks like for people with dementia and inform the next phase of CQC’s Dementia Strategy. The CQC Dementia Strategy has 6 core objectives: CQC will co-produce evidence-based statutory guidance for what good dementia care looks like and link to good practice guidance under our assessment framework. CQC will apply the statutory guidance across their regulatory activity. CQC will use their independent voice to tackle inequalities and encourage improvement and innovation. The CQC will be a dementia-friendly and inclusive organisation to benefit our staff and the wider public. CQC staff will receive comprehensive dementia training and work with partners to influence training and competency for the health and social care workforce. CQC will actively work in partnership with key stakeholders to collectively affect real change. Work will be focused on the following areas: Developing statutory guidance and defining good practice CQC will work towards achieving objective 1 to develop statutory guidance. CQC will: involve people with lived experience, carers and a wide range of other stakeholders in co-production, ensuring the guidance is led by the voice and experiences of people who use services carry out research into the characteristics of effective dementia care, including learning from other countries and regulators, as well as further information gathering to develop a robust evidence base on which to build the statutory guidance principles. Learning and development needs of CQC’s workforce To ensure they are effective in our regulation of services for people with dementia, CQC will ensure that they understand and respond to the learning needs of their own staff in this area. This includes carrying out a learning needs analysis, defining learning objectives and developing training and guidance for CQC staff aligned to the statutory guidance we publish. Engagement and communication CQC will apply a wide range of tools and approaches to involve people, carers, key stakeholders and CQC staff in the development of this work. They will continue to work collaboratively with other key stakeholders and policymakers on joint improvement ambitions and actions that enable good dementia care, in areas like workforce, system pathways and technology. They will share updates on our work with the public, providers and other partners and share future opportunities to get involved.
  4. Content Article
    Adult social care is in desperate need of reform. Done well, social care has the power to positively transform people’s lives. Yet too many people aren’t getting the care they need, care workers are undervalued and far too much pressure is placed on unpaid carers. The cost of this vital public service continues to increase, with £32 billion spent on adult social care in 2023/24, and an unsustainable pressure is falling on local authorities. Without reform we will all keep paying a high price for a failing system. This Health and Social Care Committee report does not aim to document fully the current state of this failing system though the evidence does expose aspects of this, nor does it suggest how to fix it. Instead, it aims to shift the dial when it comes to reform by reframing the narrative around the cost of action to one that interrogates the cost of the status-quo or ‘inaction’. Some of the unaccounted-for costs of inaction include: 2 million people aged 65+ and 1.5 million people of working-age are not getting the care they need, leading to lives led at the bare minimum rather than to their fullest. Individuals face unknowable, and potentially life-changing, charges for care, including 1 in 7 older people with care costs over £100,000. The care individuals do receive can be inadequate, or neither the right care nor in the right place, leaving people unable to work or take part in other meaningful activities and risking the worsening of existing conditions. 1.5 million unpaid carers are providing over 50 hours of care per week to loved ones, and many of these withdraw partially or wholly from employment as a result, and who themselves suffer adverse outcomes as a consequence of putting the needs of their loved ones before their own. Due to the current funding model, local authorities’ budgets are buckling under the pressure of adult social care, with more councils seeking emergency funding and increasing proportions of budgets being spent on adult social care to the detriment of other services, leading to the perception of a democratic deficit in local government with people paying more and more for fewer and fewer services. The care provider market is in distress, struggling to cover existing costs via fees and facing underfunded increases in the National Living Wage and National Insurance. Care workers continue to be underpaid, driving high turnover and vacancy rates, and are twice as likely to be claiming benefits; The NHS struggles to divert admissions from the community and to discharge medically fit patients, causing knock-on costs of at least £1.89 billion, putting at risk the mission to build an NHS fit for the future. The economy is missing out on the sector’s potential to drive growth and regional rebalancing, as well as on tax receipts from unpaid carers and people in receipt of care, who are unable to work as much as they would like.
  5. Content Article
    This King's Fund article sets out how prioritising non-clinical support for people who frequently attend A&E can contribute to the government’s ambition to deliver three major shifts in health and care.
  6. Content Article
    More information about "Care co-ordination for people with long-term conditions: Patient Safety Learning’s response to HSSIB investigation"
    On the 10 April 2025, the Health Services Safety Investigations Body (HSSIB) published a report looking at how care is co-ordinated for people with long-term conditions. In particular, the investigation considered the role of ‘care co-ordinator’ to understand how care is co-ordinated within the existing workforce. In this blog, Patient Safety Learning sets out its reflections on the findings and recommendations in this report. HSSIB investigates patient safety concerns across the NHS in England and in independent healthcare settings where safety learning could also help to improve NHS care. Their latest report looks at primary and community care co-ordination for people with long-term conditions, specifically considering the role of ‘care coordinator’ in this context.[1] While language around the care coordination is varied, the role of care co-ordinated is defined by NHS England as follows: “Care co-ordinators help to co-ordinate and navigate care across the health and care system, helping people make the right connections, with the right teams at the right time. They can support people to become more active in their own health and care and are skilled in assessing people’s changing needs. Care co-ordinators are effective in bringing together multidisciplinary teams to support people’s complex health and care needs.”[2] In this blog we set out our reflections on the findings and recommendations in this HSSIB investigation. Challenges navigating the healthcare system Navigating the healthcare system in the UK can be complex and frustrating for patients, families and carers. At Patient Safety Learning we hear time and time again about the lack of joined up care and communication within and across organisations. Failing to share the right information at the right time can create significant patient safety risks. Poor communications, both with patients and between healthcare professionals, can result in misunderstandings and mistakes resulting in poor outcomes and potentially patient harm. In a recent series of blogs published on the hub, patients and their relatives shared with us the challenges and barriers they have faced when trying to navigate the healthcare system.[3] The concerns and issues raised in this HSSIB investigation echo many of the key themes we identified in our new blog series. Confusing communications HSSIB’s report refers to the case of a child prescribed anti-epileptic medication by a specialist hospital to reduce the number and severity of their seizures. It then details the difficulties the parents subsequently found in getting this medication through their GP or consultant. The parents highlighted concerns about the lack of communication between the separate services, with the report noting: “The parents told the investigation that they were ‘exhausted’ because of the effort they had had to put in over the years to connect services together, having to tell the same story over and over again, while having to provide care for their child.” Delays to treatment The investigation report also highlights the case of a middle-aged professional working man who suffered a stroke. He received hospital care to treat and manage his healthcare needs; however, once discharged he encountered significant difficulties when seeking appropriate support for his additional healthcare needs. HSSIB highlighted how he had told them it required significant effort from him directly to ensure the right level of care was maintained for his needs. Recounting his experience, the report states: “He said that these multiple agencies ‘all operate in their own silos’ and not as a team, and that ‘there was nobody to create that team [a cross-system team aware of all his health and care concerns]’. The way that he and his wife cope with this situation is that they ‘manage the team’ to connect the individual parts of the system and get the care he needs.” Impact on mental health HSSIB also spoke to a man in his late seventies who is the main carer for his wife. She has multiple long-term conditions that require primary, secondary and community care. Reflecting on the impact that coordinating her care had on their lives, the report noted: “The husband explained that his role of care co-ordinator had placed a considerable burden on him, which led him to ‘feel overwhelmed’. He said that because he needing to act as her ‘co-ordinator’ he was unable to spend time with his wife as her husband. He also described having to administer medication and dress his wife’s wound which caused her considerable pain.” HSSIB’s investigation also highlights broader areas of concern relating to the coordination of care in the healthcare system, again mirroring themes raised we heard from patients in our recent blog series. Difficulties sharing information The investigation highlights a recurring concern around problems sharing patient information and the negative impact of this on coordinating a patient’s care. It highlights both issues of digital systems in different organisations not being compatible with one another and other barriers, stating: “Healthcare professionals described the challenges in information sharing. Digital patient records could not be viewed across primary, community, secondary and tertiary care because information technology systems are unable to ‘talk to each other’. They also said that sometimes they were unsure whether patient information could be shared as it was ‘protected information’. This was a particular problem when trying to share information between health and social care.” A complex and confusing system The report also reflects more broadly on how accessing and navigating health and care services can be difficult and complex, and potentially overwhelming for patients. This was highlighted by examples such as this from the investigation: “A GP practice told the investigation that it had tried to put together an easy-to-read document explaining the care pathway for patients with dementia, including contact numbers and ways to access services. The GP practice went on to say that the system was so complex that it was unable to bring together all the information. It stated: ‘We are healthcare professionals and we can’t do this, so how can patients cope?’” Safety recommendations A theme that runs throughout HSSIB’s investigation is that there is a clear need and support for the role of care co-ordination. It highlights that while patients and carers can, and often do, themselves act in this role, when they are unwell or unable to do so a patient’s care can be significantly impacted. The report states that the availability of care co-ordination varies widely across the system. This is a particular issue for those living with multiple long-term conditions as there is no single centralised care co-ordination function to span across primary, secondary and tertiary care. Concluding its investigation, HSSIB recommends that: NHS England/Department of Health and Social Care, working with other relevant organisations, reviews and evaluates the implementation of the care co-ordinator role. This is to ensure that all patients with long-term conditions have their care co-ordinated and that they have a single point of contact 24 hours a day, 7 days a week, to help them with any queries or concerns that they may have. The Department of Health and Social Care works with NHS England and other stakeholders to develop a strategy that ensures that all diseases are given parity and that all people with a long-term condition in primary, secondary, tertiary and community or social care have their care effectively co-ordinated across multiple agencies. This is to ensure that people with long-term health conditions have co-ordinated care plans with effective communication between services and a single point of contact for concerns or questions. Patient Safety Learning agrees that there needs to be greater time and investment into care coordination. On the first recommendation, we would note that seeking to ensure all patients with long-term conditions have a single point of contact 24 hours of day, 7 days a week, would be a significant shift from the status quo. This would require a clear commitment of both financial and workforce resources from NHS England and the Department of Health and Social Care to deliver. In considering how this might be approached, it would also be important to consider: How this can be flexible depending on the long-term condition in question. Different conditions will require different levels and types of coordination. Systemic barriers that result in many of the difficulties navigating the care system would not be addressed by implementing this recommendation. For example: – We would continue to have various digital systems in primary, secondary and tertiary care that lack interoperability (the ability of computer systems or software to exchange and make use of information). – Non-digital communication barriers that prevent cross-organisational sharing of information in the NHS, ranging from data sharing restrictions to cultural attitudes within organisations, would also remain. On the second recommendation we agree with the principle of this, that there needs to be parity for people with a long-term condition and an expectation that their care is effectively co-ordinated across multiple agencies. Poorly coordinated care is not only confusing and frustrating for patients but also creates safety risks that can result in serious avoidable harm. Concluding comments The challenges of navigating the healthcare system discussed in this report are not a new issue, but a long-standing set of problems that do not have a simple solution. Their impact on patient experiences and outcomes is exacerbated in the current environment, when our healthcare system that is under increasing pressure and in a “critical condition”.[4] Patient Safety Learning believes that care co-ordination should form an important area of focus for the UK Government’s forthcoming 10 Year Health Plan. If it is to achieve its strategic ‘shift’ of moving the future of the NHS from "hospital to community" this will require a healthcare system where patients aren’t simply left to "join the dots for patient safety".[5] This will require organisational and leadership commitment to take forward the issues raised in this HSSIB investigation. The needs of patients should be central to improving health and care services, actively listening and acting on their experiences and insights when things go wrong for safety improvement. References HSSIB. Workforce and patient safety: primary and community care co-ordination for people with long-term conditions, 10 April 2025. NHS England. Care co-ordinators, Last accessed 10 April 2025. Patient Safety Learning. The challenges of navigating the healthcare system, 24 February 2025. UK Parliament. NHS: Independent Investigation, Hansard, Volume 753, 12 September 2024. Department of Health and Social Care, Independent report: Review into the operational effectiveness of the Care Quality Commission, 15 October 2024. Related reading Digital-only prescription requests: An elderly woman sent round the houses How the Patients Association helpline can help you navigate your care Lost in the system? NHS referrals Navigating the healthcare system as a university student: My personal experience The challenges of navigating the healthcare system: David's story The challenges of navigating the healthcare system: Sue's story Share your story What has been your experience of navigating the healthcare system? What is and isn’t working? How does it feel as a patient or carer when you hit barriers? Has your health been affected? Share your story in our community forum or contact our editorial team at [email protected].
  7. Content Article
    People who have a long-term condition may be in contact with multiple health and care organisations and may experience harm if their care is not co-ordinated. This investigation focuses on people with long-term conditions and how their care is co-ordinated, specifically considering the role of ‘care co-ordinator’. It is intended for healthcare organisations, policymakers and the public to help improve patient safety in relation to co-ordinating care for people with long-term or complex healthcare needs.  Findings The NHS has produced a definition of the professional role of NHS care co-ordinator. However, there is variation in how this role is implemented. Other national organisations have different definitions of care co-ordination and care navigation, which can create ambiguity for people overseeing these roles. There is not a single person/role/organisation responsible for co-ordinating care for people with long-term or complex health and care needs across multiple health and care organisations. The health and care system frequently fails to support care co-ordination across multiple care pathways and instead focuses on individual diseases or issues. This can leave people who have complex long-term conditions with uncoordinated care. Accessing and navigating health and care services can be difficult and complex, and patients and carers would like improved service integration and care co-ordination. Patients and carers act as a central point for information and contact for providers, but when they are unwell or unable to do this, care can be impacted. People who are unable to navigate the health and care system can experience deterioration of health, miss appointments or their care may become delayed or forgotten about, meaning they may need more intense treatment in the future or longer stays in hospital. Patients and carers have to retell their health history to different health and care providers. They believe the system is not joined up and that information does not flow across health and care organisations, or that different parts of the system cannot access information from other providers. When patients are discharged from a health or care setting out of normal working hours they do not always know who they can speak to about any concerns or their ongoing care. Different methods of sharing health and care information can create an information gap, particularly out of hours and at the weekend, resulting in a situation where not all health and care staff have the appropriate information to make decisions. Patients and carers can feel exhausted, burnt out, frustrated, angry and guilty, among other emotions. Patients and carers physical and mental health may deteriorate because of the extra burden of navigating the health and care system. Patients and carers may disengage with the health and care system because they are exhausted and frustrated. This may lead to poor outcomes for both patients and carers. There are different ways of supporting care co-ordination across the system, some of which are assisted by the charity sector. Safety recommendations HSSIB recommends that NHS England/Department of Health and Social Care, working with other relevant organisations, reviews and evaluates the implementation of the care co-ordinator role. This is to ensure that all patients with long-term conditions have their care co-ordinated and that they have a single point of contact 24 hours a day, 7 days a week, to help them with any queries or concerns that they may have. HSSIB recommends that the Department of Health and Social Care works with NHS England and other stakeholders, to develop a strategy that ensures that all diseases are given parity and that all people with a long-term condition in primary, secondary, tertiary and community or social care have their care effectively co-ordinated across multiple agencies. This is to ensure that people with long-term health conditions have co-ordinated care plans with effective communication between services and a single point of contact for concerns or questions. Safety observation Health and care organisations can improve patient safety by allocating a point of contact for patients and/or their carers when people are discharged from services out of normal working hours. This will ensure patients and their carers are able to escalate any concerns relating to their ongoing care and drive improvements in care co-ordination. Related reading on the hub: Read Patient's Safety Learning's response to the findings and recommendations of this HSSIB report
  8. Content Article
    The Nuffield Trust and The King’s Fund join forces each year to analyse and present findings from the gold-standard survey of public attitudes and opinions towards the NHS and social care, as surveyed by NatCen. The 2024 survey results show that the British public are deeply unhappy with the way the NHS runs – just 1 in 5 people said they were satisfied. Key findings Satisfaction with the NHS In 2024, just one in five British adults (21%) were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs. This is the lowest level of satisfaction recorded since the survey began in 1983 and shows a steep decline of 39 percentage points since 2019. Only 2% of respondents were ‘very’ satisfied with the NHS, down from 4% in 2023. The percentage of people who were ‘very’ or ‘quite’ dissatisfied with the NHS rose to 59% in 2024, from 52% in 2023. This represents a statistically significant 7-percentage-point increase from the year before, which already had the highest dissatisfaction seen in 40 years of the British Social Attitudes survey. A higher proportion of people in Wales (72%) were dissatisfied with the NHS compared to the survey average and compared to people in England (59%). Supporters of the Reform party were less likely to be satisfied (13%) than the survey average and this was significant after controlling for other variables like age and income. There is a divide between generations, with satisfaction lower and falling in younger age groups. While the proportion of people who were satisfied rose slightly for those aged 65 and over, from 25% to 27%, among those under 65 it fell significantly, from 24% to 19%. Satisfaction with social care In 2024, only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care (the same figure as 2023). 53% of respondents were ‘very’ or ‘quite’ dissatisfied. Respondents in Wales (69%) were again significantly more likely to be dissatisfied than the survey average. Satisfaction with different NHS services Public satisfaction with A&E services has fallen sharply, from 31% to just 19%, and dissatisfaction has risen from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with lowest satisfaction levels for the first time. Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any specific NHS service asked about. Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023. Inpatient and outpatient hospital care is the part of the NHS with the highest levels of satisfaction, with 32% saying they were satisfied and only 28% dissatisfied. Attitudes to standards of care, staffing and efficiency The majority of the public (51%) said they were satisfied with the quality of NHS care. People aged 65 and over were more likely to be satisfied (68%) with the quality of NHS care than those under 65 (47%). Dissatisfaction with waiting times and the ability to get an appointment is widespread, and is consistent across respondents from all ages and UK countries: 62% of all respondents were dissatisfied with the time it takes to get a GP appointment. 23% were satisfied. 65% of respondents said they were dissatisfied with the length of time it takes to get hospital care. 14% said they were satisfied. Dissatisfaction levels are highest regarding the length of time it takes to be seen in A&E. 69% of respondents said they were dissatisfied, while just 12% said they were satisfied. Only 11% agreed that ‘there are enough staff in the NHS these days’. 72% disagreed. NHS funding, principles and priorities 8% of respondents said that the government spent too much or far too much money on the NHS; 21% said that it spent about the right amount, and 69% said that it spent too little or far too little. When asked about government choices on tax and spending on the NHS, the public would narrowly choose increasing taxes and raising NHS spend (46%) over keeping them the same (41%). Only 8% would prefer tax reductions and lower NHS spending. Only 14% of respondents agreed that ‘the NHS spends the money it has efficiently’. 51% disagreed with this statement. Respondents felt the most important priorities for the NHS should be making it easier to get a GP appointment (51%) and improving A&E waiting times (49%), with increases in staff (48%) and better hospital waiting times close behind (also 48%). A&E has now slightly overtaken staffing as a priority, reflecting the sharp fall in satisfaction described above. People under 65 were more likely to prioritise improving mental health services (34%) than those aged 65 and over (21%). As in previous years, a strong majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2024: that the NHS should be free of charge when you need to use it (90%); the NHS should primarily be funded through taxes (80%); and the NHS should be available to everyone (77%). The percentage of people saying that the NHS should ‘definitely’ be available to everyone decreased from 67% in 2023 to 56% in 2024. This is the only statistically significant change year-on-year across all three principles. Supporters of the Reform party (20%) were significantly less likely to say that the NHS should ‘definitely’ be available to everyone than the survey average.
  9. Content Article
    Patient safety, patient and family experience, and staff wellbeing are the joint responsibility of anyone working within health and social care. An understanding of how Humans Factors and Ergonomics can improve our interactions with systems and processes can often lead to improved patient and staff outcomes. If you are responsible for implementing Human Factors and Ergonomics programmes within a health and social care setting – or if you just want to understand more about how the principles of human factors might apply to your role – this practical introduction will help you navigate your way around Human Factors and Ergonomics approaches within the healthcare setting. Key features include: Aligned to the Chartered Institute of Ergonomics and Human Factors professional competencies, this book shows how these can be framed within real-life practice. Packed with case studies and helpful tips you can use in your day-to-day practice. Clear structure showing the different levels of a system with specific chapters on organisation, people, equipment and environment. Fully illustrated to facilitate your learning.
  10. Content Article
    This report is one in a series examining the underlying causes of care home failures, and aims to present proactive strategies to ensure long-term sustainability. This report explores how clinical and financial key performance indicators (KPIs) can serve as critical early warning signs, helping providers identify emerging risks before they escalate. It argues that by closely monitoring trends such as infection rates, occupancy levels, and financial performance, care home leaders can intervene swiftly to prevent small challenges from becoming systemic failures.
  11. Content Article
    The number of people living with dementia in the UK is rising. Even if treatments can be developed quickly, the social care system needs to change in order to better support the growing numbers of people affected. This report by the Nuffield Trust sets out what the current challenges are with providing good social care for people with dementia, and makes recommendations about what needs to change to improve social care for people with dementia.
  12. Content Article
    Rosy is unable to move, breathe or eat unassisted. Yet NHS assessors think it’s fine to leave her alone for hours at a time. At just 53, motor neurone disease means Rosy is losing her body piece by piece. Too weak to breathe easily, she is reliant on a ventilator at night. In the two-bedroom house Rosy shares with her teenage daughter and cat, she is living out of her front room: a hospital-style bed and commode squashed in next to the television. You don’t have to be a doctor to recognise that Rosy urgently needs 24/7 specialist home care. Instead, a hospice she had used suggested she apply for continuing healthcare (CHC) – the NHS-funded service that provides care workers for people with “primary health needs” outside hospital – and wait for however long it took for swamped assessors to get to her application. In the meantime, the local council had given her a couple of hours of social care a day: a slot with a well-meaning but untrained agency worker to help her get up and another to get to bed. Without a carer overnight, Rosy can’t use her ventilator; if she were to choke from the secretions in her lungs, she wouldn’t be able to get the vent mask off herself. On the nights she struggled to breathe, she was forced to stay awake and hold the mask to her face in the dark. The NHS’s solution? Rosy said one assessor suggested her 14-year-old daughter fill in as a child carer, including being on call for the ventilator throughout the night. In recent weeks, the government has launched NHS reforms and a social care consultation to considerable fanfare. There has been no mention of CHC, or the tens of thousands of people like Rosy who rely on it.
  13. Content Article
    Adult social care covers a large range of services given to the frail and disabled, from home visits to end-of-life care. The sector employs 1.6 million people in England (about the same as the NHS). There are many concerns about the sector: staff shortages, low pay, rising costs, poor conditions, patchy quality etc. But with a rapidly ageing society, the main area of worry is old-age care, and how to pay for it. The NHS Confederation estimated that in 2019/20 alone, 855,000 emergency admissions to hospital of older people could have been avoided with the right care at the right time. And as of September 2024, 13% of NHS hospital beds were occupied by people waiting for social care.
  14. Content Article
    The Care Inspectorate supports quality improvement (QI) across social care, social work, local health and social care partnerships and early learning and childcare. Their Quality Improvement and Involvement three year strategy 2022- 2025 focusses on the four pillars of quality improvement and involvement support from this strategy. The process for accessing quality improvement can be found here: the identification, pathways and levels of quality improvement support. In 2025/26 the Care Inspectorate will work with assurance and improvement colleagues to further strengthen and align this process to ensure QI work is prioritised in the right areas at the right time. The four pillars of quality improvement and involvement:
  15. Content Article
    Right Care, Right Person (RCRP) is an approach that is aimed at ensuring that people of all ages who have health and/or social care needs, are responded to by the right person, with the right skills, training, and experience to best meet their needs. Home Office and Department of Health and Social Care (DHSC) analysts evaluated the implementation of RCRP through a rapid process evaluation covering police, fire, health and social care services. The findings highlighted the importance of communication, openness and transparency across agencies when implementing RCRP. While generally supportive of RCRP principles, participants highlighted some implementation challenges, such as capacity limitations for health and social care services. Early data monitoring showed a reduction of police time spent on health-related incidents post RCRP implementation. Recommendations to support the implementation of RCRP are included.
  16. Content Article
    The Public Services Ombudsman for Wales has powers under the Public Services Ombudsman (Wales) Act 2019 to undertake ‘Own Initiative’ investigations, where evidence suggests that there may be systemic service failure or maladministration. Four local authorities were included in the investigation: Caerphilly County Borough Council, Ceredigion County Council, Flintshire County Council and Neath Port Talbot Council. The investigation considered: Whether the local authorities being investigated were meeting their statutory duties under the Social Services and Well-being (Wales) Act 2014 and its Code of Practice and The Care and Support (Assessment) (Wales) Regulations 2015. Whether those entitled to a carer’s needs assessment were being made aware and understand their right to request a carer’s needs assessment. Where carers’ needs assessments are commissioned, whether those assessment services are being delivered appropriately and whether local authorities appropriately monitor the contracting arrangements. Whether carers’ needs assessments, including those completed by commissioned service providers, are undertaken in accordance with the Social Services and Well being (Wales) Act 2014. The investigation considered evidence provided by each of the Investigated Authorities, in the form of documentary evidence and evidence from staff, evidence from commissioned service providers and their staff, evidence from those with lived experience of having their needs as carers assessed and evidence from other organisations. Advice was also sought from one of the Ombudsman’s professional advisers The investigation found: Between 10% and 12% of the population (over 5 years old) in the Investigated Authorities identified as a carer in the 2021 Census. Only 2.8% of the carer population in the Investigated Authorities had their needs assessed. Only 1.5% of the carer population in the Investigated Authorities had an assessment that led to a support plan. Many carers are not aware of their rights and are unaware of the support that may be available to them. There was evidence of carers not being fully informed of their rights by the Investigated Authorities. In some instances, carers were signposted to commissioned service providers without being informed of their rights. Carers’ needs assessments are referred to by different names, which caused confusion amongst carers and carers were sometimes unaware that their needs had been assessed. There needs to be consistency in the language used. There is lack of clear information about the process of assessment, the role of commissioned service providers (where applicable), what carers may expect from the assessment and how carers may be supported following an assessment. This would enable carers to make an informed decision about whether to have their needs assessed. Where they are undertaken, carers’ needs assessments at the Investigated Authorities are generally being completed appropriately, with the exception of young carers’ needs assessments in Ceredigion and Neath Port Talbot. Some improvements could be made to the recording of carers’ needs assessments, including the involvement of the cared for person (where feasible), the extent the carer is able and willing to provide care and the carer’s wishes in terms of work, education, training and leisure. There is a need to implement quality assurance audit processes for completed carers’ needs assessments in Caerphilly, Ceredigion and Neath Port Talbot council areas. There are discrepancies between the Investigated Authorities in the way that support provided to carers is recorded. Improved, consistent and comparable data collection could enable better analysis to drive improvement, monitor progress and identify areas in which further improvements are necessary. Carers must be offered advocacy – the decision on whether an advocate is needed is not one for the staff completing assessments to make, nor is it appropriate for the staff member to consider themself to be the advocate. The appropriateness of Direct Payments for carers is variable and 3 of the Investigated Authorities need to ensure that Direct Payments are something the carer is able to manage, with this being reviewed if circumstances change. The SSWB Act places a duty on both local authorities and health services in respect of carers. Collaboration and joint working between health services and local authorities in relation to carers and their rights is essential and should be strengthened. The recording of equality data relating to carers is limited and inconsistent at the Investigated Authorities.
  17. Content Article
    A King's Fund long read reflecting on the UK's Autumn Budget. Headline announcements Real-terms increase in core local government spending power of around 3.2%, including £600 million of new grant funding to support social care (for both adults and children’s services) and a £86 million increase to the Disabled Facilities Grant. Total health spending increases by 3.8% a year on average in real terms between 2023/24 and 2025/26. This includes a 3.4% increase to day-to-day (resource) spending on items like staff salaries and medicines, and a 10.9% increase in capital investment on items like buildings and equipment over this period. Disincentivising activities that cause ill health by renewing and increasing duties on tobacco-related products and the Soft Drinks Levy. Increases to the National Living Wage and National Insurance Employer Contribution costs, which will particularly affect non-public sector employers.
  18. Content Article
    The 'State of Care' is the Care Quality Commission (CQC) annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. Areas of specific concern The 2023/24 report highlights some areas of specific concern. The concerns involve issues around safety, quality, workforce, and inequalities, including: Too many women are still not receiving the high-quality maternity care they deserve. Of the 131 locations we inspected in our national maternity inspection programme, almost half were rated as either requires improvement (36%) or inadequate (12%). We have concerns that children and young people are not always able to access services in a timely way – both planned and in an emergency. Anecdotal evidence suggests that parents and carers are well placed to recognise when their child is very unwell, but many feel they are not being listened to. The number of health visitors, who give individual support for young children and their parents, has declined by 45% over the last 9 years. Only around a quarter of people with a learning disability were recorded on the learning disability register, which means that many people are missing out on the proactive care and treatment they are entitled to. Despite fewer new referrals for autism diagnoses over 2023/24, the average waiting time to start an assessment reached a peak of nearly a year (328 days) in April 2024, rather than the recommended 3 months. People in Black or Black British ethnic groups are over 3 and a half times more likely to be detained under the Mental Health Act than people in white ethnic groups. Work on our cross-sector dementia strategy is highlighting the compassionate care and initiatives that are improving people’s lives, but staff do not always understand the specific needs of people with dementia.
  19. Content Article
    This analysis from Age UK finds that 2 million older people in England are now living with some unmet need for social care. Drawing on the latest available data, the report concludes that England’s health and care services continue to be under enormous pressure so that, despite the best efforts of many dedicated staff, they are currently unable to meet the needs of all the older people presenting who require treatment, care and support.
  20. Content Article
    This review by the UCL Institute of Health Equity (IHE) concludes that racism damages health and wellbeing and drives inequalities in London.  Racism in the capital is widespread and persistent causing damage to individuals, communities and society as a whole. Its impacts are experienced in different ways and to varying levels of intensity related to individual experiences, socioeconomic position and other dimensions of exclusion such as disability, age and gender. The intersections with other dimensions of exclusion can amplify the effects of racism. The focus of this review is on the effects of racism on health and its contribution to avoidable inequalities in health between ethnic groups – a particularly unacceptable form of health inequity. It is urgent that society tackle the damage to health and wellbeing as a result of racism. The review is part of a series of evidence reviews funded by the Greater London Authority (GLA) to build the evidence for reducing health inequalities in London through action on specific social determinants of health. The other three reviews cover housing, the cost of living and adult skills.
  21. Content Article
    This service model brings together the good practice taking place in local areas, and that  which has previously been described for this group of people. It recognises that improvements  are typically underpinned by visionary leadership, a focus on human rights based approaches,  workforce development, co-production and a preparedness to reflect and learn. It aims to support  commissioners across health and social care to work together to commission the range of services  and support required to meet the needs of this diverse group.
  22. Content Article
    This framework sets out what good digital working looks like for care providers and local authorities with responsibility for adult social care in England.
  23. Content Article
    As the NHS is approaching its 75th birthday, this report from the Tony Blair Institute for Global Change proposes how the NHS needs to transform if it is to survive. The paper propose six areas for reform where radical-but-practical policy action will begin to transform the future of the NHS and deliver better patient care: 1. Put patients in control of their own health: First, the government must provide every person with a digital Personal Health Account (PHA) that offers a simple, single digital front door to the NHS and wider health-care services. It will become the portal through which people interact with the NHS, allowing patients to have direct access to services, including general practitioner (GP) appointments, at-home diagnostic services and even opportunities to participate in clinical trials. Most importantly, it will give people direct access to and ownership of their health data, including information provided by third-party providers or wearable technologies. 2. Create new access routes for services and providers: The range and availability of health-care services must increase to reflect citizens’ demands and their increasingly complex needs. Pharmacies, gyms, supermarkets, workplaces and other spaces should all be able to provide or facilitate the provision of health care, bringing services closer to patients and reducing demands on general practice. Most importantly, the PHA will create a new marketplace for services. This should focus on high-volume, low-complexity services – for instance dermatology – to make them directly available to patients. Introducing multiple providers, including third parties, will offer patients greater choice through the ability to balance outcomes, waiting times and costs. 3. Harness the power of genomics and other “omics” platforms to personalise care: The NHS Genomic Medicine Service should be made accessible to more patients for a greater range of conditions to improve early diagnosis, prevention and treatment. Specifically, universal clinical whole-genome sequencing should be offered to all patients upon disease diagnosis, all newborns and all healthy populations with known risk factors, including a family history of disease. As science progresses, other omics disciplines such as proteomics and metabolomics, should be integrated into routine clinical care, to improve the prevention, management and treatment of disease. 4. Create a locally led and self-improving system: There must be a new deal for accountability and autonomy between Whitehall and the Integrated Care Systems (ICSs). This must allow local leaders to operate with much greater freedom and hold them to account for delivering a set of clear and transparent outcomes focused on creating and improving health, rather than simply treating sickness and delivering against activity targets. ICSs should also be given multi-year budgets that are adjusted for the needs of their local population. And they should be allowed to keep and redeploy savings from innovating and improving care. Finally, quality and care outcomes should be made transparent and available to patients to empower them to make an informed choice between GPs and secondary care providers within an ICS. 5. Invest in new and more efficient infrastructure to deliver better care: NHS productivity and efficiency must be transformed through investment in basic technology as well as increasingly powerful AI, and by enhancing existing infrastructure. This will require upfront investment but will be offset, at least in part, through increased automation of processes and by finally tackling wastage across the system. The future operating model we are setting out in this paper will be much more capital intense, much more efficient and much less reliant on labour. 6. Energise and modernise the NHS workforce: The new NHS Long Term Workforce Plan is welcome and will provide much-needed investment to help create a pipeline of future talent, increase long-term capacity and provide new training routes to increase workforce diversity across the NHS. However, the NHS is facing an immediate workforce crisis with concerns over staffing pressures and pay that must be resolved. In addition, putting more staff into an outdated and unproductive delivery model is not sustainable and much greater focus is needed on harnessing the potential for technology to improve the efficiency of services, help to reduce the demands on frontline services and improve outcomes for patients. In addition, a comparable commitment and long-term plan is needed for social care and public health to create fully supported health and care services.
  24. Content Article
    Report, together with formal minutes relating to the report. Three years after the start of the COVID-19 pandemic, the Department of Health and Social Care (the Department) has spent £14.9 billion of public money overpaying and over ordering significant volumes of Personal Protective Equipment (PPE), COVID-19 medicines and vaccines. The Department will never use a significant proportion of the PPE purchased, which will end up being burnt at a significant cost to the taxpayer. The PPE storage costs remain high and were nearly £200 million in the first 9 months of 2022–23 and the Department estimates that its future storage and disposal costs for unusable PPE will be approximately £319 million. The UK Health Security Agency (UKHSA) became fully operational on 1 October 2021, in the midst of the pandemic. There were significant issues in setting up this new organisation and the Department failed to appropriately support UKHSA during this process. This led to a fundamental absence of governance arrangements and controls. Non-executive directors were not appointed until April 2022 and UKHSA’s financial controls and processes were so poor that the organisation could not prepare auditable accounts for the 2021–22 financial year. This resulted in the Comptroller and Auditor General (C&AG) disclaiming his audit opinions. UKHSA faces a significant challenge implementing strong financial controls and processes and the Department must provide sufficient support and oversight to achieve this. Over the last few years, there have been repeated governance and financial control failings across the Departmental group leading to a number of qualified accounts. This has undermined Parliamentary accountability and resulted in the Departmental group incurring expenditure without Parliamentary approval. The Department has also been unable to lay its accounts before the summer recess, only just managed to do so before the final statutory deadline. It has not yet got a credible plan to return to laying its accounts before the summer recess. The Department must strengthen its governance and financial controls and set out a clear plan to restore timely accountability across the Departmental group. To do this, the Department must work with NHS England and local auditors to restore timely financial reporting across the NHS.
  25. Content Article
    Visits from loved ones are vital to the health and wellbeing of people receiving care in care homes, hospitals and hospices. There have been concerns about visiting restrictions in health and care settings for several years, and the restrictions introduced in response to the COVID-19 pandemic exacerbated these concerns. While those restrictions were in place at the time to control the risk of transmission and keep people safe, it was detrimental for loved ones to have been kept apart or not to have had someone supporting them in hospital. Guidance is now clear that visiting should be encouraged and facilitated in all circumstances. This consultation seeks views on introducing secondary legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. This includes accompanying people to hospital appointments (outpatients or diagnostic visits). Related reading on the hub: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative

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