State of Care report 2019/20

October 16, 2020

The Care Quality Commission (CQC) has released its annual State of Care report for 2019/20, looking at the quality of care over the past year.

This includes the period before the full impact of COVID-19 began and CQC’s routine inspections were suspended as a result of the pandemic.

The State of Care 2019/20 report finds that, pre-COVID-19, care was generally good, but with little overall improvement and some specific areas of concern including a lack of long-term funding for social care resulting in a 'fragile' sector. CQC suggests that the sector is in need of investment and workforce planning.

However, the report notes that the progress achieved in transforming the way care is delivered since the COVID-19 outbreak has been extraordinary, noting that changes which were expected to take years – like the switch to more flexible GP consultations by phone and online – took place almost overnight. The report therefore highlights many examples of collaboration among services which have made a real difference to people’s care.

At the start of the pandemic, the focus on acute COVID-19 care was driven by the urgent imperative that the NHS should not be overwhelmed. Decisions were made in order to ensure capacity as quickly as possible – but CQC says that, now, priorities need to be reset in a more sophisticated way to ensure that the longer-term response includes everyone, regardless of what kind of care they need, or where they receive it.

In social care, COVID-19 has not only exposed, but has exacerbated existing problems. The sector faced significant challenges around access to PPE, testing and staffing – and co-ordinated support was less readily available than for the NHS. The long-standing need for reform, investment and workforce planning in adult social care has been thrown into stark relief by the pandemic.

CQC's State of Care 2019/20 report makes clear that these issues need to be urgently addressed – underpinned by a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.

Ian Trenholm, Chief Executive of CQC, said, 'Pre-COVID, the health and care system was often characterised as resistant to change. COVID has demonstrated that this is not the case. The challenge now is to maintain the momentum of transformation, but to do so in a sustainable way that delivers for everyone – driven by local leadership with a shared vision and supported by integrated funding for health and care.

'There is an opportunity now for Government, Parliament and health and care leaders to agree and lay out a vision for the future at both a national and local level. Key to this will be tackling longstanding issues in adult social care around funding and operational support, underpinned by a new deal for the care workforce. This needs to happen now – not at some point in the future.

'COVID is magnifying inequalities across the health and care system – a seismic upheaval which has disproportionately affected some more than others and risks turning fault lines into chasms. As we adjust to a COVID age, the focus must be on shaping a fairer health and care system – both for people who use services, and for those who work in them.'

The state of health care and adult social care in England 2019/20 is based on inspections and ratings data, along with other information, including from people who use services, their families and carers, to inform CQC’s judgements of the quality of care.

This includes quantitative analysis of inspection ratings of 31,000 services and providers, drawing on other monitoring information including staff and public surveys, and performance. In previous years, ratings have been as at 31st July, to enable as contemporaneous a view as possible. Due to the suspension of CQC’s routine inspections in March 2020 as a result of the pandemic, the ratings in this report are as at 31st March 2020 and all comparisons with the previous year are to ratings as at 31st July 2019.

As at 31st March 2020:

  • 80% of adult social care services were rated as good and 5% as outstanding (31st July 2019: 80%, 4%).
  • 89% of GP practices were rated as good and 5% as outstanding (31st July 2019: 90%, 5%).
  • 67% of NHS acute core services were rated as good and 8% as outstanding (31st July 2019: 65%, 7%).
  • 71% of NHS mental health core services were rated as good and 11% as outstanding (31st July 2019: 71%, 10%).

Read and download the full State of Care 2019/20 report.

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