Mounting concerns over feasibility of plans to shift care closer to home

Responding to the CQC's State of Care report, Nuffield Trust Fellow Camille Oung said:

“This report lays bare the extent of the huge pressures facing almost every part of the health and care system. In particular, it reveals what an uphill struggle the government’s planned shift from hospital to home will be in the context of community services already struggling to deliver timely care.

“Almost 1.2 million people are waiting for NHS community care and one in four children on this list wait over a year for their treatment. Other countries which have tried to make this shift happen, such as Denmark and Ireland, have shown how important it is to invest in community services in parallel with hospitals – without additional funding it is extremely difficult.

“Our work to understand the progress made by integrated care systems in delivering key government priorities highlights that, while there are examples of good practice, financial and workforce barriers are still standing in the way of delivering tangible improvements across the board. It is striking that over a quarter of the system leaders we surveyed are not at all confident in their system’s ability to deliver the government’s ambitions to move care from hospitals to community or shift care from sickness to prevention.

“The CQC has also added to mounting evidence that the social care sector is under severe strain and still overreliant on overseas recruits. As tighter immigration restrictions kick in, this is becoming increasingly risky and firm plans to boost the domestic workforce won’t take effect until 2028/29 at the earliest.”