New approaches to funding, commissioning and regulation needed to meet people’s health and care needs

The Care Quality Commission (CQC) has published a report today (Tuesday 3 July) following the completion of 20 local authority area reviews, exploring how older people move between health and social care services and making recommendations for change.

Beyond Barriers highlights examples of health and care providers working well together, and individuals working across organisations to provide high quality care – but too often a lack of effective co-ordination leads to fragmented care. This is reinforced by the way funding, commissioning, management and regulation encouraging organisations to focus on individual performance rather than on positive outcomes for people.

In one example, an older lady was living at home with domiciliary care support.  One Friday she fell, bumped her head and was taken to hospital. After a night in hospital she was ready to go home – but with staff unavailable over the weekend she could not be discharged.  On the Monday she was ready be discharged, but her care package was no longer available, so she couldn’t go home. She was on the ward over a month as her condition deteriorated and eventually moved into a residential care home.  She never saw her home again.

As the NHS turns 70, genuinely person-centred coordinated health and care cannot just be a long-term ambition – it’s an urgent and immediate requirement to meet the changing health and care needs of people living longer with increased complex conditions. Read the CQC's full report.

Jeremy Hughes, Chief Executive of Alzheimer's Society, commented:

This report highlights a broken system – and as the biggest users of social care, people with dementia are being hit hardest by this. The care crisis is a dementia crisis.

'We know staff on the frontline work tirelessly to provide the best support possible, but too often this is despite the system rather than because of it. Families call our Helpline at their wits' end because they simply can’t navigate such a fragmented system, so people with dementia can’t get the care they need.

'A million people will have dementia by 2021 and, after decades of successive governments shirking the issue, we must act now or the system will collapse. Just a fraction of the £20bn NHS birthday present would be able to join up health and social care, so that everyone who needs it could get high quality care at a fair price.'

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