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CQC raises concerns over state of health and care for young people
The Care Quality Commission’s (CQC’s) annual assessment of the state of health and social care in England has raised concerns around the state of children’s services and the health and wellbeing of young people. The report draws on inspection activity, findings
from CQC’s national NHS patient survey programme and statutory reports, bespoke research into people’s experiences, insight from key stakeholders and evidence collected by the regulator throughout the year about the quality and safety of services in all areas of health and care. Getting the right care, at the right time and in the right place is important for everyone. For children and young people, however,
delays can have especially significant and lasting consequences. Some treatments and interventions are less effective if not administered at a specific age or developmental stage – and the opportunity to intervene can be missed completely if the wait for diagnosis is too long. The CQC found that many children and young people are not currently getting the support they need. This year’s State of Care report highlights this as a risk not just for today, but for the future. Children who do not receive the care they need today are at increased risk of becoming adults with long-term mental or physical illnesses, which could affect their quality of life and their ability to contribute to society tomorrow. More broadly, timely access to good care continues to be a struggle for many, and inequalities in care persist. Issues getting access to services are also often exacerbated by deprivation; in 2023/24, attendance rates for urgent and emergency care for people living in the most deprived areas of England were nearly double those for people in the least deprived areas. Analysis conducted for CQC showed that for people attending for mental health reasons, the difference was over three times higher for those in the most deprived areas.
The safety and quality of some services is not good enough. CQC’s review of maternity services shows that women and babies are still not receiving the high-quality maternity care they deserve, and women from Black and ethnic minority backgrounds continue to be more at risk of experiencing poor maternity care and outcomes. Mental health services are also a cause for serious concern. Lack of resources, ageing estates and poorly designed facilities are affecting the safety of inpatient wards. CQC’s special review of the care provided by Nottinghamshire Healthcare NHS Foundation Trust also identified wider concerns around community mental health services, leading to recommendations to improve oversight and treatment of people with serious mental health issues.
CQC has particular concerns about children and young people’s mental health services, where demand continues to rise. In 2023, 1 in 5 children and young people between the ages of 8 and 25 were estimated to have a mental health disorder. While the mental health workforce has grown, problems with staffing and skill mix remain. Across the country, services are facing challenges in recruiting staff including nurses,
psychologists, occupational therapists, and consultant psychiatrists – all of which are having an impact on capacity, and therefore on the availability and regularity of appointments. Research commissioned by CQC into attendances at urgent and emergency care settings by people with a mental health issue found that those aged 18 to 21 consistently have the highest rates of presentation for mental health issues at both emergency departments and urgent care centres. Not getting the right help at the right time can lead to people’s symptoms to deteriorate and they can then end up in crisis and/or inappropriate environments, such as urgent and emergency care. CQC’s inspections of urgent and emergency care services found issues around triage and patient flow that affect care for all patients but identified specific issues around care for deteriorating children. Low numbers of children’s nurses and gaps in staff training in safeguarding and recognising sepsis meant that in some services, there was a risk that a deteriorating child might not be identified quickly, with patients at risk of sepsis not being assessed and treated promptly. Actively involving parents in their child’s care decisions and addressing their concerns promptly is critical to safety. The report also highlights concerns about care for autistic people and people with a learning disability – both the quality of care and access to it. The waiting time to begin assessment for a possible autism diagnosis is far too long. Ian Dilks, Chair of CQC, said: “While some children
are receiving timely, appropriate care, we know that there are more who don’t, with potential long-term repercussions for their mental and physical health. “Action now – targeted funding for early
intervention, better understanding of local need and improved management of demand, and genuine two-way communication with children and families – will help to ensure a healthier population tomorrow.”
UK to create world-first ‘early warning system’ for pandemics
The UK will create the world’s first real-time surveillance system to monitor the threat of future pandemics, prevent disease and protect the public. Plans have been announced to form a new partnership between the Government, Genomics England, UK Biobank, NHS England and Oxford Nanopore (a life sciences company). Oxford Nanopore uses long read sequencing technology to
analyse genes and pathogens to rapidly diagnose a range of cancers, along with rare and infectious diseases. The technology will help to create an early
warning system for future pandemics and potential biological threats. It will be used in the expansion of NHS England’s Respiratory Metagenomics programme, being led by Guy’s and St Thomas’ NHS Foundation Trust. It uses samples from patients
with severe respiratory infections and rapid genetic testing to match those patients with the right treatments within 6 hours. Following an initial successful pilot at St Thomas’ Hospital, the technology will now be rolled out from 10 to up to 30 NHS sites to address the current time lag between new pathogens emerging in the UK and action being taken to both treat affected patients and to prevent their spread.
December 2024 I
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