Healthcare delivery
in the workforce delivering short-term care to people recovering at home after a hospital stay. Capacity in rehabilitation, reablement and recovery services is consistently the biggest cause of delayed discharges nationally.
Hospital discharge delays persist On any given day in March 2025, nearly 6 in 10 patients who were ready to be discharged experienced a delay. The CQC points out that this reduces the number of beds available for new patients and creates knock-on effects for people’s care across the whole system, from how quickly they get seen in A&E to the length of time they wait for planned medical procedures. Over the last ten years, there has been a
steady increase in percentage of emergency readmissions, with older people and people living in more deprived areas more likely to be readmitted within 30 days of being discharged from hospital.
CQC commissioned research from National
Voices into people’s experience of the discharge process – although this includes positive experiences, it also describes very poor experiences, including someone whose hospital stay and discharge left them feeling dehumanised. Primary and community care capacity
challenges also contribute to system-wide pressures. Although the number of trainee GPs has risen per head of population this year, and work is underway to increase capacity and improve access, the number of fully qualified GPs per head of population has fallen, and demand continues to grow. Based on the information and insight from
CQC’s regulatory work, as well from the GP Patient Survey 2025, access to GP appointments remains a challenge, with evidence that some groups find it harder than others. This includes those living in the most deprived areas, autistic people and people with a learning disability, and people with a mental health condition. When people can’t get help from their GP, it
may mean they go to a service not designed to meet their needs. The GP Patient Survey 2025 found that when people couldn’t contact their GP or didn’t know what the next step would be, 1 in 15 went to A&E. This was higher for people living in the most deprived areas. However, some people did not seek further help at all, risking a deterioration in their health. This was more likely to be the case for people over 85, who are also more likely to experience serious outcomes from poor health.
District nursing services are key to shifting
care from hospital settings into the community – but the number of qualified district nurses per 10,000 people aged 65 and over has dropped by 50% in the last 14 years. CQC analysis of NHS electronic staff record data found that the total annual numbers of new trainees are rarely more than half the number of staff leaving the profession.
Dr. Arun Chopra, Interim Chief Executive
of CQC, said: “The Government’s 10-year plan is a real chance to improve care by putting people’s needs first. But for the plan to succeed, community health and care services need more support. Without this, there’s a risk fewer people will be able to access good care, with vulnerable groups hit hardest. “Right now, community services tell us they’re struggling because the way care is funded and organised is designed around hospitals. That’s also true of how data about care is collected and how outcomes are measured. All these things make it harder to move towards care that keeps people well, delivered closer to home. “We’re calling for more investment in care outside hospital, and more emphasis on measuring quality of care, not just numbers of procedures. Services need to focus on really understanding the needs of their local population – especially in deprived areas – and on working together to address those needs. “We’ll play our part – with a renewed focus
on listening to what people tell us about their care and acting on their feedback. When we find
poor care, we’ll take steps to protect people. We’ll work with healthcare providers and local systems to make care better, and we’ll find and share examples of good, innovative care that puts people first. And where we see barriers to good care, we’ll work with partners to find solutions.” Professor Sir Mike Richards, Chair of CQC,
added: “Our inspections and oversight have found some excellent examples of health and social care services working together to put people first. We highlight neighbourhood health services with high patient satisfaction; artificial intelligence helping reduce admin for GPs; and a new integrated urgent community response service that’s improved ambulance response times and is helping keep people out of hospital if they can get the care they need nearer home.” “But we’ve also found too many examples
where poor coordination between health and social care, inadequate information sharing, and lack of digital integration stand in the way of joined up care. The current fragmented system means vulnerable people are falling through the gaps. “The 10-year plan provides a roadmap to fix
these problems, with both community care and social care playing a vital role. The Casey Commission will be an important step in reforming social care – but it won’t solve the core funding problem. We continue to call for long- term, sustainable funding for adult social care.” Commenting on the State of Care report,
Sarah Woolnough, Chief Executive at The King’s Fund, said: “This report highlights that lack of access to community services is driving some people to seek care in A&E, and sometimes not seek care at all. A finding echoed in our recent NHS admin report, which shows issues of navigating the system can put people off seeking care altogether. “The government is absolutely right to want to shift the focus of the NHS from hospital to
16
www.clinicalservicesjournal.com I December 2025
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