Editorials

State of health and care in England

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4799 (Published 17 October 2017) Cite this as: BMJ 2017;359:j4799
  1. Chris Ham
  1. King’s Fund, London, UK
  1. c.ham{at}kingsfund.org.uk

Services are at full stretch and struggling to maintain standards

The annual assessment of health and social care by the Care Quality Commission (CQC) provides a veritable treasure trove of information about the state of services in England.1 Based on inspections of 21 256 adult social care services, 152 NHS acute trusts, 197 independent acute hospitals, 18 NHS community health trusts, 54 NHS mental health trusts, 226 independent mental health locations, 10 NHS ambulance trusts, and 7028 primary care services over three years, the assessment offers grounds for concern and reassurance in equal measure.

The CQC’s headline finding is that most services are good and many providers have improved the quality and safety of care since inspections. Behind this headline lies a much more nuanced assessment, with variations between and within services and evidence of growing pressures on staff and deterioration of quality in some services. Adult social care is identified …

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