Intended for healthcare professionals


Cost of living and workforce crises are creating two tier health and care system, CQC warns

BMJ 2023; 383 doi: (Published 20 October 2023) Cite this as: BMJ 2023;383:p2440
  1. Elisabeth Mahase
  1. The BMJ

The unsustainable pressures on England’s health and social care system are leading to a “two tier system” where those who can afford to are paying for treatment while those who can’t are facing long waits and reduced access, the Care Quality Commission (CQC) has said in its annual state of care report.1

“The combination of the cost-of-living crisis biting even harder and workforce challenges that are escalating has meant that there is a real risk of unfair care,” CQC’s chief executive Ian Trenholm told a press briefing.

The report highlights a range of challenges facing health and social care, including a notable decline in ratings across maternity, mental health, and ambulance services in 2022-23, the care backlog and long waiting lists, and concerns over how racial stereotypes and a lack of cultural awareness among staff may be impacting care for ethnic minority patients.

It also highlighted how adult social …

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