Crisis in Social Care Adding to Problems in NHS, Says Minister

Health Secretary Wes Streeting leaving Downing Street, London, after a Cabinet meeting on July 9, 2024. Lucy North/PA Wire

The crisis in social care is adding to the problems already facing the NHS, Secretary of State for Health and Social Care Wes Streeting has said.

Streeting said challenges arising in social care “are presenting either at the NHS’s front door or clogging up the exit doors of hospitals,” meaning that many of the issues facing the health service “are driven by social care.”

There is “a real crisis in social care,” the minister said during a fringe event at the Labour Party conference in Liverpool on Sunday.

He added, “I think people in this country are genuinely shocked when they need social care to find out how expensive it is and how poor the quality of social care is.”

The minister said that fixing social care would be undertaken during Labour’s 10-year plan to reform the NHS, which he had declared “broken“ in the days after Labour won the July 4 election.

“The challenge we’ve got in health and social care is enormous. It’s the worst crisis in the history of the National Health Service,” he said.

In August a survey revealed almost one-fifth of care providers in the UK reported weeks-long waiting times for people to be discharged into their care, prompting the government to brand the NHS hospital discharge system “broken.”

The most common reason for delays was a failure to agree on how the person’s social care would be paid for. Others listed issues including a lack of communication, wrong or insufficient information being provided to them from hospital discharge teams, waits for patients to have care assessments, or transport not being agreed.

Widespread Problems in NHS

During his speech, Streeting acknowledged the findings of the Darzi report into the state of the NHS, saying it revealed the scale of the failures within the service.

Led by former Labour minister Lord Darzi, the report found widespread problems in the taxpayer-funded health service. Issues include the quality of cancer care in the UK having fallen behind other countries, waiting times for hospital procedures having ballooned in 15 years, and waiting times at A&E having caused thousands of extra deaths annually.

Responding to the Darzi report’s findings earlier this month, Prime Minister Sir Keir Starmer said that the NHS needs fundamental reform. But citing inefficiencies and falls in productivity in the current system, Starmer said he was not prepared to use any more of taxpayers’ money to fix the NHS.

“No more money without reform,” the prime minister said, adding that the service must “reform or die.”

Streeting echoed the prime minister’s calls for the NHS to reform, saying that otherwise the service faced an “existential threat” from a combination of rising chronic disease, an aging population, and rising cost pressures.

He said these issues will “combine to basically make the NHS unaffordable in the longer term, as the system we know today, as a public service, publicly funded, free at the point of use.”

Care Quality Commission

Problems are not only facing the NHS and social care systems, but the regulator that assesses them.

In July, a review into the Care Quality Commission (CQC) found England’s health watchdog was in “urgent need” of reform, amid a lack of expertise and long delays between inspections.

The interim report by Dr. Penny Dash said the failings were impeding the CQC in its ability to spot poor performance at care homes, GP practices, and hospitals during the inspection process. Some of Dash’s findings include health and social care settings not being reinspected for several years, with one NHS hospital having not been rated since June 2014.

Dash’s findings prompted Streeting to brand the CQC  “not fit for purpose.”

Analysis by the Homecare Association later found that six out of 10 home care providers have either significantly outdated ratings or have not been rated at all by the CQC. The August report said that insufficient inspections are putting the quality and safety of those receiving care at risk, as well as damaging public confidence in the sector.

The Department for Health and Social Care has since appointed Professor Sir Mike Richards, a senior cancer doctor, to review CQC assessments. The government also has increased oversight of the CQC, with the body updating the department regularly on its progress in implementing Dash’s recommendations.

Kate Terroni, the interim chief executive of the CQC, said the watchdog accepted in full Dash’s findings and recommendations and was committed to increasing the number of inspections and strengthening its senior level health care expertise.

PA Media contributed to this report.