'˜Grim picture' is painted of A&E care system which is reaching a '˜tipping point'

A&E departments are buckling under the pressure of a social care system that is reaching its 'tipping point', a health watchdog has warned.

Some people across the country are receiving “very poor care”, the Care Quality Commission (CQC) said as it released its annual assessment of care in England.

Overall, three in five hospital trusts have been told they need to make improvements - with particular problems being highlighted in medical services and accident and emergency departments.

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And 81% of acute NHS trusts are rated as either inadequate or requiring improvement in terms of safety.

The CQC has also set out a bleak picture of the social care sector across the country - which it says is linked to wider problems in the NHS.

“We have found too much acute care that we rated inadequate - particularly urgent and emergency services and medical services,” the report states.

“And it will be increasingly difficult for trusts to make improvements to these services unless they are able to work more closely with adequately funded adult social care and primary care providers.”

The quality of care people receive from health and care services in England varies considerably, the report adds.

The report says that hospitals are under increasing pressure.

Just one in five NHS acute trusts are rated as “good” in terms of safety. None received the top rating of outstanding, the report shows.

Serious safety issues could include surgeons operating on a wrong body part or patients receiving the wrong medication.

The report also paints a woeful picture of social care.

“There are indications that the sustainability of adult social care is approaching a tipping point,” it states.

The watchdog said that despite a 33% rise in the number of people aged 85 and over in the last decade, the proportion of people receiving local authority care has reduced.

It said the number of beds in nursing homes is not increasing in line with demand and care home providers are pulling out of local authority contracts as funding does not cover the costs of care.

Meanwhile, a number of organisations that have previously been flagged as not providing adequate care for patients are failing to making improvements.

The CQC called for “urgent action” to tackle the issues, including an injection of funding into the care system.

CQC chief executive David Behan said: “What’s happening, we think, is that where people aren’t getting access to care, and we are not preventing people’s needs developing through adult social care, is that they are presenting at A&E.

“Emergency admissions of older people are increasing and we also know that the number of delayed bed days in hospital are increasing.”

He added: “We think more resources need to be made available to adult social care. That will help people in adult social care and it will also improve the impact it is having on the system.”

“Without urgent action being taken, we are concerned that there will be more people whose needs aren’t being met, that improvement in adult social care will be harder to make and there is a risk that more services will deteriorate.”

When asked if politicians were paying enough attention to the issue, David Behan said: “We have just finished the party conference season and I made a particular issue to look at the speeches of all of the political leaders and I couldn’t see adult social care referred to in the speeches that were made at the party conferences.”

Dr Jennifer Dixon, chief executive of the think tank the Health Foundation said: “Today’s report shows that, against the odds, most health and social care providers in England continue to provide high quality care, despite an extremely challenging context.”

But she added: “Further deterioration in social care will drag down NHS performance with it. This is a high risk situation needing an urgent political solution.”

Margaret Willcox, vice-president of the Association of Directors of Adult Social Services, said: “We are at a tipping point where social care is in jeopardy and unless the Government addresses the underfunding of the sector, there will be worrying consequences for the care market, the NHS and, most importantly, for older and disabled people, their families and carers.”

Caroline Abrahams, charity director at Age UK, said: “When any regulator says that it is worried that a service may be reaching a tipping point in terms of quality and sustainability, it is clearly time for very serious concern.

“Next month’s Autumn Statement is an opportunity for the Government to give social care the priority it deserves in terms of public spending and this report shows how important it is that the Government acts.

Otherwise ‘a tipping point’ threatens to become something infinitely worse, placing many older people at risk of harm.”

Janet Morrison, chief executive of the older people’s charity Independent Age, said: “This report is the first time we have had a truly comprehensive picture of what is happening in social care, and it is a grim picture.”

A Department of Health spokeswoman said: “This report from our independent inspectorate shows that the majority of the NHS, 72% of adult social care services and 87% of GP practices inspected are good or better - and that improvement is taking place all over the country.

“The NHS is performing well at a time of increasing demand - the Government is investing £10 billion to fund its own plan for the future, and crucially is ensuring that the amount of money available to local authorities for social care is rising in future years of the Parliament, reaching up to £3.5 billion extra by 2020.”