cqcMost dental services (90%) are offering safe, effective, caring and responsive care and treatment, the CQC says.

Of the 1,336 dental practices inspected over the last year:

  • 90% required no action
  • 9% required action
  • 1% needed enforcement action.

Inspections by the CQC also found practices were giving patients evidence-based advice on improving oral health.

‘Through inspection, we have found examples of responsive notable practice in dentistry,’ the State of Care assessment concludes.

‘Where practice teams have used innovative ways to target children and prevent dental disease.

‘Dentists have raised concerns with CQC that there may be issues about the oral health of people in residential care homes.

‘We intend to carry out a review of this and expect to be able to report on this next year.’

‘Good’ care

Elsewhere people are getting ‘good’ care, but only where they can access it, according to the Care Quality Commission (CQC) assessment.

The CQC’s State of Care assessment shows that overall, quality of health and social care has been maintained from last year.

It points out that this is despite a fall in funding and an increase in demand.

‘The fact that quality has been broadly maintained in the face of enormous challenges on demand, funding and workforce is a huge testament to staff and leaders,’ Peter Wyman, chair of the CQC, said.

‘But we cannot ignore the fact that not everyone is getting good care.

‘Safety remains a real concern: although there have been some small improvements.

‘Forty per cent of NHS acute hospitals’ core services and 37% of NHS mental health trusts’ core services were rated as requires improvement on safety.

‘All providers are facing similar challenges.

‘In acute hospitals, the pressure on emergency departments is especially visible.

‘But while many are responding in a way that maintains quality of care, some are not.’

‘Postcode lottery’ or ‘integration lottery’?

The CQC highlights the efforts made by staff, leaders and carers to ensure patients receive good safe care.

However, patient’s experience of care varies depending on where they live.

Many people cannot access the services they need, experience ‘disjointed’ care, or can only access poor services.

‘This year’s State of Care highlights both the resilience and the potential vulnerability of a health and care system where most people receive good care, but where access to this care increasingly depends on where in the country you live and how well your local health system works together,’ Ian Trenholm, chief executive of the CQC, said.

‘This is not so much a “postcode lottery” as an “integration lottery”.

‘We’ve seen some examples of providers working together to give people joined-up care based on their individual needs.

‘But until this happens everywhere, individual providers will increasingly struggle to cope with demand – with quality suffering as a result.’

Increasing demand for acute services

Ineffective collaboration between local health and care services can lead to patients being unable to access care they need.

This can cause unnecessary hospital admissions, leading to an increase in demand for ‘acute services’.

Demands on emergency departments continues to rise, they’re the most likely services to be rated as needing improvement (41%) and inadequate (7%).

‘There need to be incentives that bring local health and care leaders together, rather than drive them apart,’ Mr Trenholm continues.

‘That might mean changes to funding that allow health and social care services to pool resources.

‘For example, to invest in technology that improves quality of care.

‘Like the digital monitoring devices for patients’ clinical observations that have saved thousands of nursing hours.

‘The e-prescribing in oncology that’s helping people directly.

‘And the electronic immediate discharge summaries that have improved patient safety.’

Adult care

The CQC highlights the adult social care market as particularly fragile, with some providers closing or ceasing to trade.

Demand for these services is continuing to rise, with Age UK estimating 1.4 million people will not be able to access care needed.

Over the last two years, the number of older people unable to access care needed has jumped by almost 20%.

‘Two years ago, we warned that social care was “approaching a tipping point”,’ Mr Wyman says.

‘This tipping point has already been reached for some people who are not getting the good quality care they need.

‘It is increasingly clear without a long-term funding settlement for adult social care, the additional funding for the NHS will be spent treating people with complex conditions for whom care in the community would have been more effective both in terms of their health and wellbeing and use of public money.’


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