Beyond barriers: How older people move between health and social care in England

Care Quality Commission | July 2018 | Beyond barriers: How older people move between health and social care in England

Care Quality Commission (CQC) latest report brings together key findings and recommendations for change following the completion of 20 local authority area reviews exploring how older people move between health and adult social care services in England. 

Beyond barriers
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‘Beyond Barriers’ highlights some examples of health and care organisations working well together – and of individuals working across organisations to provide high quality care. But the reviews also found too much ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people (Source: CQC).

An accompanying press release is here 

The report can be accessed from CQC


Two thirds of patients with serious mental health problems placed in rehab far from home and local support

Care Quality Commission | People in rehab for serious mental health problems more likely to face lengthy stays far from home and local support | 2018

The Care Quality Commission (CQC) sent information requests to 54 NHS and 87 independent healthcare providers that manage mental health rehabilitation inpatient services.  CQC, working in collaboration with NHS England and NHS Improvement, asked providers for information about the mental health rehabilitation inpatient services that they manage. This included information about the number of locations and wards providing mental rehabilitation services, and the average daily cost of a bed on those wards, the length of each patient’s stay, funding authority and the mental healthcare provider responsible for aftercare. university-2540603_1920They found nearly two thirds (63%) of placements in residential-based mental health rehabilitation services are ‘out of area’, which means they are in different areas to the clinical commissioning groups (CCGs) that arranged them.

CQC estimates that £535 million is spent on residential mental health rehabilitation annually, with ‘out of area’ placements accounting for around two thirds of this expenditure.  The review shows that people in residential mental health rehabilitation services provided by the independent sector are, on average:

  • More likely to be further from their homes than those staying in NHS services – 49km compared to 14km.
  • More likely to stay there for longer – 14.5 months on their current ward compared to 7.5 months on their current ward in a NHS service.
  • At a greater risk of having their aftercare compromised because the managers there are less likely to know which NHS trust would care for them following discharge – 99% of managers of NHS rehabilitation services were able to name the NHS trust that would provide their patients’ aftercare, in comparison to 53% for independent services.

CQC recommend that the Department of Health and Social Care, NHS England and NHS Improvement agree a plan to engage local health and care systems in a programme of work to reduce the number of patients placed in mental health rehabilitation wards that are out of area. (CQC)

Press release available here 

Briefing can be read on the CQC website 

GPs face ‘scandalous’ 76% hike in CQC fees from 2017

Bostock, N. GP Online. Published online: 20 October 2016


CQC fees could rise by £2,000 for a GP practice of average size from 2017 under proposals from the watchdog to increase charges levied from GPs sharply for the second year running.

Figures released by the GPC show that an average-sized GP practice with between 5,001 and 10,000 patients could see CQC fees rise from £2,574 in 2016/17 to £4,526 in 2017/18 – a 76% increase.

GP leaders have condemned the proposed increase in fees for practices as ‘scandalous’, and said plans to drive up fees at a time when the CQC has pledged to scale back inspections on practices was ‘inexplicable’.

The proposed rise comes just a year after the CQC tripled the annual fee it charges GP practices as part of a bid to reduce its reliance on central government funding and move towards recovering a greater proportion of costs from providers.

Read the full article here

Better care in my hands: A review of how people are involved in their care

 Better Care In My Hands describes how well people are involved in their own care and what good involvement looks like. | Care Quality Commission

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People’s right to being involved in their own care is enshrined in law in the fundamental standards of care. It is an essential part of person-centred care and leads to better and often more cost effective outcomes.

This report is based on newly analysed evidence from CQC national reports and inspection findings, as well as national patient surveys and a literature review. It identifies what enables people and their families to work in partnership with health and social care staff and illustrates this with good practice examples from our inspection findings.

Key findings

  • Just over half of people asked say they feel definitely involved in decisions about their health care and treatment.
  • Women who use maternity services are particularly positive about how well they are involved in decisions about their care.
  • We found examples of good practice of people’s involvement in their care in our inspections over the last year.
  • There has been little change in people’s perceptions of how well they are involved in their health or social care over the last five years.
  • Some groups of people are less involved in their care than others. They are:
    • Adults and young people with long term physical and mental health conditions.
    • People with a learning disability.
    • People over 75 years old.
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For commissioners:

The CQC are encouraging commissioners to support this effort by making sure that there is:

  • Accessible information about health and care options and treatment or support for people and their families/carers
  • Flexible advocacy provision as people use different services
  • Coordinated community and peer support for people to manage their care through programmes with voluntary sector partners

Case study: Outstanding, safe care for all

Care Quality Commission

Inclusion Healthcare provides primary medical services for homeless people in Leicester. It was rated outstanding following its CQC inspection in November 2014. CQC inspectors found strong leadership at its heart and a positive culture that ensures patient safety is paramount. CQC went back to the practice to talk to some of its staff and find out more.

View the full case study here

NHS Clinical Commissioners say CQC fees increase will be detrimental to patients

Latest Health News

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NHSCC has criticised the Care Quality Commission’s (CQC) proposals to substantially increase its fees for regulating general practice services, stating that this would be detrimental to services being provided for patients.

Responding to the regulator’s consultation on the fees increases, NHSCC raises concerns about the disproportionate financial burden this will place on general practice at a time when its members are looking to invest further in primary care in line with the Five Year Forward View. The NHSCC response also highlights and shares the concerns expressed by the Public Accounts Committee that the CQC has not yet demonstrated its value in driving quality improvement through regulating general practice in the way that it currently does.

NHSCC co-chair, and Chief Clinical Officer of NHS Blackpool CCG, Dr Amanda Doyle said:

“We are extremely concerned about the impact that the proposed CQC fee increases will have on the…

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