CQC’s new report on barriers between health and social care in England

The Care Quality Commission (CQC) has published a new report looking at how services are working together to support and care for people aged 65 and over.

Beyond barriers: how older people move between health and care in England, focuses particularly closely on the relationship between health and social care organisations. With increasing numbers of older people having complex and long-term care needs, many need support from more than one professional and more than one service. Thus, cooperation between agencies is vital.

The report is based on a review of health and social care systems in 20 local authority areas. It looks at how each area works with respect to three key areas:

• maintaining people’s health and well-being at home
• care and support when people experience a crisis
• supporting people when they leave the hospital.

The report’s authors conclude that most organisations have good intentions and intend to work together. However, most were found to focus on their own goals. Although there was good planning between services, the CQC says that the way services are funded does not support them to work together.

The CQC also found that organisations:

• prioritise their own goals over shared responsibility to provide person-centred care
• do not always share information with each other which means they are not able to make informed decisions about people’s care
• are not prioritising services which keep people well at home
• plan their workforce in isolation to other services.

There are four main recommendations:

1. Commissioners should be encouraged and enabled to bring about effective joined-up planning and commissioning
2. There should be a new approach to system performance management
3. A move to joint workforce planning is needed
4. There should be better regulation and oversight of local system performance.

The CQC says that an agreed joint plan, funded in the right way, should support older people in their own homes, help them in an emergency, and then to return home safely. Local leaders must take a reformed approach to funding that allows and encourages local systems to deliver this plan by aligning and pooling their budgets.

The report calls for a single, joint, nationally agreed framework for measuring the performance of how organisations collectively deliver improved outcomes for older people. Local leaders should give more emphasis to investing in models of care that support prevention and avoid unwarranted admission to secondary care.

According to the CQC, local leaders should agree joint workforce plans, with more flexible and collaborative approaches to staff skills and career paths.

To support the improved planning and reformed commissioning at a local level, the CQC says that the government should consider new legislation to allow it to regulate local systems and hold them to account for how people and organisations work together to support people to stay well.

Beyond barriers can be downloaded from the CQC website https://www.cqc.org.uk/.