Skip to main content

The state of health care and adult social care in England 2017/18

Most people in England receive a good quality of care. Our ratings show that quality overall has been largely maintained from last year, and in some cases improved, despite the continuing challenges that providers face. Some services have improved due to the focus and hard work of care staf and their leadership teams. Others have declined in quality as providers have struggled with the challenges they face. But quality and access to care are not consistent, and people’s overall experiences of care are varied. Some people have told us about the outstanding care they received and how some individual services have changed their lives for the better. Others have told us about the poor and sometimes disjointed care they have received.

Public sentiment about health and care services remains largely positive – for example, 84% of patients said their GP practice was fairly good or very good. However, there are real concerns, such as the one in four (25%) of people receiving NHS mental health services who did not feel they got services often enough for their needs. This year’s State of Care builds on our July 2018 report about the way that older people in 20 English local areas experienced care as they moved between the diferent services they need. We highlighted how services for many people with multiple or complex needs in these areas were not joined up around their individual needs: fnding good joined-up care was sporadic and sometimes it occurred despite the lack of a systematic approach to put people at the centre of their care. We found that providers are ofen focused on their own corporate priorities and targets, rather than working with one another to make sure people get the best care possible.

The challenge for all local health and social care services is to recognise the needs of their local populations and find sustainable solutions that put people first. In this context, we have considered five factors that afect the sustainability of good care for people: access to care and support; the quality of care services; the workforce available to deliver that care; the capacity of providers to meet demand; and the funding and commissioning of services.