Ian Trenholm, Chief Executive at the Care Quality Commission

Our annual assessment of the quality of health and social care in England, State of Care 2017/18, has now published.

This year’s State of Care is a story of contrasts, highlighting both the resilience and the potential vulnerability of the health and care system.

I would like to thank everyone who works and volunteers across the many health and social care services where good, safe care continues to be delivered despite the challenges around demand and funding, coupled with significant workforce pressures across all sectors.

However, although quality has been largely maintained, and in some cases improved, from last year, it is also clear that access to good care increasingly depends on where in the country you live, what care needs you have and how well your local health and care system works together — an ‘integration lottery’.

Local systems are made up of a variety of services which in turn make up a person’s experience — not as individual episodes of care, but as part of their health and social care journey.

We know that ineffective collaboration between local health and care services can result in people not being able to access the appropriate care and support in the community that would avoid unnecessary admissions to hospital.

This leads to increased demand for acute services, with the most visible impact of this being pressure on emergency departments. July 2018 saw the highest number of attendances on record, and emergency departments are the core hospital service most likely to be rated requires improvement (41%) or inadequate (7%).

A struggling local hospital can be symptomatic of a struggling local health and care system.

In order to relieve this pressure, we need to make sure that people are supported to live well at home.

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