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You can find the current article at its original source at https://www.theguardian.com/society/2018/oct/11/nhs-watchdog-warns-good-healthcare-is-becoming-more-of-a-postcode-lottery
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| NHS watchdog warns good healthcare is becoming more of a postcode lottery | NHS watchdog warns good healthcare is becoming more of a postcode lottery |
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| Patients in England are increasingly being subjected to “care injustice” in which they can access either no or poor quality hospital, mental health and social care services, the NHS watchdog has warned. | Patients in England are increasingly being subjected to “care injustice” in which they can access either no or poor quality hospital, mental health and social care services, the NHS watchdog has warned. |
| Access to good care is more and more of a lottery depending on where people live, with some areas providing only services that have been deemed substandard, according to the Care Quality Commission (CQC). | Access to good care is more and more of a lottery depending on where people live, with some areas providing only services that have been deemed substandard, according to the Care Quality Commission (CQC). |
| “Some people can easily access good care, while others cannot access the services they need, experience ‘disjointed’ care or only have access to providers with poor services,” the CQC’s annual report says. | “Some people can easily access good care, while others cannot access the services they need, experience ‘disjointed’ care or only have access to providers with poor services,” the CQC’s annual report says. |
| Health and care services in some areas are “struggling” so much that “there are parts of the country where people are less likely to get good care,” it added. They include Kent, the Wirral, Portsmouth and the Isle of Wight. | Health and care services in some areas are “struggling” so much that “there are parts of the country where people are less likely to get good care,” it added. They include Kent, the Wirral, Portsmouth and the Isle of Wight. |
| In Kent, for example, seven of its nine hospitals are rated as “requir[ing] improvement” by the CQC for their quality of care, while only two are deemed to be “good”. In addition, it has fewer nursing homes and residential homes rated good or outstanding than the national average. | In Kent, for example, seven of its nine hospitals are rated as “requir[ing] improvement” by the CQC for their quality of care, while only two are deemed to be “good”. In addition, it has fewer nursing homes and residential homes rated good or outstanding than the national average. |
| “We cannot ignore the fact that not everyone is getting good care,” said Ian Trenholm, the care regulator’s chief executive. “It cannot be right that people’s care depends on where they live or the type of support they need.” | “We cannot ignore the fact that not everyone is getting good care,” said Ian Trenholm, the care regulator’s chief executive. “It cannot be right that people’s care depends on where they live or the type of support they need.” |
| Too many people are receiving substandard care, the CQC found. Its ratings show that a sixth of adult social care services and a fifth of NHS mental health services need to improve. | Too many people are receiving substandard care, the CQC found. Its ratings show that a sixth of adult social care services and a fifth of NHS mental health services need to improve. |
| Patients in some areas may have to confront “geographical disparities” in their search for good care. For example, bed shortages mean that some people who need to receive inpatient care for a mental health problem “have to travel unreasonable distances to get it”, he added. Too much care is “fragmented” because health and social care services do not work together. | Patients in some areas may have to confront “geographical disparities” in their search for good care. For example, bed shortages mean that some people who need to receive inpatient care for a mental health problem “have to travel unreasonable distances to get it”, he added. Too much care is “fragmented” because health and social care services do not work together. |
| Urging ministers and NHS bosses to tackle the growing variation in care quality, including reforming the way the NHS’s finances work, Trenholm added: “The alternative is a future in which care injustice will increase and some people will be failed by the services that are meant to support them, with their health and quality of life suffering as a result.” | Urging ministers and NHS bosses to tackle the growing variation in care quality, including reforming the way the NHS’s finances work, Trenholm added: “The alternative is a future in which care injustice will increase and some people will be failed by the services that are meant to support them, with their health and quality of life suffering as a result.” |
| A&E units are treating growing numbers of frail elderly people and those experiencing a mental health crisis who have come for help because they could not access the help they needed closer to their homes. “Hospital emergency departments are often the first point of contact for people in need of care,” the report adds. | A&E units are treating growing numbers of frail elderly people and those experiencing a mental health crisis who have come for help because they could not access the help they needed closer to their homes. “Hospital emergency departments are often the first point of contact for people in need of care,” the report adds. |
| They include older people who have fallen, become dehydrated or developed bed sores because they could not access social care, and people who could not get immediate help when their mental health deteriorated. | They include older people who have fallen, become dehydrated or developed bed sores because they could not access social care, and people who could not get immediate help when their mental health deteriorated. |
| Dr Taj Hassan, president of the Royal College of Emergency Medicine which represents A&E doctors, said patients with dementia and young people who have self-harmed were of particular concern. “There is little doubt that, as services become stretched and fragmented, vulnerable groups that were managed in the community are seeking help in emergency departments.” | Dr Taj Hassan, president of the Royal College of Emergency Medicine which represents A&E doctors, said patients with dementia and young people who have self-harmed were of particular concern. “There is little doubt that, as services become stretched and fragmented, vulnerable groups that were managed in the community are seeking help in emergency departments.” |
| However, the CQC also stressed that overall the quality of NHS and social care had held up and improved in some places despite financial problems, relentlessly rising demand and worsening understaffing. | However, the CQC also stressed that overall the quality of NHS and social care had held up and improved in some places despite financial problems, relentlessly rising demand and worsening understaffing. |
| But services’ struggle to recruit and retain staff is hampering their efforts to provide good care, it added. A lack of newly-qualified GPs means “the workforce was unstable in some places and impacted on people being able to see their GP” while shortages of paramedics have left ambulances unable to answer 999 calls fast enough. | But services’ struggle to recruit and retain staff is hampering their efforts to provide good care, it added. A lack of newly-qualified GPs means “the workforce was unstable in some places and impacted on people being able to see their GP” while shortages of paramedics have left ambulances unable to answer 999 calls fast enough. |
| It also voiced unease that “the safety of people who use health and social care services remains our biggest concern: 40% of NHS acute hospitals’ core services and 37% of NHS mental health trusts’ core services were rated as requir[ing] improvement on safety at the end of July 2018”. | It also voiced unease that “the safety of people who use health and social care services remains our biggest concern: 40% of NHS acute hospitals’ core services and 37% of NHS mental health trusts’ core services were rated as requir[ing] improvement on safety at the end of July 2018”. |
| Barbara Keeley, shadow minister for social care and mental health, said: “Repeated hammer blows to health and care services from this austerity-obsessed Tory government has led to unsafe mental health wards, social care ‘deserts’ and emergency departments which have become overwhelmed.” | Barbara Keeley, shadow minister for social care and mental health, said: “Repeated hammer blows to health and care services from this austerity-obsessed Tory government has led to unsafe mental health wards, social care ‘deserts’ and emergency departments which have become overwhelmed.” |
| A Department of Health and Social Care spokesperson said that most people were still receiving good, safe care. | A Department of Health and Social Care spokesperson said that most people were still receiving good, safe care. |
| “We want the NHS to be the safest healthcare system in the world, and this starts by ensuring every single patient in this country receives the highest quality of care, no matter where they live.” | “We want the NHS to be the safest healthcare system in the world, and this starts by ensuring every single patient in this country receives the highest quality of care, no matter where they live.” |
| In the UK, Samaritans can be contacted on 116 123 or emailjo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org. | In the UK, Samaritans can be contacted on 116 123 or emailjo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org. |
| In the UK, Samaritans can be contacted on 116 123 or emailjo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org. | In the UK, Samaritans can be contacted on 116 123 or emailjo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org. |
| Care Quality Commission (CQC) | Care Quality Commission (CQC) |
| Health | Health |
| NHS | NHS |
| Mental health | Mental health |
| Hospitals | Hospitals |
| Social care | Social care |
| Ageing | |
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