NHS faces winter 'tsunami' as shocking report reveals half of A&E and urgent care services not good enough

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More than half of A&Es and urgent care services require improvement or are inadequate in England, a scathing report by the government's care quality watchdog has found.

The Care Quality Commission (CQC) report said inspectors had “serious concerns” about some areas of emergency care in England, including ambulance handover delays at hospitals which, it outlines, put “the safety of patients at risk”.

The CQC warned of a potential "tsunami of unmet needs" rippling across essential services this winter.

Among 204 individual urgent and emergency services reviewed, 47% required improvement, 6% were inadequate, 42% were good and 5% were outstanding.

NHS and independent mental health core services, overall ratings CQC report 2020/2021
NHS and independent mental health core services, overall ratings, July 2021 (Care Quality Commission)

In further damning statistics that highlight concerns around the safety of some NHS and independent mental health core services, 38% were found to be inadequate (6%) or requiring improvement (32%), with 42% of acute wards and psychiatric intensive care units for adults inadequate (5%) or requiring improvement (37%).

The report - The Care Quality Commission’s 2020/2021 State of Care report - also outlined staff shortages in the care sector as a "deteriorating" situation.

"The £5.4 billion investment in health and social care announced in September 2021 is welcome – this includes £500 million across three years to support the adult social care workforce," the report reads.

"But we are increasingly seeing social care providers struggle to attract and retain staff, and the situation is serious and deteriorating."

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The report comes a day after Sajid Javid refused to implement the government's COVID Plan B strategy - which would involve the return of some social distancing measures - despite soaring infection numbers that passed 50,000 daily cases on Thursday.

The health secretary admitted the NHS was under "huge pressures", but insisted: "At this point we don’t believe they are unsustainable."

Health Secretary Sajid Javid during a media briefing in Downing Street, London, on coronavirus (Covid-19). Picture date: Tuesday October 19, 2021.
Health Secretary Sajid Javid during a media briefing in Downing Street, London, on COVID-19 (PA Images)

In the CQC report, executive Ian Trenholm warned of exhausted workers, staff shortages, and a "tsunami of unmet need" across health care sectors.

"As we go into winter, the health and care workforce are exhausted and depleted – which has clear implications for the vital care they deliver," he said.

“While staffing is an issue for all sectors, we’re particularly concerned about adult social care."

Staff shortages in the NHS and caring sectors are a growing issue, with NHS figures showing it is nearly 10,000 doctors short and almost 40,000 nurses short - and it is estimated the NHS will need an additional 1.1 million staff within the next ten years.

The care sector is also facing a staffing crisis, with the National Care Association reporting 170,000 vacancies.

Trenholm also urged the government to improve working conditions and pay.

NHS and independent mental health core services, overall ratings, July 2021 CQC
NHS and independent mental health core services, overall ratings, July 2021 (Care Quality Commission)

Labour has condemned the government over the findings of the report, with shadow minister for social care Liz Kendall saying its findings required "urgent action".

“This devastating report provides yet more evidence of the overwhelming pressures facing social care and the need for Ministers to take urgent action," she said.

“The Government’s recent announcement on social care will do nothing to tackle these issues.

"Social care won’t get any extra funding from the Tories’ National Insurance tax hike for the first three years, with little if any guarantee of extra funding after 2023."

Earlier this week chief executive, of the NHS Confederation, Matthew Taylor, warned the government about an incoming crisis this winter, urging them to introduce some social distancing guidance as soon as possible - such as home working, or the reintroduction of mask mandates.

"We are right on the edge - and it is the middle of October," he said.

"It would require an incredible amount of luck for us not to find ourselves in the midst of a profound crisis over the next three months."

Watch: England's chief medical officer says this winter will be "exceptionally difficult" for the NHS