A report by the Care Quality Commission (CQC) has found that older people living in Stoke-on-Trent sometimes have a poor experience of health and social care because councillors and the local Clinical Commissioning Group are failing to work together to meet their needs.
Stoke-on-Trent City Council and Stoke-on-Trent CCG were criticised in the report for “not working in a joined-up way” and overseeing a system where people aged 65 and over found it difficult to get a prompt GP appointment and were instead referred to A&E by their GP.
The report, which looked at the way hospitals, community health services, GP practices, care homes and home care agencies work together, found that older people often endured long waits in A&E before being admitted to a hospital ward and many were delayed in hospital despite being ready to return home, suffering “avoidable harm” or a deterioration in their condition as a result.
CQC researchers also concluded that people’s health and care needs in the community were not being reviewed consistently.
“This meant that people may have been at risk of entering into crisis if their needs had changed. It also represented a missed opportunity when people’s conditions might have improved, to release capacity in home care services that could be used to support other people who need care,” the report said.
A number of recommendations were made including better communication between health and social care leaders, effective joint strategic planning based on the local community’s needs and an integrated system of assessment and review of people’s needs.
“It is quite clear that some older people in Stoke-on-Trent have suffered a poor experience of care because the local health and social care services have not been working together effectively,” said professor Steve Field, chief inspector of primary medical services and integrated care.
“We have heard of a history of poor relationships across the system with limited joint working. he consequences are too many people ending up in hospital in the first place or being unable to leave hospital because there are no support services available.
“Leading organisations in the health and social care system, including Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, need to come work together urgently to improve services for people, and in particular develop how it works together to prevent people from requiring acute hospital care.
“Our team found that the workforce across the local authority and the CCG were willing and enthusiastic about doing the right thing for people but did not have clarity about how to achieve this.”
Professor Field added: “However we have found that the working relationships between the main organisations have started to improve. It is encouraging that there are some new leaders working in Stoke-on-Trent who have a clear understanding of the challenges that the system faces and are committed to transforming services for people by working in more of a joined-up way.”
There has been speculation that the CQC could replace the General Pharmaceutical Council as the regulatory body of pharmacy. The Department of Health this year launched a consultation on proposals to reform health professional regulation and explore how a system with a reduced number of regulators might function.
The consultation will examine the possibility of reducing the number of regulators from nine to four on the belief that bodies with between 100,000 and 200,000 registrants generate efficiencies. The GPhC has 77,285 registrants based on this year’s annual report.
The statutory regulation of healthcare professionals costs about £200 million each year to operate according to the Centre for Health Service Economics and Organisation.