The CQC’s annual assessment, published on Friday, exposed chronic workforce shortages, unsustainable funding pressures, and a fragmented system struggling to meet rising demand. The regulator reported adult social care vacancy rates running three times higher than the national average, with providers handing back contracts due to escalating costs.
The findings have prompted renewed calls for immediate government action on the promised fair pay agreement and long-term sustainable funding, ahead of the forthcoming Casey Commission.
Dr Hugh Alderwick, Director of Policy and Research at the Health Foundation, said the report showed “gaps in care outside hospitals are pervasive”, particularly in community and mental health services.
“The government is far from having a coherent plan to make its promises a reality,” he said. “Meeting demand, improving access, and boosting pay could cost an extra £8.7bn by 2028/29.”
Caroline Abrahams, Charity Director at Age UK, said the government’s ambitions to move care out of hospitals and into communities “will ultimately fail” without sustainable funding.
“The report is full of examples of harm being caused to people and the system as a whole,” she warned. “The full solution lies in the hands of politicians.”
Camille Oung of the Nuffield Trust said nearly 1.2 million people are waiting for NHS community care, adding:
“Other countries like Denmark have shown how vital parallel investment in hospitals and community care is. Without this, the government’s plans will remain rhetoric.”
Dr Layla McCay of the NHS Confederation echoed concerns, saying community services “cannot deliver transformation without a shift in resources from hospitals into primary and community care.”
Sarah Woolnough, Chief Executive of The King’s Fund, said the report showed poor access to community services was “driving some people to A&E, and others not to seek care at all.”
“Government focus remains fixed on hospital waiting times,” she said. “For change to happen, investment in primary and community care is essential.”
Vic Rayner, CEO of the National Care Forum, said the pressures described were “no surprise”, adding:
“If the government is serious about prevention, investment must reach community care. What should alarm policymakers is the increasing fragility of services for working-age adults.”
Minesh Patel from Mind said chronic underfunding risked overwhelming services:
“The government will not realise its 10-year plan without proper resources. Marginalised groups, particularly Black men, continue to face barriers to accessing culturally appropriate care.”
Kathryn Marsden OBE, Chief Executive of SCIE, warned that demand was rising faster than local authorities could respond.
“People in deprived areas face poorer outcomes and barriers to accessing care. Unless we tackle these inequities, the most vulnerable will continue to suffer.”
Emily Hindle from Alzheimer’s Society said only a third of care workers in England have dementia training, adding:
“The CQC report shows people are waiting too long for diagnosis and care. We need mandatory dementia training and urgent social care reform.”
Professor Martin Green OBE, Chief Executive of Care England, said the sector’s challenges in recruitment and funding were growing rapidly. However, he praised the CQC’s recognition of innovation through the Vivaldi Project, which shares care home data with the NHS to improve health outcomes.
“Proper investment in social care and projects like Vivaldi will ease pressure across the health system,” he said.
The consensus across the sector is clear: without urgent government action on funding, workforce reform, and integration, the health and social care system risks a deeper and longer-lasting crisis.
