The annual review, which assesses the performance of NHS and social care services, found that while there are signs of innovation, community services need substantial investment to deliver the transformation outlined in the Government’s 10-Year Health Plan for England.
The CQC warned that without stronger support, the quality of care will decline, leaving vulnerable groups including older people, those with dementia, and people with complex mental health needs struggling to access essential services.
Mounting Pressures on Mental Health Services
The report highlighted rising demand across mental health care since the pandemic, with growing waiting times for patients.
According to the 2024 Community Mental Health Survey, one in three respondents reported waiting at least three months for treatment, while nearly half of young people referred to child and adolescent mental health services faced even longer delays.
The longer the wait, the report found, the more likely patients were to experience deteriorating mental health.
CQC has now launched a comprehensive inspection programme targeting community mental health and crisis services, citing widespread staff shortages, fragmented systems, and poor coordination between providers.
Adult Social Care Under Severe Strain
Demand for local authority-funded social care continues to rise. Despite some improvement in recruitment, the sector still faces a vacancy rate three times higher than the wider economy.
Homecare services remain particularly fragile, and with the end of new care worker visas, recruitment challenges are expected to intensify.
CQC warned that many small providers are struggling financially, forcing some to hand back contracts due to rising costs. This, the report said, could limit the growth of home-based care services essential for helping people remain independent and avoid hospital admissions.
Hospital Discharge Delays Persist
The regulator found that nearly six in ten patients ready for discharge in March 2025 experienced delays, causing a backlog across the NHS.
This has knock-on effects across the system, from A&E waiting times to cancelled or postponed elective procedures.
Older people and those in deprived areas are disproportionately affected, with rising rates of emergency readmission within 30 days of discharge.
Primary and Community Care Facing Workforce Challenges
While the number of GP trainees has risen, the number of fully qualified GPs per head of population continues to fall.
Access to appointments remains difficult, particularly for people with disabilities, mental health conditions, or those living in deprived communities.
The GP Patient Survey 2025 revealed that one in 15 patients unable to reach their GP resorted to visiting A&E instead while some, particularly those over 85, did not seek help at all, risking worsening health outcomes.
Urgent Need for Investment and Integration
Dr Arun Chopra, Interim Chief Executive of CQC, said the 10-year plan was “a real chance to improve care by putting people’s needs first” but warned that community services are still designed around hospital models.
“Without proper funding, fewer people will be able to access good care, and the most vulnerable will be hit hardest,” Dr Chopra said.
“We need to focus on quality of care not just the number of procedures and ensure services work together to meet the needs of local populations.”
Professor Sir Mike Richards, Chair of CQC, praised examples of innovation, including neighbourhood health services and integrated community response schemes that reduce hospital admissions.
However, he warned that “poor coordination, inadequate information sharing and lack of digital integration” continue to undermine joined-up care.
He reiterated calls for long-term, sustainable funding for adult social care, noting that the Government’s upcoming Casey Commission would be a step forward, but not a full solution.
