T: 01822 851370 E: [email protected]
Visit RSN Survey about life in rural England to find out more.
CQC Warns Underfunded Community Services Risk Care Quality ‘Erosion’
The Care Quality Commission (CQC) has warned that the health and social care system remains fragmented and under severe strain as England prepares for a major shift from hospital to community-based care.
Publishing its State of Care 2024/25 report on 24 October, the regulator said that while there are examples of innovation and progress, community health and care services need significant investment in both capacity and capability to deliver the transformation called for in the Government’s 10-Year Health Plan for England.
Without this support, the CQC cautions there is a “real risk of erosion in care quality,” with vulnerable groups likely to be hit hardest through longer waits, reduced access and poorer outcomes.
Rising Pressures Across The System
The report finds growing demand across GP, community and mental health services:
- Around 700,000 more people were registered with GP practices than last year, yet the number of fully qualified GPs per head of population continues to fall.
- One in three respondents to CQC’s Community Mental Health Survey waited three months or more for care; one in seven waited over six months, with many reporting their mental health worsened during this time.
- District nursing numbers have fallen by 50% over the last 14 years, undermining efforts to move care closer to home.
Social Care Under Strain
Local authority-funded adult social care requests have risen, but workforce vacancies remain three times higher than in the wider economy. Homecare shortages continue to delay hospital discharges, with nearly six in ten patients ready for discharge in March 2025 still waiting for suitable community or home support.
The end of new care worker visas could worsen recruitment problems, making a sector-wide workforce strategy and fair pay implementation increasingly urgent.
Fragmented Services And Inequalities
The CQC highlights that poor coordination and data sharing between health and social care continue to cause gaps in care, particularly affecting older people, people with dementia, autistic people, and those with learning disabilities or complex mental health needs.
Deprivation remains a key factor in unequal outcomes: people in the most deprived areas report poorer access to GP care, higher readmission rates, and worse health outcomes overall.
Call For Long-Term Investment
CQC Chair Professor Sir Mike Richards said the shift to neighbourhood-based care is a vital opportunity, but community services “must be robust enough to support this change.”
He and Interim Chief Executive Dr Arun Chopra both called for long-term, sustainable investment in community health and adult social care, better integration between services, and a stronger focus on measuring quality rather than activity.
“Without reform and sustained funding,” the report concludes, “there is a real risk that the quality of care people receive will deteriorate, and inequalities will deepen.”
Read The full State of Care 2024/25 report here
|
Rural Perspective: The Community Care Gap Is Even Wider In Rural England The CQC’s warning that underinvestment in community health and social care risks an “erosion of care quality” rings especially true for rural areas where distance, workforce shortages and funding disparities already stretch local services to breaking point. For rural residents, the shift from hospital to community care cannot succeed without targeted investment that reflects the real cost of delivering services in sparsely populated areas. As highlighted in the Rural Services Network’s Delivering for All campaign, rural councils and providers face higher delivery costs, lower wage economies, and shrinking workforces — yet receive around 40% less government-funded spending power per head than urban counterparts. This inequity directly affects access to health and care. Many rural patients face longer travel times, fewer GP appointments, and limited homecare capacity, while shortages of district nurses and carers make “care closer to home” a distant reality. The CQC’s findings on delayed discharges, community workforce gaps, and fragile homecare markets are challenges long familiar to rural authorities. If the Government’s 10-Year Health Plan is to work for all communities, it must be rural proofed from the ground up, ensuring fair funding, locally driven workforce strategies, and investment in rural connectivity and transport so that residents can reach and receive the care they need. A true “neighbourhood care” model must include neighbourhoods of every kind, including the hamlets, market towns and coastal villages that make up rural England. Without this, the risk isn’t just erosion of care quality, it’s exclusion from it. |
