A lack of resources, workforce shortages, ageing estates and poorly designed facilities are affecting the safety of inpatient wards, according to the latest annual State of Care report from the Care Quality Commission (CQC)
These problems “lead to issues around privacy and dignity for patients, as well as compromising the safety of both patients and staff,” the report said. It also found that children and young people are not always able to access care in a timely manner. CQC chair Ian Dilks said that the current standards are risking children’s futures: “While some children are receiving timely, appropriate care, we know that there are more who don’t, with potential long-term repercussions for their mental and physical health.”
The CQC highlighted several areas of unequal access or treatment. People from deprived areas were three times more likely to access services for mental health than those in more affluent areas, the report found. There were also racial disparities – about a third of Black men felt they had to wait for too long to get help with their mental health, and had longer stays in hospital than white men. Out of 106 respondents who had been in contact with NHS mental health services for the past two years, 13% reported waiting three-to-six months and 8% said they waited more than six months for their first appointment for treatment following assessment with the NHS mental health team.
Problems with staffing remain
Although the mental health workforce has grown, persistent problems with staffing and skill level remain, the report found, and services are facing challenges with recruitment, affecting capacity and the availability and regularity of appointments.
Other findings include:
Only a quarter of people with a learning disability were recorded on the learning disability register, which means that many people are missing out on the proactive care and treatment they are entitled to.
Despite fewer new referrals for autism diagnoses over 2023/24, the average waiting time to start an assessment reached a peak of nearly a year (328 days) in April 2024, rather than the recommended three months.
People in Black or Black British ethnic groups are more than three-and-a-half times more likely to be detained under the Mental Health Act than people in white ethnic groups.
Staff do not always understand the specific needs of people with dementia.
The report’s findings are based on inspection activity, stakeholder insight, patient surveys, statutory reports, and other sources.
Demand ‘outstripping capacity’
Responding to the findings, Minesh Patel, associate director of policy and campaigns at Mind, said: “This report brings more appalling news for people with mental health problems and their loved ones. Too many are still waiting for far too long to get the help they need in the community, and are getting more unwell while on sometimes year-long waiting lists. This means more people are reaching crisis point, and if there is a bed free locally, they are detained under an outdated Mental Health Act in hospitals that are often run-down and not fit for purpose.”
The NHS Confederation, which represents NHS organisations, described the report’s findings as “deeply worrying”. Dr Layla McCay, director of policy at the organisation, said that “the NHS is experiencing a spike in children and young people coming forward for mental health treatment and we know that not everyone is getting access to the timely care they need. The lack of capital and flat revenue growth, highlighted in the recent report from Lord Darzi, has led to demand far outstripping capacity.”
Natasha Curry, deputy director of policy at the Nuffield Trust, a think tank, said: “The latest CQC State of Care report clearly amplifies persistent stark figures and warnings about failing services and unequal access to health and social care. From social care provision, to children and young people’s health services, to maternity, dementia and dentistry – it shows access and standards of care are just not keeping up with need.” She added that next week’s Budget “needs to send a clear message that the government is serious about supporting and improving the long-term health and care of the nation.”