Stoke-on-Trent: CQC publishes its review of how local health and social care systems work together

The Care Quality Commission has published its findings following a review of health and social care in Stoke-on-Trent.

This report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for people aged 65 and over living in a local area.

CQC found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs.

CQC reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This meant that:

• People found it difficult to access a GP appointment in a timely way and as a consequence many people went straight to A&E or were referred to A&E by their GP.
• Older people often had poor quality experiences when they were admitted to hospital, including long waits in A&E before being admitted to a ward that met their needs.
• Older people were often delayed in hospital after they were ready to return home or move to a new care setting. In some cases people suffered avoidable harm or their condition deteriorated as a result of delays.
• People’s needs and care packages in the community were not reviewed as regularly as they should be. 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.

Professor Steve Field, Chief Inspector of Primary Medical Services and Integrated Care, said:

"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. We have heard of a history of poor relationships across the system with limited joint working. The 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 together urgently to improve services for people, and in particular develop how the system 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.

“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.”

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