The Care Quality Commission has published two new reports: the most recent COVID-19 Insight report and findings from our latest provider collaboration review (PCR). These share findings from activity in urgent and emergency care over the pandemic.
Local systems are starting to develop recovery plans and our reports can help them consider how to embed the best of the innovations developed in response to the pandemic. Lessons from this winter must be learnt and planning for next winter must start now to ensure these hard-learnt lessons of the current crisis are not lost.
We found that urgent and emergency care services continue to experience exceptional pressure. This is due to a combination of regular winter pressures and the pandemic. We have seen some good examples of how systems are working together to respond to this. However, we are continuing to find significant problems of access and capacity in these services, and whole systems need to work together to make further improvements if providers are to manage future pressures better.
We want to help everyone involved in health and social care to work together to learn from the pandemic. This includes:
- sharing and reflecting on what has gone well
- understanding and learning from the experience of what hasn’t
- identifying challenges and barriers, and how these have been overcome.
To support this vital learning, we have published the full findings of our provider collaboration reviews of urgent and emergency care in eight areas of England in October 2020.
Looking forward to next winter and beyond, the main challenges that we identified for systems are how to:
- Develop and build on relationships. Provider and system leaders across all health and care sectors must collaborate to meet the needs of their local populations. Our work shows that it is crucial to establish good and meaningful relationships across local areas and systems.
- Share important information. Urgent and emergency care services will be able to help people most in need of care if they achieve lasting solutions for information sharing.
- Understand staffing. Workforce strategies should cover a local system or area, not just localised services. This will ensure the right numbers of people and skills.
- Understand inequality. Leaders must work hard to understand the inequalities that exist in their areas and further develop strategies to address them.
- Embrace technology. Rapid advancement of new ways of working have shown that often there is an opportunity to improve people’s access to care and their experience.
This month’s insight report supports the findings of the PCR report. It looks at inspections of acute hospital emergency departments which took place in winter 2020. The report identifies the key factors affecting services’ ability to provide a good standard of care in emergency departments:
- Changes to the environment
- Onward capacity from the emergency department to other parts of the hospital
- Delayed transfer of care
- Staffing levels and absence
- Leadership and governance
- What systems were in place to mitigate risk.
The insight report also shares how chief pharmacists and medicines optimisation leaders in NHS trusts assured themselves of safe medicines practice during the pandemic.
We would encourage system leaders and providers to review these reports and to consider how they might use the learning now to work together and plan for the coming winter. This will help ensure people can access high-quality safe care in the right place, at the right time.