The State of Health Care

Most of the care that we see across England is good quality and, overall, the quality is improving slightly according to the latest Care Quality Commission report titled The state of health care and adult social care in England 2018/19.

“But people do not always have good experiences of care and they have told us about the difficulties they face in trying to get care and support. Sometimes people don’t get the care they need until it’s too late and things have seriously worsened for them,” says the summary of the report.

The report features the impact of poor care on those with a learning disability or autism.

“Too many people with a learning disability or autism are in hospital because of a lack of local, intensive community services. We have concerns about the quality of inpatient wards that should be providing longer-term and highly specialised care for people. 

“We have shone a spotlight this year on the prolonged use of segregation for people with severe and complex problems – who should instead be receiving specialist care from staff with highly specialised skills, and in a setting that is fully tailored to their needs. 

“Since October 2018, we have rated as inadequate 14 independent mental health hospitals that admit people with a learning disability and/or autism, and put them into special measures. This is an unacceptable situation.”

 “A better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments. We must all work together to make this happen. 

“We also know that people with the most severe and enduring mental ill-health do not always have access to local, comprehensive rehabilitation services and are often in inappropriate placements far from home. 

“This weakens support networks and the ability of family and commissioners to stay in close contact, sometimes with devastating consequences. We are seeing issues with the availability of care. There has been a 14% fall in the number of mental health beds from 2014/15 to 2018/19. While this is in line with the national policy commitment to support people in the community, it is vital that people in crisis can access support when needed. 

“All of this is underpinned by significant issues around staffing and workforce. Our inspectors are seeing too many mental health and learning disability services with people who lack the skills, training, experience or clinical support to care for patients with complex needs. In the majority of mental health inpatient services rated as inadequate or requires improvement since October 2018, the inspection reports identified a lack of appropriately skilled staff as an issue.”

To read the full report go to

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