Published 24th October

The Care Quality Commission’s State of Care 2024/25 report paints a deeply concerning picture. Behind every statistic in this report is a patient who expects safe, timely, and compassionate care, yet these findings show that the health and care system is often falling short delivering these basic standards. While the report provides some examples of innovation happening in pockets across the country, we have a long way to go to realise the much-needed potential of the 10 Year Health Plan. 

Access 

While many people continue to report good experiences of GP care, demand is continuing to rise, and too many patients are struggling to get the help they need when they need it. 

When people can’t access their GP, they often turn to other parts of the NHS for support, including A&E, which adds pressure elsewhere in the system. Access to NHS dental care also remains deeply concerning, particularly for the rising number of children, and especially those in deprived areas, requiring decay-related extractions. 

Maternity services

Safe and equitable maternity care is critical in ensuring children have the best start in life. We have seen far too many reviews and inquiries with not enough action taken to genuinely improve services. The last three State of Care reports have shown declining standards, with Black and Asian women continuing to face unacceptable disparities in outcomes. 

Baroness Amos recently stated that there was no time to co-produce the upcoming national inquiry into maternity care in England. However, the solution to these issues lies in genuinely valuing patient experiences and voices, listening to their voices and acting on their concerns. 

Health inequalities 

Health inequalities have been a persistent theme in recent State of Care reports and comes up consistently throughout all areas reviewed in the past year. While disappointing, it is unfortunately not surprising that yet again patients from minoritised backgrounds, those living in areas of high deprivation, autistic people, and people with a learning disability are facing the most barriers to safe and effective care. 

We know from our work with patients that the social and structural determinants of health, such as where someone lives, their ability to work and their income, has a detrimental impact on their access to care and overall health. 

The 10 Year Health Plan provides insight into how the Government plans to tackle health inequity, but it is high time to turn these plans into action, to ensure patients have equitable access to care. 

Unsafe discharge from hospital

The report rightly highlights the significant need to improve the process and experience of hospital discharge, especially for older people. A lack of capacity in the social care sector is certainly a factor, but as this report and other research indicates, it is not the sole cause of unsafe or difficult discharges. February 2025 work from Healthwatch England highlights the importance of patient involvement in discharge plans. It highlights that many patients still do not receive proper support of information when leaving hospital, and are often excluded from discharge planning discussions.  

Mental health services

Demand for mental health support continues to rise, yet too many people are still waiting far too long for care. When help isn’t available quickly, people’s conditions can worsen and is often compounded by challenges like housing or employment insecurity. 

Recruitment and retention issues mean that many services are understaffed, leaving staff unable to deliver the person-centred support patients need. Meanwhile, poor co-ordination between services and a lack of continuity of care can leave people feeling lost in the system. 

People deserve timely, person-centred care that supports recovery and dignity. To achieve that, the system must invest in services, workforce, and joined-up pathways that truly put patients first. 

Commenting on the report, Professor Alf Collins, Trustee, said: 

“This decline cannot continue. Health and care services must improve, and patients must be at the centre of every reform, every redesign, and every decision about the future of the NHS. True partnership with patients is the only way to rebuild confidence in the system and ensure care is accessible, safe, equitable, compassionate, and fit for the future.” 

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