CQC’s State of Care Report 2023/24 | BASW England Response

BASW England recognises the critical insights offered in the Care Quality Commission’s (CQC) State of Care Report 2023/24 but notes with concern the pervasive issues in access, safety, and service quality. For social workers, who are on the frontline facing these systemic pressures, the findings reaffirm the urgent need for enhanced support, investment, and reform across the sector.

The report reveals widespread struggles with accessing primary and community services, including GP and NHS dental services, with high demand resulting in record waiting times and regional disparities. Rural and deprived areas are experiencing significant service gaps, amplifying health inequalities. Social workers play an essential role in these settings, helping to bridge gaps in access and advocating for seldom heard populations. Yet, without additional resources and support, social workers face additional pressure to meet these rising demands.

The findings in mental health services highlight particularly acute challenges, with demand for care soaring—especially for children and young people. Notably, people from deprived communities, women, and certain ethnic minority groups face greater barriers to accessing mental health support, leading to critical delays and disparities in care. Social workers are essential in supporting these communities, providing person-centred advocacy and promoting continuity of care. However, this work is severely limited by chronic workforce shortages and high caseloads, issues that BASW together with SWU are taking action through our campaign for better working conditions. 

The report’s assessment of adult social care paints a troubling picture. Delays in assessments, insufficient care home availability, and constrained home care provision mean that increasing numbers of people cannot access necessary support. These capacity issues have led to lengthy hospital discharge delays, compounding pressures on the acute care system. Social workers are vital in facilitating people to be discharged safely, advocating for the rights and well-being of older adults and people with disabilities. However, the current conditions often hinder their ability to provide timely, dignified care.

BASW England also notes the report’s focus on specific areas of concern, including maternity services, the Deprivation of Liberty Safeguards (DoLS) system, and support for autistic people and those with learning disabilities. With nearly half of inspected maternity locations rated as requiring improvement or inadequate, and critical delays in DoLS authorisations, there is an urgent need for comprehensive reform to protect people’s rights and safety. Social workers are fundamental in safeguarding individuals within these vulnerable populations, but without the necessary structural and resourcing changes, the profession’s response in addressing these issues is compromised.

The report’s evaluation of Integrated Care Systems (ICSs) raises further concerns. ICSs face significant obstacles in addressing local health inequalities due to resource shortages, workforce challenges, and competing priorities. Social workers, as advocates for social justice and connectors across services, are critical to the success of ICSs and the pursuit of equitable care. However, these systems must address the gaps in governance, data access, and capacity for social work to be effectively integrated into care planning and delivery.

BASW England is calling for urgent, coordinated action across government and care stakeholders to address the under-resourcing and severe capacity, quality, and safety issues across the care system. Social workers are crucial in navigating these crises, but they cannot continue to shoulder these burdens without the wider structural issues highlighted in this report being addressed. 

Jacqueline Mahoney (Vice Chair BASW England National Standing Committee) commented: 

“This report reminds us of the troubling state of England’s care systems and highlights the unsustainable pressures that social workers, as well as those who rely on our services, are facing. Social work must be empowered with the resources and support needed to provide effective advocacy, access, and person-centred care to those who need it most. Without decisive action, the system risks further compromising the care and rights of the most vulnerable.”

BASW England urges for immediate and meaningful investment in the social work workforce and the workforce supporting the whole sector, and for reform that places the needs and rights of individuals at the forefront of the health and care agenda.