The Care Quality Commission checks whether hospitals, care homes and care services are meeting government standards. Visit our website at www.cqc.org.uk.

The shape of health and social care provision

In this section of the report, you can find out about the changing number and types of services available to people.

In preparing this report, we have looked at the information we hold about the providers and services we register across the country, drawing also on key external sources of information.

Health and social care is constantly evolving and with it providers and services are also changing.

The data we held in July 2011 about registered care services in England shows there are:

378 NHS trusts delivering health care in 891 hospitals across England.
Almost 2,500 independent hospitals and clinics offering a diverse range of services.
4,608 care homes with nursing and 13,475 care homes without nursing, although these numbers are not mutually exclusive so some locations may be registered as both.

Changes in care

Health care

There are now just over 140,000 beds available each night in NHS hospitals in England. This figure has reduced by around 2,000 since last year. The ongoing increase in day treatment offered in the NHS has reduced the length of time people spend in hospital, however, and increased overall capacity.

Adult social care

We have continued to see the types of care offered develop to enable people to live at home for longer. The number of residential care services fell by 10 per cent between 2004 and 2010 while, during a similar period, the number of agencies offering care in people’s homes went up by more than a third.

We found that, of those people living in care homes, around 45 per cent funded their places privately rather than being paid for by the state. In addition, some people funded by local authorities have their care home fees ‘topped up’ by relatives or other third parties.

Case study
Community health in Kent

A map showing the location of Kent community health services

The merger of Eastern and Coastal Kent Community Health NHS Trust and West Kent Community Health in April 2011 created one of the biggest providers of community care in England.

The merger came about because of the Transforming Community Services (TCS) programme, in which all PCTs were required to separate their provider and commissioning functions. An aim of TCS was to encourage new and different providers, increase competition, and improve the quality of services.

The formation of the new Kent Community Health NHS Trust brought together 5,700 staff including community nurses, physiotherapists, dieticians, podiatrists and many other healthcare professionals – providing healthcare to 1.4 million residents. It has 12 community hospitals, some with minor injury units, and a walk-in centre.

The trust has used the merger as an opportunity to take a good look at the standards of care provided by its workforce. It wanted to find ways to increase staff ownership of the new essential standards of quality and safety. These included software to help each service critically self-assess their area against the standards, staff briefings outlining the new standards, and the Staff Guide.

This guide, developed by the trust’s staff themselves, is an example of how organisations are using the standards to improve patient safety. It is an easy to read booklet that makes it clear to staff what the standards mean for them in reality. Using plain English, the guide prompts individuals to consider the action they take day-to-day. It demystifies the legal regulations and reminds staff that regulatory compliance is really about patient outcomes and experience.

“The introduction of the essential standards of quality and safety and quality, together with front line inspections, has provided health and social care providers with an opportunity to change their approach to compliance. Our Staff Guide is one example where we have used the introduction of the standards to remind staff about their responsibilities”, said Jane Burgess, Standards Assurance Manager at the trust and author of the guide.