The state of health care and adult social care in England 2024/25

Key findings

• Overall, people aged over 65 reported having a positive experience when it came to being discharged from hospital and receiving follow-up care in the community, with most people agreeing that it helped them stay independent. However, a few people said they didn’t feel ready to be discharged, and others said the follow-up care didn’t meet their emotional needs.
• The number of people being diagnosed with dementia is increasing. However, staff in health and social care do not always understand the specific care needs of people with dementia and providers do not always have the knowledge of person-centred approaches and dementia-friendly environments.
• Despite the same issues being reported over the last 10 years, efforts to address the underlying causes of poor maternity care have continued to fall short. Too many women are still not receiving the high-quality maternity care they deserve, with some women with protected characteristics under the Equality Act 2010 remaining at greater risk of harm. The national maternity review, announced in the 10-year plan, presents a real opportunity for change.
• Autistic people and people with a learning disability can find it challenging to get an appointment with their GP, because booking systems may not offer the flexibility and choice that they need. Our research also suggests that there are not always the right reasonable adjustments in place to make primary care a positive experience.
• In 2024/25, we delivered a series of Independent Care (Education) and Treatment Reviews (IC(E)TRs) into the care and treatment of autistic people and people with a learning disability in long-term segregation. Some reviews noted there were no discharge plans, or even that some people had not been in discussions about discharge or leaving long-term segregation.
• Longstanding inequalities in mental health care for Black men continue – staff must be properly trained to fight racism and support Black men with respect and understanding, and services need to be held accountable when they fail to do the right thing.
• Between January 2023 and December 2024, the number of children and young people waiting to access community health services increased by 26%. This compares with an increase of 19% for adults waiting for community services. The number of children and young people waiting for over a year for these services increased almost threefold in this period.
• Our joint targeted area inspections with Ofsted, His Majesty’s Inspectorate of Constabulary, Fire and Rescue Services, and His Majesty’s Inspectorate of Probation show that children with special educational needs or disabilities are having to wait too long for their needs to be assessed, which makes them more vulnerable to serious youth violence.
• Applications to authorise the deprivation of a person’s liberty have continued to increase significantly over the last decade, far beyond the levels expected when the Deprivation of Liberty Safeguards (DoLS) were designed, often resulting in lengthy delays.
• Issues with the DoLS system continue to disproportionately affect certain groups of people, as respondents to our survey of Mental Capacity Act leads in hospitals highlighted particular concerns around older people, including those with dementia.
• Our local authority assurance assessments continue to show wide variation in how local authorities are managing DoLS applications – while some local authorities report not having any backlogs, others are still struggling to meet demand.