Risk of “failing the future” if children and young people don’t get the care they need, says the Care Quality Commission (CQC)

Concerns were raised in the report over the long-term health of children and young people due to delays in treatment which may have significant consequences.

The report highlights the need for treatments and interventions within specific age and developmental stages which are being hampered by long wait lists. State of Care also points to the effects of wait times on children’s education due to ongoing symptoms.

Safey concerns are also noted in emergency services which are also impacted by delays and low numbers of qualified staff, including children’s nurses and in subjects including safeguarding and recognition of sepsis.

CQC found that schoolchildren living in the most deprived areas of England are more than twice as likely to experience tooth decay than those living in the least deprived areas.

31% of parents who participated in State of Care reported difficulty in accessing dental care for their child. Dental appointments are usually offered during school hours, which is inconvenient, and many are struggling to register with NHS dentists. The report also found instances of children being left in pain due to a lack of emergency appointments, whilst 18% of 25 to 34-year-olds are resorting to DIY dentistry

The numbers of children and young people seeking support for their mental health is increasing, with 1 in 5 8–26-year-olds experiencing a mental health disorder. Long waiting times are leading to a lack of trust in mental health services, CQC reports.

CQC’s survey of 1,600 adults in England shows a decrease in access GP appointments compared to previous years, with 59% of respondents saying they had struggled to access a GP appointment in 2023 – 2024.

CQC found that 5 million people had needed to wait for 2 weeks to access a GP appointment – an 18% increase from 2020. An additional 1.4 million had waited for over 4 weeks.

Pressure on GP services has increased as the number of patients registered with a GP in England rose by 5% between March 2020 and March 2024 from 60 to 63 million.

The report found that people in rural areas tend to experience higher waiting times than those in urban areas such as London.

CQC found major health inequalities for autistic people and people with a learning disability, with life expectancy remaining significantly lower than that of the general population.

The report found that autism is underdiagnosed due to long wait times, which is increasing health inequalities for autistic people.

NHS England data suggests that 80% of people aged 14 and over on the register of people with a learning disability received a health check in in 2022-23, which was a vast improvement from 2018-19, when the figure was just 59%.

However, not all GP surgeries maintain an up-to-date register. CQC states, “through our regulatory work, we have seen examples where autistic people and people with a learning disability have not been supported to attend routine medical screening, such as breast screening, either by their social care service, or by their GP as part of their annual health check.”

CQC report a long-standing concern over the mental health of Black men in England, particularly around timely access to care, long wait times for talking therapies and lack of follow-up care.

This year’s report examined the responses to the NHS Community mental health survey which states that 8% of respondents had waited for over 6 months for their first appointment for treatment, and 56% said their mental health deteriorated as they waited for care.

Record numbers of people are being diagnosed with dementia in England, with 490,163 people having a diagnosis in July 2024.

In response, the CQC is developing a cross-sector dementia strategy shaped around the question, ‘How can CQC use its role to improve the experience of using health and social care services for people living with dementia and their carers?’

The first phase of this work has taken place and involved CQC engagement with stakeholders, including people with lived experience of dementia and their carers.

Their findings include:

• hospital staff do not always understand the specific needs of people living with dementia, which can impact the quality of care and treatment
• busy hospitals can be distressing for people with dementia, especially where there are long wait times for treatment
• family members and other unpaid carers play an essential role in supporting people with dementia to access services and receive appropriate care, but this their own needs are often neglected as a result

State of Care found that people who live in the most deprived areas of England were nearly 3 times more likely to be admitted to hospital for potentially avoidable treatment if care in the community had been provided in a timely and effective way.