A new report has condemned England’s health and care system as “extremely difficult” to navigate, with patients and carers suffering from burnout, distress, and worsening health due to poor coordination. The investigation, led by the Health Services Safety Investigations Body (HSSIB), uncovered frequent failures in the system, particularly in managing long-term health conditions. The report highlights how these failures contribute to patient harm, longer hospital stays, and increased treatment costs.
The findings reveal that 41% of adults and 17% of children in England live with at least one long-term health condition, yet the health and care system often struggles to provide the necessary support. Patients with complex needs regularly miss vital appointments, experience delays in care, or have their treatments overlooked, which can lead to more serious health problems requiring intensive care in the future.
The report details the difficulties faced by patients and caregivers in communicating with multiple health and care providers. Carers and patients are forced to repeatedly share their health histories, as the system is not integrated, and information does not flow smoothly between different organizations. This lack of coordination is taking a significant toll on individuals, leaving them feeling frustrated, angry, guilty, and physically and mentally exhausted.
One key finding of the investigation is the increasing number of patients disengaging from the system due to fatigue and frustration. The report warns that this disengagement can result in further deterioration of health, as patients avoid seeking necessary care.
Neil Alexander, a senior safety investigator at HSSIB, emphasized the complexity of long-term care, acknowledging the challenges providers face, especially in the context of limited resources. However, he stressed that inadequate care coordination can lead to severe consequences, including mental and physical decline, longer hospital stays, and a higher demand for intensive treatments.
“The stories shared with us were powerful and heartbreaking,” said Alexander. “Patients and carers expressed deep anguish, exhaustion, and a loss of trust in a system they felt was working against them. The frustration of not being able to access the right care, or speak to the appropriate staff, was overwhelming for many.”
Alexander also highlighted the administrative burdens faced by patients, carers, and health staff, urging national organizations to focus on improving the capacity and capability of the workforce to provide personalized, coordinated care. Reducing this burden, he argued, would alleviate the anxiety and fear experienced by patients and carers who often feel isolated and unsupported.
The report also raised concerns about out-of-hours care, where a significant “information gap” leaves health and care providers without the full details they need to deliver appropriate care. Investigators found that the role of the “NHS care coordinator” is inconsistently implemented across different areas, leading to varying levels of support for patients. HSSIB is calling on government ministers to ensure that patients and carers have access to a single point of contact when needed, improving communication and coordination.
In response, a spokesperson for the Department of Health and Social Care acknowledged the challenges faced by individuals with long-term conditions and the strain on the healthcare system. They pointed to the Labour government’s plans for neighborhood health centers, which aim to provide integrated care for long-term conditions in a single location within communities, as a potential solution to improve care delivery.
This report comes at a time of increasing pressure on the NHS and care organizations, as they continue to deal with mounting demand and strained resources. The findings call for urgent action to address the systemic failures that are causing harm to some of the most vulnerable patients in the country.
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