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The independent regulator of health
and social care in England |
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A regular update for providers and professionals working primary and community care
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 Our annual State of Care report, assessing the quality of health and adult social care in England, has been published.
The report warns that the system remains under significant strain as it prepares for a major shift from hospital to community-based care. While there are examples of innovation, community services need greater investment to deliver the ambitions of the government’s 10-Year Health Plan.
In primary and community care demand for GP services continues to rise, putting increasing pressure on the system. More people are registering with GPs and booking appointments, but the number of fully-qualified doctors isn’t keeping pace. While there’s been a boost in trainee GPs, the overall availability of experienced practitioners has slightly declined. Patients generally report positive experiences, but many still struggle to get through by phone, and access remains uneven, especially for those in deprived areas or with complex health needs.
When GP services fall short, people often turn to A&E, particularly in communities facing greater deprivation. Dental care is also under strain, with activity levels still below pre-pandemic standards and wide regional differences in service delivery. Children in poorer areas are much more likely to be hospitalised for tooth extractions due to decay. Meanwhile, district nursing, key to shifting care into the community, has seen a steep drop in staffing, leading to more fragmented care. Although most GPs are optimistic about the role of AI in improving services, its use remains limited, and public confidence in its benefits is still mixed.
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Julian Hartley has stepped down as Chief Executive of the Care Quality Commission (CQC) with immediate effect. Dr Arun Chopra, Chief Inspector of Mental Health, has taken on the role of Interim Chief Executive until a permanent successor is appointed.
Julian said the decision was difficult but necessary due to his previous role at Leeds Teaching Hospitals NHS Trust and the ongoing inquiry into maternity services there. He expressed his regret to affected families and pledged full support for the inquiry. Reflecting on his time at CQC, Julian said he was proud of progress made in improving culture and listening to people, and confident the organisation will continue to strengthen public trust in its work.
 We’ve launched a public consultation on proposals to improve how we assess, make judgements, and award ratings for health and care services.
The proposals build on earlier engagement and external reviews by Dr Penny Dash, Professor Sir Mike Richards, and the Care Provider Alliance. They aim to make our approach clearer, simpler, and more trusted through collaboration and co-design with people who deliver and use services.
Changes include reintroducing rating characteristics, replacing quality statements with assessment questions, and strengthening the role of professional judgement.
An equality impact assessment has been published alongside the consultation. The consultation is open to everyone until 5pm on 11 December 2025.
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- We have published a Brief guide on Care of children and young people in inappropriate settings. This guide sets out what our inspectors look at when checking the care of children and young people who may be placed in an inappropriate setting.
- Pension Credit offers more than financial help – it can unlock extra support worth hundreds of pounds a year, from help with housing and energy costs to free NHS dental treatment and TV licences for over-75s. Please share this information or repost @DWP messages to help reach eligible pensioners. Find out what you could get and how to apply. Eligibility criteria apply.
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