CQC Report Highlights Growing Inequalities and Pressure on Social Care Market

The Care Quality Commission (CQC) has warned that England’s health and social care system is struggling to keep pace with rising demand, with persistent inequalities affecting access to services, care quality and outcomes.

Published on 23 October 2026, the regulator’s annual State of Care 2025/26 report identifies increasing pressure across health and adult social care, despite improvements including more GP appointments, greater use of digital solutions and shorter waits for planned hospital treatment.

Children and young people face some of the sharpest challenges. More than 80,000 are waiting over a year for community health appointments, almost 11 times the number of adults. The number waiting for their first contact with mental health services has also increased by 31% over two years. Meanwhile, declining health visitor and school nursing numbers are raising concerns about early identification of needs and safeguarding.

The report also highlights inequalities linked to deprivation, ethnicity and location. Children in the most deprived areas experience more than twice the level of tooth decay seen in the least deprived areas. CQC also identified variations in maternal readmissions by ethnicity, alongside differences in primary care staffing and access to annual health checks for people with severe mental illness.

Adult social care is undergoing significant structural changes, with homecare provision becoming more fragmented as smaller providers enter the market, while care home beds are increasingly concentrated in larger facilities. CQC attributes these trends partly to economic pressures and differences in local authorities’ ability to plan and shape services around local needs.

The regulator warned that financial pressures are also encouraging some providers to prioritise people who can fund their own care, potentially limiting choice and availability for those relying on council-funded support. Although staffing vacancy and turnover rates have fallen slightly, concerns remain over reduced international recruitment and leadership, which CQC identifies as an area requiring improvement.

However, the report highlights examples of effective local commissioning. Wigan Council received an outstanding assessment from CQC for its collaborative approach to shaping care provision and tackling health inequalities. Its work to expand local services has reduced reliance on placements outside the borough, while a jointly delivered reablement service has helped more people avoid ongoing support needs.

Chris Badger, CQC’s Chief Inspector of Adult Social Care and Integrated Care, highlighted the need for sustainable funding, stronger commissioning and investment in leadership to build more resilient care services. He also emphasised that reforms must address workforce challenges, prevention and inequalities together.

CQC Chair Baroness Julia Neuberger highlighted the connections between pressures across the system, including how gaps in social care can delay hospital discharges and shortcomings in community mental health provision can push people towards crisis services.

The report calls attention to the need for coordinated action across government, commissioners, providers and regulators to ensure improvements in care reach people consistently, regardless of their circumstances or where they live.

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