What We Learned from the 2025 CQC State of Care Report

The Care Quality Commission’s (CQC) State of Care 2024/25 report is one of the most important reflections of where the UK’s health and social care system really stands.

And this year’s report tells a story that’s as familiar as it is urgent: a system still held together by the determination of its people, but strained to its limits.

From workforce shortages to record waiting times and widening gaps between health and social care, the report captures a moment where compassion alone is no longer enough.

Care leaders now face the challenge of building systems that can deliver consistency, accountability, and quality in an environment defined by pressure and fragmentation.

But beyond the expected headlines about waiting times and workforce shortages, this year's report reveals something more fundamental about the state of English healthcare, and more importantly, where the gaps between policy ambition and operational reality continue to widen.

Let's look beyond the surface-level statistics and explore what this report actually means for those of us working in healthcare delivery every day.

Getting Care When You Need It Is Still Too Difficult

The CQC highlights that people cannot always get the care they need when they need it.

Only half of the people who tried to contact their GP by phone said it was easy.

Meanwhile, the number of children waiting more than a year for community health services, such as autism assessments, is now three times higher than at the start of 2023.

Access to care, the most basic expectation, is slipping. 

And these delays have ripple effects: families lose confidence, conditions worsen, and care becomes more reactive than preventative.

This isn’t just a capacity issue. It’s a coordination issue. When systems don’t talk to each other, neither do teams, and patients fall through the cracks.

Social Care Is at a Breaking Point

Perhaps the most worrying trend is the continued decline in local authority-funded social care. Twenty years ago, 1 in 12 older people received support from their council.

Today, it’s 1 in 27.

That’s not just a statistic, it’s a shift in who gets care, and who goes without. As councils tighten budgets and staffing gaps widen, care providers are forced to do more with less, often at the cost of staff wellbeing and resident outcomes.

The CQC’s findings underline that fragmented funding and disconnected systems are weakening the link between hospitals, community services, and care homes.

Older people are discharged too soon or left waiting for care packages that never arrive.

And without shared oversight, continuity of care is becoming harder to achieve.

A Workforce Under Immense Pressure

There are three times more vacancies in adult social care than in other sectors. District nurses have halved in number per person aged 65+ compared to 14 years ago.

This workforce crisis is not new, but its consequences are deepening. Care teams report that burnout, stress, and unsafe workloads are eroding morale, and ultimately, quality.

At Safe Workplace, we see this every day when speaking with care leaders.

it’s not that staff don’t care, it’s that they’re drowning in admin, policies, audits, and incident follow-ups that pull them away from what they do best, caring for people.

Waiting Times and Worsening Health Outcomes

More than two in five people said their health had deteriorated while waiting for hospital treatment. In emergency departments, nearly two million people waited over 12 hours to be admitted or discharged.

These delays have become the new normal, and that should alarm all of us. Not just because of the human impact, but because every delay compounds risk.

Without integrated data between primary, acute, and social care, it’s nearly impossible to track, learn from, and prevent these issues at scale.

Equality and Experience Gaps Remain Wide

The report also shines a light on inequality.

People in poorer areas are more likely to be readmitted to hospital within 30 days. Autistic people and those with learning disabilities still struggle to access the right care in accessible formats.

Too many women continue to receive substandard maternity care.

For a system built on the principle of universal care, these disparities are a clear signal that compliance on paper doesn’t equal quality in practice.

CQC’s call for more joined-up, person-centered systems isn’t just aspirational, it’s essential.

The Evidence Gap in Your Own Service

The report's emphasis on demonstrating quality through evidence rather than assertions applies not just to CQC inspections but to internal quality assurance. Can you quickly demonstrate:

What do your incident patterns look like across the last six months, and whether they're improving or worsening? Which staff have completed the required training, and whether that training is actually improving practice?

Are your policies being followed in practice or just acknowledged in theory? How long patients are waiting for different aspects of your service, and whether waits are growing or shrinking?

If answering these questions requires days of manual data compilation, you have an evidence infrastructure problem that will show up during inspections, but, more importantly, limits your ability to manage quality proactively.

The Integration Reality Check

The report's discussion of integration challenges between health and social care prompts questions about integration within your own organisation.

Do your incident management, policy management, training systems, and risk management processes actually talk to each other?

When an incident reveals a training need, does training automatically generate and assign? When policies update, do all affected systems and processes update accordingly?

Most healthcare organizations operate with disconnected systems that require manual effort to maintain connections between different governance functions. This creates administrative burden, compliance vulnerabilities, and missed opportunities for learning and improvement.

The Workforce Retention Question

With workforce challenges highlighted throughout the report, how is your organization addressing retention? Administrative burden that pulls staff away from meaningful work contributes to burnout and turnover.

Systems that make compliance feel like a burden rather than support for good practice demoralize staff.

Reducing administrative burden through better systems isn't just about efficiency, it's about making healthcare jobs more sustainable and satisfying, which directly affects your ability to recruit and retain skilled staff.

Glimmers of Improvement: Innovation and Local Success Stories

Despite the challenges, there are signs of progress. 

The CQC noted encouraging results where integrated care systems (ICSs) and local pilot schemes are helping people receive care closer to home.

Some providers are also starting to use artificial intelligence and digital governance tools to streamline operations and free up staff time.

These aren’t silver bullets, but they’re steps in the right direction.

They show that when care teams are supported with the right infrastructure, they can rebuild confidence, consistency, and compassion.

What This Means for Care Leaders

The CQC’s 2025 State of Care report isn’t just a warning; it’s a mirror. It reflects the cumulative impact of underinvestment, burnout, and fragmented oversight, but it also shows where opportunity lies.

For care leaders, the message is clear:

• Culture and systems must work together. One without the other will fail.

• Data is no longer optional. The shift to continuous CQC assessment will rely heavily on ongoing evidence, not just inspection snapshots.

• Accountability must be shared. Compliance can’t live in silos; it needs to flow across roles, sites, and teams.

The Role of Technology, Not as a Fix, But as a Framework 

At Safe Workplace, we believe that technology’s role in care isn’t to replace people, it’s to restore clarity.

To give care leaders one connected place to manage policies, incidents, risks, audits, and training, so that quality and governance are continuous, not chaotic.

When you remove the friction from compliance, what’s left is culture. And culture is what sustains quality long after inspections have passed.

Looking Ahead: The 10-Year Plan Challenge

The CQC report arrives as the government develops its 10-Year Health Plan, providing evidence of both the scale of challenges and the consequences of insufficient action.

CQC's interim chief executive, Dr. Arun Chopra, stated: "The Government's 10-year plan is a real chance to improve care by putting people's needs first. But for the plan to succeed, community health and care services need more support. Without this, there's a risk fewer people will be able to access good care, with vulnerable groups hit hardest."

The report provides baseline evidence against which the 10-Year Plan's effectiveness can eventually be measured. The question is whether policy ambitions will be matched with resources and structural changes needed to achieve them.

The Single Assessment Framework: A Fundamental Shift in How CQC Inspects

While the State of Care report documents current challenges, CQC is simultaneously preparing a fundamental change in how it assesses services. 

The Single Assessment Framework, currently in consultation and expected to launch mid-2026, represents the most significant shift in CQC's approach in years.

Instead of separate assessment frameworks for care homes, hospitals, dental clinics, and other service types, CQC will use one unified framework across all healthcare settings. 

This consolidation means that quality statements and evidence requirements will become more consistent, but it also means services need to think differently about how they demonstrate compliance.

What the Single Assessment Framework Means for Your Service

The shift to a single framework brings both opportunities and challenges. On the positive side, if you operate multiple service types, you'll no longer need to navigate different compliance requirements for each. 

Quality improvement approaches can become more consistent across your organisation.

The challenge lies in CQC's accompanying move toward continuous compliance monitoring and data-based assessments. 

Rather than periodic inspections where you present evidence at a specific point in time, CQC increasingly expects services to maintain continuous evidence of compliance through data that can be shared and analysed ongoing.

This isn't just about being "inspection-ready"; it's about operating in a way where compliance data flows continuously and can be accessed by regulators when needed. 

For many healthcare organisations, this represents a fundamental shift from episodic evidence compilation to continuous evidence infrastructure.

The Data Integration Imperative

CQC's openness to compliance software integrating directly with their reporting systems through APIs signals their recognition that modern compliance requires modern infrastructure. 

Enter healthcare GRC tools like Safe Workplace.

Services that can automatically generate and share compliance data will find themselves better positioned than those still manually compiling evidence from disconnected systems.

This matters because the State of Care report's findings about access challenges, workforce pressures, and quality variations all point to the need for better data visibility, not just for regulators, but for service leadership trying to manage complex operations.

The Single Assessment Framework combined with data-driven continuous compliance, creates an environment where having connected systems that automatically maintain evidence becomes less optional and more essential.

When the CQC can request compliance data at any time and your systems can generate it instantly, the administrative burden of compliance decreases dramatically while your assurance increases proportionally.

Evidence Demands Action

The CQC’s State of Care report doesn’t just measure performance; it measures trust. Trust between providers and the public. Between staff and leadership.

Between systems that should be connected but often aren’t.

We don’t fix that overnight. But by rebuilding clarity, culture, and confidence, one system, one process, one team at a time, we can begin to change what “good care” looks like, and more importantly, how it feels.

Because compliance shouldn’t feel like chaos. It should feel like confidence.

Healthcare organisations looking to strengthen their governance and compliance infrastructure can explore how connected systems reduce administrative burden while improving evidence management. 

Safe Workplace provides integrated platforms for incident management, policy management, training, and compliance monitoring designed specifically for healthcare operational realities.

Book a demo to learn more about building evidence infrastructure that supports rather than burdens your team.