You are currently using an unsupported browser which could affect the appearance and functionality of this website. Please consider upgrading to the latest version or using alternatives such as Mozilla Firefox, Google Chrome or Microsoft Edge.

RCOG responds to ’The State of Health Care and Adult Social Care in England’ CQC report

20 Oct 2023

The Care Quality Commission has today published ‘The state of health care and adult social care in England’, providing a comprehensive picture of the system, and the experiences of staff and patients.

Responding to the report, Dr Ranee Thakar, said:  

“This report reflects a system chronically stretched to its limit, with NHS pressures impacting the health and wellbeing of staff, affecting patient care, and compounding unacceptable inequalities experienced by both ethnic minority staff and communities.

“The impact on women cannot be underestimated. Maternity service pressures mean women are not always receiving the care they deserve. Too many people with debilitating gynaecological conditions are waiting far too long for hospital treatment. Similarly, difficulty accessing general practice is leaving women without essential diagnoses and timely treatment.

“We are committed to solutions, working with the NHS and all our partners to deliver improvement programmes and innovations in care. However, the significant pressure that services delivered by our members are currently experiencing, and the impact felt by patients, will only be resolved with sufficient, long-term NHS investment by the Government.”

The report shows record numbers of people waiting for planned care and treatment, with over 7 million people on elective care waiting lists. While it is encouraging to see decreasing numbers of patients waiting more than 78 weeks, gynaecology elective care waiting lists continue to grow faster than any other specialty, and is one of the highest specialities in terms of absolute increases in waiting list numbers.

The CQC report echoes the findings of our Left Too Long Report, where 75% of surveyed women reported that their symptoms have worsened while on gynaecology waiting lists. The RCOG remains committed to actively seeking solutions to ensure fair and equitable prioritisation of NHS care for gynaecology conditions. An important part of this is improving understanding of the serious impact of gynaecological conditions across the NHS, and ensuring women and people with these conditions feel they are being taken seriously.

Difficulties accessing general practice appointments also impact women’s health across their life course. This is the first point of call for many women’s health needs, such as contraception, menstrual health problems, fertility issues and menopause care. Delayed access to seeing a GP will prolong the time women wait for the right care, including referral for essential hospital treatment.

The report takes a deep-dive into the challenges facing NHS maternity services. Feedback gathered from patients by the CQC describes staff going above and beyond for women and their families, but with some still not receiving safe, high-quality care. Ten percent of maternity services were rated as inadequate overall, with 39% rated as requires improvement, with themes around leadership, staffing levels and communication emerging from the CQC maternity inspection programme.

Delivery of NHS England’s Three year delivery plan for maternity and neonatal services, fully supported by Government investment, will be crucial to addressing these challenges. The RCOG will continue to work closely with our Fellows and Members, with our colleagues at the Royal College of Midwives, the NHS and the Government to support progress.

The CQC report also focuses on inequalities in maternity care experience and outcomes for ethnic minority groups. The College is committed to doing all it can within its remit to support the delivery of maternity safety improvement programmes and developing clinical solutions to reduce these inequalities, alongside tackling racism within the obstetrics and gynaecology workforce, as one of our President’s priorities.

The CQC report shows the impact that higher demand and acute pressure in the health and care system is having on the health and wellbeing of staff, staff retention and recruitment. This includes high vacancy rates and staffing levels below the recommended workforce numbers in midwifery and in leadership teams. The RCOG has delivered the first phase of an Obstetrics workforce staffing tool, and is keen to continue work with the Department of Health and Social Care to make the tool available for services for future workforce planning.

The publication of the NHS Long Term Workforce Plan this year was an important milestone, which the RCOG welcomed with some caution. The ambitions set out will only be achieved with sufficient resource and investment for the full 15 years of the plan, and a huge commitment across the NHS to its successful implementation.


  • To read full CQC report click here.
  • To find out more about the RCOG maternity safety programmes go here.
  • To find out more about the RCOG’s ambition for race equality in obstetrics and gynaecology, here. 
  • You can read about the case for a cross-government strategy to reduce health inequalities, here.
  • Clinical and research
  • Careers and workforce
  • Policy and governance
  • Pregnancy and birth
  • Gynaecology