Health and Social Care – The NEN – North Edinburgh News

Burnham: Time for problem-solving, not point-scoring

FIXING THE BROKEN SOCIAL CARE SYSTEM

Visiting a care home today [Wednesday 29th July], the Prime Minister will say he is making the choice to fix the broken social care system by finding common ground across party lines to tackle the big issues.

He will draw a line under decades of decline and a refusal to tackle these problems head on, calling on all political parties to focus on solving problems and find solutions together.

He will reiterate the need for a new kind of politics that puts differences aside in order to come together and face up to the challenges that Westminster has left unaddressed for too long.

Delivering on that pledge, he has invited the leaders of the two main opposition parties, Kemi Badenoch and Ed Davey, to meet with him today to kickstart this work and discuss how to drive urgent reform on social care.

Speaking ahead of his speech, Prime Minister Andy Burnham said: “Last week I said we needed a different kind of politics: problem-solving, not point-scoring. Nowhere is that more urgent than social care.

“For decades, governments have kicked this issue down the road because they’ve seen it as too risky, too difficult, and too complicated.

“Politicians might have different views but I’m serious about fixing this issue and to do that, we have to find common ground and listen to others to find a way forward.

“It’s time to draw a line under people playing politics when the human cost of that means carers struggling, families paying the price and our NHS buckling under the strain.

“This comes down to a choice. We can carry on passing the problem to the next generation, or we can face it head on and work together to build a care system that gives people dignity, security and the support they deserve.

“This is about bringing back hope that we can finally fix the difficult issues that have been ignored for too long, and making Britain believe again. That’s why I’m making this choice and I’m prepared to put everything I’ve got behind it.”

At the speech he will be joined by the Health and Social Care Secretary and Baroness Louise Casey, who is leading the Independent Commission on Adult Social Care which will draw up recommendations to deliver a National Care Service.

She will also launch the Big Conversation on Care today, which will give the public their chance to share their views and help shape the future of adult social care in England so that it is designed for the people it is there to serve.

It will be open to everyone through a new online platform, starting off the conversation by asking people about the values and principles we should all expect from a care system.

Baroness Casey of Blackstock said: “For too long, we have been stuck in the same cycle: crisis, promises of reform, another review, and then retreat, while the people who need care, and their families, bear the brunt.

“Fixing adult social care is about far more than money. People are already paying for failure through council tax, pressure on the NHS, their savings, giving up work, and the forced sale of their homes.

“The choice is whether we keep putting money into a system that is unfair, unpredictable and broken, or have an honest conversation about how to build something better.

“That is why we need a public conversation on care that tackles the tough questions. It’s only by facing up to this problem together that we can fix social care once and for all.”

Dedicated specialist support for families affected by childhood dementia

Scotland has taken an ‘important step forward’ in recognising childhood dementia by funding specialist support for families affected by it, Health Secretary Neil Gray has said.

The Scottish Government is providing £118,873 to Alzheimer Scotland to support the employment of two childhood dementia development officers – the first country in the United Kingdom to fund this kind of dedicated support.

The development officers will be responsible to raising awareness of childhood dementia, developing understanding amongst professionals, and ensuring a support network is in place for families affected by it.

Childhood dementia is a term used to describe a range of rare, inherited conditions that affect children and young people. Often life-limiting, it can lead to symptoms more commonly associated with adult dementia – including loss of speech, memory, mobility and the ability to carry out everyday tasks.

Mr Gray said: “My sympathies go out to any young people and families affected by childhood dementia.

“Childhood dementia may still be considered rare but for many it can be life-limiting. That’s why we’re doing all we can to maximise life expectancy and to ensure families have access to the support and care they need.

“The First Minister and I recently met with campaigners and families living with childhood dementia. I thank them for sharing their experiences and that meeting had a profound impact on us.

“That’s why I’m pleased we have become the first country in the United Kingdom to provide specialised support, through Alzheimer Scotland, for childhood dementia. It’s an important step forward in recognising the impact of childhood dementia in Scotland and providing the care and advice to those who need it.”

Improving social care pay and conditions

Collective bargaining arrangements introduced

A new voluntary social care bargaining body will help improve pay and conditions for more than 110,000 workers.

It will provide a forum for trade unions and care providers to negotiate better wages and wider terms and conditions for workers delivering adult social care services commissioned by local government. Arrangements will be extended to other commissioned services, such as children’s social care, in line with the Scottish Government’s commitment to fair work.

It will be established by the Scottish Government and partners, in response to requests from trades unions, and will begin negotiating in 2026, with deals implemented from 2027-28.

In addition, the Scottish Government is taking immediate action to improve conditions for workers delivering commissioned services in the private, voluntary, and independent sector, including:

funding an increase in maternity and paternity entitlements to bring them in line with that of staff employed directly by local government; and
funding Protecting Vulnerable Groups (PVG) checks for workers.

Minister for Social Care and Mental Wellbeing, Tom Arthur, said: “Social care workers provide essential, skilled support to the people we love, often in demanding and emotionally challenging circumstances. They deserve pay and conditions that reflect that.

“Fairer working conditions are essential to making social care the attractive and rewarding career which it should be. I thank trade unions and provider representatives for their positive engagement on this issue and look forward to close cooperation with them as we deliver sectoral bargaining.

“The steps we are taking today, with partners, deliver on our commitments and mark a major milestone in building a social care sector which we value, which we can be proud of – and that any of us may one day depend on.”

Supporting people with complex care needs

New plan to help people live in their own communities

Almost 400 people with learning disabilities and complex support needs will benefit from £20 million of funding to implement the Coming Home Action Plan, which sets out measures to ensure tailored support and housing close to home, family and friends.

This will fund bespoke support, home adaptations, equipment and technology to enable people to return to their communities rather than spending longer periods in hospital than necessary or living in supported accommodation far from home.

Minister for Social Care and Mental Wellbeing Tom Arthur said: “Every day spent unnecessarily in hospital is time away from someone’s community, family and friends. We cannot allow people to spend longer in hospital than they need to or to stay far from home just because they have more intensive support needs.

“We are beginning to see progress. The latest data shows that fewer people are delayed in hospital or placed in care settings far from home – but there is more to do.

“I am pleased to see this £20 million funding bringing total investment in delivering the Coming Home agenda to £40 million since 2021. I thank Dr Anne MacDonald and partners for their commitment. Real change is delivered locally and this Action Plan, alongside additional investment, provides a strong framework for that.”

Cllr Paul Kelly, COSLA Spokesperson for Health and Social Care said: “We recognise the vital importance of ensuring that people with learning disabilities and complex needs spend no more time away from home than is absolutely necessary. COSLA remains fully committed to delivering the Coming Home Action Plan and to improving outcomes for the individuals and families we all serve.

“We have worked closely with the Scottish Government, Local Government, Integration Authorities, the NHS and Third Sector partners to develop the Action Plan and set out how we will jointly address these long standing issues. I am grateful for the significant commitment and time that all partners have invested in producing the Plan, which is published today. We now need to maintain that drive and collective focus as we move into delivery.

“Sustained, additional investment across the whole system will be crucial to ensuring that people with learning disabilities and complex needs can return home as quickly as possible.”

Dr Anne MacDonald, Chair of the Coming Home Short Life Working Group, said: “I’d like to thank colleagues across the sector for all their input to developing this Action Plan, which we hope will make a real difference to the lives of people with learning disabilities and complex support needs.

“The Action Plan is focused on changes that will support people to live well in their local communities, to have choice and control about where they live, and to have their human rights upheld.”

Coming Home Action Plan

Easy Reader Summary

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Scotland needs to stop centralising care and start trusting councils

WHEN we talk health and social care in Scotland, the debate tends to orbit big numbers and long-term policy frameworks (writes Councillor PAUL KELLY, COSLA Spokesperson for Health and Social Care) .

But from where I sit, speaking to councils and communities every day, the reality is far more immediate. It’s about people waiting longer for help, care workers stretched too thin, and a system close to burnout.

The £750 million COSLA is calling for isn’t a throwaway figure. It’s what’s needed just to stabilise social care and start rebuilding confidence, and right now, integration authorities are staring down a half-billion-pound deficit. That’s not theoretical. It means fewer care packages, longer waits, and more families left in limbo.

We can’t keep papering over the cracks. Care isn’t a luxury – it’s the infrastructure that allows people to live with dignity in their homes and communities and if we fail to fund it properly, we’re choosing crisis over prevention every time.

I’ve seen what good looks like, councils across Scotland are proving that when local partners are trusted, empowered and resourced, they deliver. Hospital admissions go down, delayed discharges drop and people get to stay in their homes, with the right support around them.

But the truth is, those successes are happening despite the system, not because of it.

Short sighted one-year budgets force local authorities into short-term firefighting, providers can’t plan, good staff leave for more stable work elsewhere.

The same goes for prevention, everyone talks about it but few fund it. Yet we’ve known since the Christie Commission in 2011 that unless we shift spending upstream, public services will buckle under the weight of demand. Fourteen years later, the shift still hasn’t happened.

The result? Hospitals are under strain, community are services stretched, and the most vulnerable people keep falling through the cracks. But it doesn’t have to be this way.

Across Scotland, local authorities are already delivering services that tackle inequality at the source. From mental health and suicide prevention work to alcohol and drug partnerships, councils are embedded in the places where support makes the most difference, but they’re doing it with one hand tied behind their backs.

The evidence is clear, outcomes improve when decisions are made locally and in partnership with communities, we need government to match that ambition, not with more centralisation, but with trust, flexibility and proper funding at local democracy level.

If we want to get serious about health inequalities, that starts with recognising that most of the determinants of health – housing, transport, education, employment – sit within the remit of local government and you can’t improve population health without improving people’s lives.

So, here’s the ask: fund social care properly. Commit to multi-year budgets, back prevention, and most importantly, hand decision-making power back to local communities.

If we keep waiting for someone in the centre to fix this, we’ll still be having this conversation in ten year’s time, and the system will be in a worse place.

Local government is ready to lead, it just needs the tools to do the job.

Mounting financial pressures will force tough decisions on health and social care services, says Scotland’s spending watchdog

CONCERNS OVER IJB FUNDING GAP

Integration Joint Boards (IJBs), together with their NHS and council partners, must urgently take decisions on where to redesign, reduce or discontinue services.

Funding to Scotland’s 30 IJBs increased by over two per cent in 2024/25 to more than £12 billion. But this was insufficient to meet rising costs and demands, with many IJBs using dwindling reserves to help meet the almost £450 million gap between demand and available funding. This is not sustainable.

Increasing demand, rising costs and a growing number of people with long-term complex needs are placing mounting financial pressures on IJBs. The boards have reached a critical point, with a significant risk they will become financially unsustainable within the next 12 to 24 months.

Alongside savings and using reserves, IJBs have been relying on substantial additional funding from their partners in the NHS and councils. IJBs need to plan their finances more realistically to reduce this reliance, as health boards and councils face their own significant financial pressures.

Malcolm Bell, member of the Accounts Commission said: “The cost of delivering services is rising faster than available funding.

“Tackling this could include difficult decisions about redesigning or reducing services, and whether new or additional charges need to be made. Whatever decisions are made, service users, their families and wider communities must be consulted.

“But without radical change the services delivered by IJBs can’t be sustained. The gap between funding available and the cost of meeting demand is widening, and the gap of nearly £450 million cannot be bridged with savings alone.”

COSLA Health and Social Care spokesperson, Councillor Paul Kelly, commented: “The Accounts Commission report on Integration Joint Board finances for 2024-25 confirms the stark reality our Health and Social Care Partnerships face: that severe financial challenges continue to pose a risk to the sustainability of social care, which threatens the every day lives of our most vulnerable citizens and communities.

“The challenges also threaten the sustainability of our councils, who have continued to prioritise social care, with an additional £163m invested over and above Scottish Government funding in 2024-25. This level of additional funding is unsustainable for partners, but in many cases the only option given the diminishment of reserves held by Partnerships.

“The report makes clear the validity and need for our budget lobbying ask of an immediate investment of £750m in social care. We will continue to press the Scottish Government for this investment to avoid further cuts, reductions and increased charges in future.”

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Reforming social care

Carers to help shape local services

Unpaid carers, disabled people and people with lived experience of social care will have a say on local services after Scottish Parliament regulations come into force.

Social Care Minister Tom Arthur tabled an order giving service users and third sector organisations a vote during integration joint board decision making. This ensures their perspectives carry equal weight in shaping decisions about services, such as care in the community to enable people with disabilities or long term conditions to remain at home.

The 31 boards bring together the NHS and local councils with key community and service representatives to oversee planning and delivery of social care and community health services. Until now only members appointed by the NHS health board and local councils can vote.

The draft regulations will come into force in September after the Scottish Parliament’s Health, Social Care and Sport Committee’s scrutiny of the legislation concluded yesterday.

Mr Arthur said: “I am determined to ensure those who access and support community health and social care services have an equal say in making decisions that affect their communities.

“These regulations extend voting rights to unpaid carers, service users and third sector representatives, collectively representing the voice of lived experience. It is only fair that these voices carry equal weight alongside other members – to help ensure local services are funded properly to meet the needs of people.

“People with lived experience provide valuable insight into challenges and opportunities which should be considered during planning. This change will bring decision making closer to the people we all serve. We expect to see more inclusive, collaborative and improved choices as a result.”

Westminster committees to examine children and young people’s mental health in new inquiry

Westminster’s Education and Health and Social Care committees have launched a new inquiry into children and young people’s mental health.

MPs on the cross-party committees will consider what mental health support is available to children and young people up to the age of 25 in community, health and education settings.

Through the inquiry, MPs will consider how this support is integrated with NHS services, such as specialist Child and Adolescent Mental Health (CAMHS) services, and what support is available throughout the education system, including for children with special educational needs and disabilities (SEND).

They will explore how potential reforms to CAMHS could improve children and young people’s access to mental health care and whether support could be provided in the community, such as through the Government’s new Young Futures Hubs.

Around one in five children and young people aged 8 to 25 in the UK has a “probable mental disorder”, according to NHS statistics published in 2023, while the consultancy PwC says that mental health challenges are having a significant impact on young people’s career choices and wellbeing at work. The committees will investigate what factors are driving these changes to children and young people’s mental health.

The committees will also scrutinise the implementation and rollout of relevant government policies such as the commitment to expand Mental Health Support Teams to all schools in England by 2029/30.

MPs will also consider plans to establish a network of Young Futures Hubs and alignment between various government strategies such as the 10 Year Health Plan, the Independent Review into mental health conditions, ADHD and autism, and the National Youth Strategy.

MPs will also investigate how education staff can support children and young people’s mental health, and whether current Ofsted frameworks or DfE guidance help or hinder mental health provision.

Chair of the Education Committee, Helen Hayes MP, said: “Struggling with mental health should never obstruct a young person’s chance to learn and thrive. Yet for too many, especially those with SEND or experience of the care system, that’s still the reality.

“From the early years through to university, education staff are often being asked to step in where existing support has failed.

“Our inquiry will take a forensic look at the mental health services available to children and young people at every stage of their education, from ages zero to 25.

“We will consider the role teachers can play in supporting children and young people’s mental health and whether they are getting the training they need to do that properly.

“We’ll also look at the full range of government policies and plans affecting young people, from SEND reform to the National Youth Strategy, and ask: are ministers doing enough to protect young people’s mental health?”

Chair of the Health and Social Care Committee, Layla Moran MP said: “For parents and school leaders alike, trying to get mental health support for children can feel like navigating a spaghetti junction.

“Services are frequently overwhelmed and not joined up. Too often the help doesn’t come until a child’s needs are at crisis point. These fundamental problems sit alongside issues that the Health and Social Care Committee documented in 2021 – the need to increase emphasis on prevention and early intervention. We return to these themes now amid deepening concern about the scale of need and questions of how the system can be remade fit for purpose.

“We will try and show Government how it can untangle the knotty problems that stop children getting the help they need and point to where investment should be directed. We’ll see how silos can be broken down between two sectors that should be working hand in glove, because we know that children’s education and wellbeing are intrinsically linked.”