Tag: national care service

Delivering Social Care reform

Changes proposed to reflect people’s needs

Plans to transform the way social care is delivered are being progressed as part of the Scottish Government’s commitment to improve the experience of everyone who accesses social care, social work and community health services.

Ahead of Stage 2 proceedings of the National Care Service Bill later this month, a number of amendments have been lodged, all of which are subject to Parliament’s agreement.

As the National Care Service will now be established through both legislative and non-legislative means, with reform of social care at the centre it is proposed the Bill will be known as the “Care Reform (Scotland) Bill”.

If agreed by Parliament, as amended, the Bill will also bring forward significant reforms to social care, including:  

  • Anne’s Law being enshrined into legislation to uphold the rights of people living in adult care homes to see loved ones and identify an essential care supporter
  • ensuring all those working in or supplying services to the health and social care sector follow the same information standards allowing easier communication
  • the creation of a National Chief Social Work Advisor post, in statute, to bring strategic leadership at a national level.

The Bill will also retain measures to establish a legal right to breaks for unpaid carers. Ahead of the legislation, the Scottish Government has identified an additional £5 million in the draft 2025-26 Budget to support 15,000 carers to take short breaks from their caring responsibilities.

Ministers announced in January that legislation to set up a new public body to oversee national improvements would no longer go ahead. However, work to establish a National Care Service Advisory Board is progressing and it is due to meet for the first time in March.

Social Care Minister Maree Todd said: ”Social care has the power to transform people lives, that is why it is so important that those accessing services receive the highest quality care, delivered consistently across Scotland.

“The amendments lodged in Parliament offer us the best opportunity to urgently get to work to reform the system and have a transformative impact on people’s lives.

“Positive progress is being made on establishing an advisory board that puts people with experience of the social care system at the heart of it, helping deliver the changes we all want to see.”

  • An essential care supporter is someone, for example close relatives or friends, who plays a vital role in providing their loved ones with regular care and support alongside staff. This includes companionship, personal support and advocacy.
  • Additional funding for Short Breaks Fund – gov.scot

Fraser of Allander: What next for social care in Scotland?

HOW STRONG IS THE SCOTTISH LABOUR MARKET?

LAST WEEK the Scottish government confirmed that plans for a National Care Service (NCS) in Scotland have been scrapped in favour of an advisory board and smaller, more targeted reforms (write FRASER of ALLANDER INSTITUTE’s MAIRI SPOWAGE and EMMA CONGREVE).

The decision came after months of declining support from key organizations and stakeholders including COSLA, key trade unions and representative bodies for social care providers in Scotland.

Beyond the wavering support for the NCS plans, there is clear support for social care reform, particularly in enhancing access to and the quality of services.

Our interest in the National Care Service, and wider social care reform stems back to 2022, in which we conducted analysis of the NCS bill published in June of that year. Following this work, published in August 2022, we engaged with a number of stakeholders across the private, public and third sector.

Among concerns around governance and funding of the NCS, one of the key concerns from stakeholders we engaged with was the lack of good quality and timely data that is crucial to ensuring that any reforms to social care are well informed. In particular, the need to better understand what future levels of social care demand might be, the workforce requirements to accommodate this, and the associated expenditure on social care.

Our concerns about the lack of investment in social care research were highlighted in our response to the Wave 2 consultation. The Scottish Government has not commissioned any work in this area, and we have not been able to find independent funders willing to fund work of this nature in Scotland.

It is our view that projections of demand and cost of the current service, and any future reforms, is urgently required.

New labour market data published

The latest data on the labour market in the UK was published last week. There are many documented issues with the data at the moment due to the challenges faced by the Labour Force Survey, which means the headline figure are no longer considered accredited Official Statistics.

If you can set that aside for a moment, the headline results show on the surface a strong Labour market in Scotland, with high employment (74.1%) and low unemployment (3.8%). Inactivity rates remain slightly higher than the UK at 22.9%.

There are a number of other data sources published alongside the LFS data which is used to supplement our understanding of what is going on in the Scottish economy. One of these is the payrolled employment data, known as the PAYE Real-Term Information, which is published every month by the ONS. This draws on administrative records, and so is likely to be more reliable in terms of employment (although, of course, tells us nothing about unemployment or inactivity).

This data shows that payrolled employment is almost 3% higher in Scotland than pre-pandemic levels. However, we had a look at replicating the sectoral breakdowns in this interesting piece by think.ing, which looks at government-dominated sectors vs the rest.

Chart: Payrolled employment in all sectors, government dominated sectors (public administration, health and education, and total excluding government, Scotland, January 2020=100

Source: ONS

This shows that once the government dominated sectors are excluded, payroll employment has been falling since March 2024, and is now almost back at the levels seen in January 2020. In contrast, government dominated sectors are 8% about pre-COVID levels.

Given some of the challenges facing the private sector in the first half of 2025, including large increases in employer National insurance contributions which will come in in April, the trend in private sector employment is concerning, and points to a weakness masked if we just look at employment in total.

However, it is worth emphasising again that this is just payrolled employment, and does not cover self-employment.

Social Care reform scaled back

NATONAL CARE SERVICE PLANS ‘REVISED‘

A dedicated advisory board, support for unpaid carers and enshrining care home residents’ rights to see loved ones are at the heart of revised plans for the National Care Service.

Social Care Minister Maree Todd outlined the next steps for reform to Parliament yesterday after plans to progress the National Care Service Bill were paused for further consideration in November 2024.

A new non-statutory advisory board – comprising of people with lived experience of accessing care, social care workers, care providers, trade unions, the NHS and local government – will be established to provide guidance and drive improvement within the sector. It is expected to meet for the first time in the spring.

The introduction of Anne’s Law, which upholds the rights of residents in care homes to be visited by families or friends, will remain in the legislation to reform social care, alongside a right to breaks for unpaid carers.

The Scottish Government Bill will also improve information-sharing across health settings and the ability for individuals to access and manage information about their care, while progressing plans for a national social work partnership.

Ms Todd said: “We want to deliver a National Care Service that improves the experience of everyone who relies on social care, social work and community health in Scotland.

“Change is urgently needed to reform the social care sector in Scotland but it has to be meaningful and sustainable change. That’s why we paused the Bill for further consideration, to fully capture the views expressed by all stakeholders, members of the public and the Parliament.

“The advisory board will include people with lived experience of social care, ensuring it has those who access services at its heart. It will allow us to drive forward vital reform more quickly than our original proposals.

“The Bill gives adult care home residents a legal right to see their loved ones with the implementation of Anne’s Law and recognises the significant contribution of unpaid carers to Scotland’s communities by introducing a right to breaks.

“There will be enhanced information-sharing to improve the coordination of individuals’ care, and we will work in partnership with the sector to bring forward reform that future-proofs the social work service in Scotland.

“People need sustainable change to social care and these actions will allow that to happen as quickly as possible.”

COSLA Leaders will meet at the end of January to take a position on the National Care Service Bill.

Councils Withdraw Support for National Care Service Proposals

Council Leaders have withdrawn support for the Scottish Government’s revised National Care Service Bill.

The Bill is currently being considered by the Scottish Parliament.

Though continuing to back key areas of reform, including enhanced support for unpaid carers, care home visitation rights and efforts to improve the experience of the social work and social care workforce, Council Leaders have expressed concern that the amended Bill currently does not reflect a model which Local Government can support.

The decision of Local Government Leaders today comes as several organisations
have expressed doubt on the legislative approach adopted by Scottish Government, including those working across the care sector. Experts have also questioned the evidence for including, within the National Care Service, services which support children and young people.

Commenting, COSLA’s Health & Social Care Spokesperson, Councillor Paul Kelly said: “Local Government cannot support the amended National Care Service Bill brought forward by Scottish Government.

“Local Government has been committed to working in partnership with the Scottish Government to develop proposals to deliver a National Care Service, but unfortunately the revised legislation does not effectively represent that partnership.

“Local Government is committed to continuing our engagement with key areas of reform which can deliver improved outcomes for people, unpaid carers and our workforce. We cannot, however, offer our support for the legislation brought forward at this stage”

“It is important that the views of people accessing, working in and planning front-line support services are listened to, both with regards to the NCS legislation and also the improvements needed to overcome the sustained financial and workforce pressures being experienced across Scotland.”

The National Care Service Bill was introduced to the Scottish Parliament on June 20th 2022, and allows for the transfer of a range of social care, social work and community health functions from local authorities to a new centralised body under the direction of Scottish Ministers.

On July 12 2023, Local Government and Scottish Government announced a shared accountability partnership for delivering the National Care Service in an alternative way, with enhanced national strategic direction through the creation of a national NCS Board, but with a continued role for local decision-making and Local Government.

Parliament’s Health Social Care and Sport Committee has sought views on the revised National Care Service Bill. Responses include those from UNISON, Children and Young People’s Commissioner Scotland,  Social Work Scotland, The Promise Scotland. COSLA’s Health and Social Care Spokesperson wrote to Parliament’s Health, Social Care and Sport Committee on 17th September 2024, accompanying COSLA’s full evidence submission on the draft, revised NCS Bill.

Creating a National Care Service

Community engagement funding to ensure groups are heard

Third sector organisations are being awarded new funding to help ensure as many voices as possible are contributing to the design of the National Care Service.

The funding will facilitate contributions from minority ethnic communities, LGBTI people, children and young people and those with experience of homelessness or the justice system.

Organisations will each receive £5,000 to encourage the communities they work with to have their say on how future community healthcare and social work services should look.

Social Care Minister Maree Todd said: “As we build a National Care Service that best fits the needs of everyone in Scotland, we need to hear from people directly.

“The new National Care Service will set the standards and guidance to support the design and delivery of community healthcare and social work services locally.

“The complexities of getting this right should not be underestimated. People with experience of the current system, whether receiving health and care support or delivering it, are the experts. We need to hear those voices – and those of groups who are often overlooked.

“We know that minority ethnic communities, LGBTI people, children and young people and those with experience of homelessness or the justice system are under-represented in our co-design work to date. We also know that people affected by dementia are a key group we want to hear more from and we will benefit from partnering with an organisation with expertise in this area.

“I am confident the funding to support co-design activity with seldom heard communities will help us shape a system we can all benefit from and be proud of.”

The partner organisations are:

  • LGBT Health and Wellbeing
  • Minority Ethnic Carers of People Project (MECOPP)
  • The Simon Community
  • Scottish Association for the Care and Resettlement of offenders (SACRO) 
  • Alzheimer Scotland

Working together? Partnership agreed on National Care Service

Scottish Government, NHS and Councils to share accountability for services

The Scottish Government has reached an initial agreement with local government and the NHS about accountability arrangements for the National Care Service (NCS).

The agreement aims to establish who will be responsible for people’s care once the NCS is established.  Overall legal accountability will be shared between Scottish Government, the NHS and local government.

Staff will continue to be employed by local authorities, and councils will still be responsible for assets like buildings and the delivery of services.

New governance arrangements will be introduced to ensure consistently high levels of service across the country, while building the flexibility to meet varying community needs at a local level.

Social Care Minister Maree Todd said: “The Scottish Government has been working closely with Local Government to find a consensus on the National Care Service (Scotland) Bill, which will allow us to deliver on the urgent improvements needed to strengthen the delivery of integrated health and social care for people.  

“This partnership between the Scottish Government, Local Government and the NHS helps establish where responsibility for people’s care will sit under the National Care Service. The detail of how this will work at a local level will be developed in the coming months and we will continue to update parliament on this work, along with the results of our ongoing co-design events taking place across the country, after the summer recess.”

COSLA’s Health and Social Care Spokesperson, Councillor Paul Kelly, said: “Further improving the experiences of people accessing and working in social care and social work services must rest on an effective partnership between Scottish Government and Local Government.

“Combining shared national accountability with local expertise ensures the right balance of further improvement across Scotland, whilst rightly reflecting the diverse needs of local communities.

“We know too that successful change is driven by the valuable staff who deliver services. We hope by setting out the continued role of local authorities in delivering social care and social work functions, and staff remaining employed within councils, we offer comfort and stability to the Local Government workforce.

“In recognising this important first step, we know there is still more to do. As we progress forward, we are committed to continuing to work closely with people in receipt of support and partners to design a system that ensures individuals and communities always experience high quality care and support.”

The consensus follows the Verity House agreement on closer cooperation between Scottish Government and local government signed last month.

Designing a National Care Service

FIRST EVENTS TAKE PLACE IN STIRLING TODAY

Social Care Minister Maree Todd will join the first of a series of events where people can co-design the new National Care Service.

Today’s event at Stirling’s Albert Halls will allow carers, people who access and deliver care, including the workforce, and anyone with an interest to contribute to how a new National Care Service could work.

Since the regional forums were announced last month, more than 600 have signed up to take part in-person and online, with additional capacity already being made for the Glasgow event next week.

Ms Todd said: “We want everyone to have access to consistently high-quality social care support across Scotland, whenever they might need it.

“There are unique demands across the country, which is why we’re going to different areas over the next 18 months, ensuring communities across Scotland can help design a National Care Service tailored to local needs.

“Having listened to people who access and deliver care support – both paid and unpaid – as well as care providers, unions and the third sector during the parliamentary process, these meetings will allow us to work with people who access care support, have a loved one that receives care, or works in the sector to think about how to meet the needs we have heard about. This will help us ensure the legislation reflects what people need and know as it progresses through Parliament.”

“I am pleased that there has been such interest in signing up, Spaces are still available, with online events providing another option for those who want to have their voices heard if they can’t make it in person.

National Care Service

Register for online events

28 June – William Quarrier Conference Centre, Glasgow

14 July – Hilltown Community Centre, Dundee

18 July – Stranraer Millennium Centre, Dumfries and Galloway

26 July – The Corran Hall, Oban

1 August – An Crùbh Community Centre, Skye

8 August – Strathpeffer Community Centre, Highland

17 August – Isleburgh Community Centre, Shetland

22 August – The Inkwell, Elgin

24 August – National online event

Public to help shape plans for a National Care Service

People across Scotland are being invited to have a say on how a new National Care Service should work.

A programme of meetings will take place over the summer, stretching from Dumfries and Galloway to Shetland. There will also be online meetings for anyone who would prefer to join discussions remotely.

There are NO events in Edinburgh or the Lothians.

During a visit to the Allied Health Professionals in Bonnyrigg, which includes the 14 health professions that make up the third largest workforce in the NHS Scotland, Social Care Minister Maree Todd spoke with staff about what they want to see from the co-design of the new national approach.

Details for all events are now available on the online booking page. The first event will take place in Stirling on 20 June.

Ms Todd said: “There are unique demands across the country, which is why we’re going to different areas, ensuring communities the length and breadth of Scotland are represented in designing a National Care Service tailored to local needs.

“Having listened to care providers, unions and the third sector during the Bill scrutiny process, these meetings will allow anyone who uses care services, has a loved one that relies on care or has worked in the sector to have their say. This will help inform future stages of the Bill as it progresses through the Parliamentary process. 

“There is general agreement that social care transformation will be of great benefit. This needs us all to have a shared understanding of what is working well and really focus on what’s needed to support people to thrive with the most suitable care for them. I would encourage everyone to be part of this conversation.

“To do this you can look to attend an event near you or join online, and be part of what will be the biggest social reform of our lifetimes.”

Alison Keir, Chair of the Allied Health Professions Federation Scotland said: “Rehabilitation is central to improving health and social care services in Scotland. Rehabilitation services are vital to people recovering from injury or supported through illness.

“When people get the rehabilitative care they need, they can be discharged from hospital sooner. Then they will need less health and social care, avoid being readmitted to hospital, and be able to regain their quality of life and their role as active citizens in Scotland.

“Allied Health Professionals, such as occupational therapists and physiotherapists, are experts in delivering rehabilitation. It is vital we improve community provision. We will fully engage with the national care service process to ensure we have the right services and systems in place.”

To register online:

  • 20 June – Albert Halls, Stirling
  • 28 June – William Quarrier Conference Centre, Glasgow
  • 14 July – Hilltown Community Centre, Dundee
  • 18 July – Stranraer Millennium Centre, Dumfries and Galloway
  • 26 July – The Corran Hall, Oban
  • 1 August – An Crùbh Community Centre, Skye
  • 8 August – Strathpeffer Community Centre, Highland
  • 17 August – Isleburgh Community Centre, Shetland
  • 22 August – The Inkwell, Elgin
  • 24 August – National online event
  • 29 August – National online event
co-design-national-care-serviceDownload

Fraser of Allander Weekly Update – Bitter pill to swallow?

This week, the Chief Economist of the Bank of England, Huw Pill, generated many headlines when he said that “we’re all worse off” due to the stubbornly high inflation the economy is experiencing – and bluntly, that we all just need to accept that (write MARI SPOWAGE and EMMA CONGREVE) .

Given this follows on from Governor Andrew Bailey’s comments that people shouldn’t ask for pay rises, it adds a bit to the narrative that the Bank of England is a bit tin-eared to the way workers and households feel right now.

However, Pill’s comments are a reflection of the current outlook. Even with the more optimistic forecasts that we had from the OBR recently, meaning that a recession may be avoided, living standards are still projected to fall significantly over the course of 2023.

It is important though that we have a debate about who in society should bear the brunt of the costs we are experiencing, and whether indeed it is ever going to be possible to protect much of our society from these external shocks.

No sign of a recession… yet

On a more optimistic note, data published this week showed that the Scottish economy grew by 0.2% in February 2023, which follows on from growth of 0.5% in January. Services grew by 0.4%, and particularly encouraging was that consumer-facing services grew by 1.3%.

This means it looks like Q1 2023 is going to show some growth, rather than a contraction as many (including us) had feared.

It will be interesting to see how the economy evolves as we move past the end of March, when we know government support for energy bills started to wind down, particularly for businesses.

How does Scotland compare to other regions of the UK?

ONS have published their latest data on regional economic activity – which you can get split up by all sorts of levels of geography, including local authority and city region, and by industry.

This data allows us to compare the level and type of economic activity across the UK, for the year 1997-2021. Looking across the 12 regions of the UK, known as International Territorial Level (ITL) 1 Regions, we can see that economic activity in London far outstrips that of the other region of the UK. Scotland usually performs pretty well on these metrics, generally 3rd or 4th in the UK depending on the year.

Chart: GVA per head, ITL 1 Regions

Source: ONS

[As statto aside, this is “onshore” Scotland only. Aficionados of economic statistics in the UK will be aware that activity associated with the whole UK Continental Shelf is put into a 13th region called “extra-regio”, which also includes activities in embassies abroad.]

There are also significant differences between different local authorities within Scotland, with the main cities outperforming many other areas of the country. We have to remember of course that the economic activity data reflects where activity takes place – i.e. the location of the place of employment – rather than where people live, so there is a significant commuting effect associated with this data.

Chart: GVA per head, local authority

Source: ONS

Despite another instalment in the long running NCS saga, we still have no certainty over what, when or how much

Last week, it became clear that the National Care Service legislation (and by extension its delivery) will be pushed back (again). In a letter to the Health, Social Care and Sport Committee on the 17th April, the Minister stated that the Scottish Government would be seeking parliamentary approval to extend Stage 1 of the Bill till after the summer recess.

We have written before on some of the questions that remained following the introduction of the Bill and the accompanying Financial Memorandum. The Finance and Public Administration Committee shared many of our concerns (and had others) about the lack of detail in the Financial Memorandum and asked the Scottish Government for an updated version. The Convenor of that Committee, Kenny Gibson, wrote to the Minister this week noting that the Committee are becoming:

“increasingly concerned at the lack of information available on the financial implications of the Bill and frustrated that we have still not received the updated FM we requested back in December last year”

They have asked for a new Financial Memorandum no later than Friday 12 May along with a breakdown of spend to date on the NCS.

The importance of the NCS to those who work and draw on social care, and to wider society, is huge. Although there remains a difference of opinion on how reform should happen, all agree that reform is needed. The delays that we have seen with the programme to date have been concerning. Understanding the financial implications of what this all means has been nigh on impossible. This call for clarity is welcome.

Pause The Bill

Common Weal and STUC call for pause to National Care Service legislation

Scottish think tank Common Weal, along with the Scottish Trade Union Congress, has launched a joint letter to the First Minister calling for the National Care Service Bill to be paused (writes NICK KEMPE).

Since Common Weal supported calls from the Trade Unions to pause the bill at the beginning of December many other organisations have done the same. Until now, however, smaller organisations have had a limited opportunity to make their views known and there has been very little joint action. The idea behind the letter, which you can read here, is to change that and to show the Scottish Government the degree of concern across Scotland.

The NCS Bill has now been considered by various Committees of the Scottish Parliament and MSPs should now be aware that there is very little enthusiasm or support for it in its current form. The hearings of the Finance and Public Administration Committee received a large amount of media coverage, not least because SNP MSP Michelle Thomson broke ranks and made some scathing comments.

The Committee’s report on the Financial Memorandum accompanying the bill, published at the beginning of December, was highly critical about the absence of costings. It highlighted the absence of costs for the creation of the new service, including VAT liability, transfer of assets and staff and the creation of a health and social care record, as well as the proposal to introduce major policies “via secondary legislation or business cases which cannot be subject to the same in-depth and formal financial scrutiny as Financial Memorandums to bills”.

It called on the Scottish Government to provide the necessary financial details at least two weeks prior to the Stage 1 consideration of the bill in March – giving very little time for any outside organisation to comment/brief MSPs

The majority report published last Friday here from the Delegated Powers and Law Reform Committee – don’t be put off by the name – added to the concerns about the lack of information and that the Scottish Government is “setting a dangerous precedent, undermining the role of the parliament.” Its reason for concluding this (the two SNP MSPs on the Committee dissented) was:

“The Committee is concerned there is insufficient detail on the face of the Bill and within the Bill documents to allow for meaningful parliamentary scrutiny. Given the far-reaching nature of the proposed reforms the Committee is mindful there is a real risk of letting down those the Bill is intended to help by allowing Scottish Government ministers to use delegated powers instead of primary legislation to introduce core and as yet unknown provisions. The Committee believes the current approach significantly reduces the threshold for parliamentary approval and prevents MSPs from bringing forward detailed amendments”.

Far from increasing democratic control over care services, as we advocated in Caring for All, the NCS Bill is now threatening to undermine democracy, whether at the local level by removing control from local authorities, or at the national level by handing unprecedented powers to Scottish Ministers.

The Scottish Government needs to have a fundamental re-think about what it is proposing and how its engaging with civic society while at the same time secretly working with KPMG to design the Target Operating Model for the NCS. If you are part of an organisation which has a stake in the future of social work and social care in Scotland, please ask them to support the letter. As an individual, please also consider contacting your MSPs asking them to support the call for a pause.

Nick Kempe – Common Weal Care Reform Group

COSLA’s Health and Social Care Spokesperson, @cllrpaulkelly, commented following the release of the letter from @ScottishTUC and signed by a number of organisations which has called for Scottish Government to pause the National Care Service Bill: