National Care Service Bill – The NEN

Holyrood agrees general principles of National Care Service Bill

Bill ‘not fit for purpose’ say unions

Legislation which will see the introduction of a National Care Service for Scotland (NCS) has passed Stage 1 in Parliament.

MSPs have voted for the general principles of the National Care Service (Scotland) Bill which will ensure greater transparency in the delivery of community health and social care, improve standards, strengthen the role of the workforce and provide better support for unpaid carers.

The proposals include establishing a National Care Service Charter, rights to breaks for carers and provisions to enact Anne’s Law so people in care homes have the right to be visited by their families.

Social Care Minister Maree Todd said: “We need long-term, widespread transformation to fix some of the ingrained issues within the system and ensure sustainability for the future.

“We have spent considerable time working with people with lived experience on how to reform social care for the better. I’m grateful to the thousands of people who have lent their voices and I am determined to ensure the Bill delivers the positive change needed.

“Today’s vote shows that the Scottish Parliament also recognises this and I am grateful to them for bringing us one step closer to this urgent reform.

“This Bill is the biggest public sector reform since devolution and it is our chance to make meaningful change that we all agree is needed to the social care system. I know the people of Scotland will see huge benefits.”

Scotland’s largest trade union bodies have condemned the Scottish Government’s proposed National Care Service Bill as ‘not fit for purpose’ as MSPs approve the legislation at Stage 1.

The Scottish Trades Union Congress (STUC) alongside the three biggest social care unions in Scotland – UNISON, GMB SCOTLAND and UNITE – have written to the Cabinet Secretary for NHS Recovery, Health and Social Care Neil Gray outlining their shared concerns on the Bill.

The letter states that social care workers’ concerns have been ‘widely ignored’ by the Scottish Government and that, at this stage of proceedings, the Bill as drafted remains ‘firmly unacceptable’.

Last week the Scottish Parliament’s Health, Social Care and Sport Committee’s report into Stage 1 drew criticism from trade unions who outlined the ‘glaring deficiencies’ of the proposals on costs and operation of the service.

Commenting, STUC General Secretary Roz Foyer said: “It beggars belief that, despite repeated warnings to the Scottish Government, Scotland’s social care workers are still in the dark on the basic fundamentals of the new National Care Service.

“Our social care sector already suffers from insecure conditions and low pay. We cannot risk those weaknesses being carried over into any new system of nationalised care.

“We must see the Scottish Government take seriously the recommendations of the Health, Social Care and Sport Committee’s report into the Bill. This would include improving pay, terms and conditions for social care staff, including a £15 per hour minimum wage. We also need to see Scottish Government guarantees on Fair Work and sectoral bargaining in addition to full sick pay from day one of employment.

“Our social care staff are the lifeblood of our system. We value their work and it’s high time the Scottish Government does likewise.”

COSLA: “SIGNIFICANT CONCERNS” ON NATIONAL CARE SERVICE PLANS

Speaking ahead of the Stage 1 debate for the National Care Service Bill in the Scottish Parliament on Thursday 29^th February, Councillor Paul Kelly, COSLA’s Health & Social Care Spokesperson, commented: “Councils have expressed significant concerns regarding current National Care Service plans and believe there is still work to do to ensure proposals can meet aspirations.

“In particular, Council Leaders are disappointed in the decision of the Scottish Government to continue to push through legislation where a power will be given to Ministers to delegate children and justice services, despite the potential disruption to services and extensive negotiations and concessions from Local Government.

“Council Leaders remain concerned that such a move risks excessive centralisation of decision-making away from local people and areas. Leaders did agree that COSLA should continue to work closely with Scottish Government to address these concerns.

“COSLA welcomes the progress which has been made in reforming some National Care Service proposals, including that local authorities will continue to play a central role in the delivery of, and accountability for care.

“There is a pressing need to improve people’s experiences of accessing and delivering care in Scotland. Although legislative and governance reform may be part of that, the reality is that national funding decisions – including the proposed council tax freeze which has not been fully funded – will further squeeze local care and social work services which are already under incredible pressure.

“Investment in social care must be seen as a priority which can enhance the wellbeing of people, of society and of Scotland.”

Having passed Stage One, the National Care Service (Scotland) Bill moves into Stage 2 where amendments will be considered by the Health, Social Care and Sport Committee before Stage 3, when the full Parliament makes a final vote on whether to pass the Bill.

Audit Scotland: Integration Joint Boards ‘face significant workforce pressures and financial challenges’

Scotland’s Integration Joint Boards (IJBs) face considerable financial challenges and immense pressures on their workforce, says public spending watchdog Audit Scotland.

IJBs have reached the point where significant transformation will be needed to ensure the long-term capacity, financial sustainability and quality of services individuals receive.

IJBs plan and commission many community-based health and care services. Demand for these services is increasing, in part due to demographic change and support for people with increasingly complex care needs.

The number of care hours for those aged over 65 reached nearly 25 million in 2021/22. The proportion of care services reporting vacancies increased by 11 per cent to 47 per cent, with a 30 per cent turnover of staff each year.

Most IJBs underspent on providing services in 2021/22. This was largely because of difficulties in recruiting staff, which led to unplanned vacancies, and pandemic-related reductions in service provision. The reductions in service provision were likely to have contributed to an increase in unmet health and social care needs.

In 2021/22 IJBs returned significant surpluses, with reserves doubling to over £1.3 billion. This was mainly due to additional funding received late in the year for specific policy commitments, including Covid-19. The Scottish Government are currently exploring options to recover around two-thirds of the unspent Covid-19 money held in reserves.

Across Scotland, IJBs have a combined projected funding gap of £124 million for 2022/23.

To be financially sustainable in the longer-term, IJBs must reduce their reliance on reserves. All IJBs must put in place detailed plans that clearly show how they will achieve the needed ongoing savings on a recurring basis and support urgently needed service transformation.

William Moyes, Chair of the Accounts Commission said: “Change is needed now – it cannot wait for a National Care Service. Action is needed to tackle funding pressures, which are under increasing stress from rising demand and cost pressures.

“The workforce challenges are considerable, with mounting unmet need.

“We need to see services focus on prevention, with appropriate funding in place to transform the way services are delivered and to improve lives. “

Local government organisation COSLA agrees.

COSLA Health & Social Care Spokesperson, Councillor Paul Kelly, said: “Today’s report from Audit Scotland is concerning and highlights the enormous pressure our health and social care infrastructure is under.

“People across Scotland rely on vital health & social care services every day, and it is critical that there is meaningful investment in the system which ensures their long-term capacity.

“We must ensure focus remains on front-line service improvement and sustainability, rather than the bureaucratic structural change presented through the National Care Service Bill.”

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National Care Service Bill published

“This is the most ambitious reform of public services since the creation of the NHS” – Humza Yousaf

Legislation to establish a National Care Service for Scotland (NCS) will ensure the best possible outcomes for people accessing care and support and end the ‘postcode lottery’ of care, says the Scottish Government.

The National Care Service Bill will make Scottish Ministers accountable for adult social care in Scotland – a change strongly supported by those responding to the recent consultation on the plans.

The Bill provides the foundation for the NCS, and enables the fine detail of the new service to be co-designed with people who have direct experience of social care services.

Plans have also been published to explain how that collaboration will work.

The aims are to:

support people in their own homes or among family, friends and community wherever possible, with seamless transitions between services;
create a charter of rights and responsibilities for social care, with a robust complaints and redress process;
introduce rights to breaks for unpaid carers
introduce visiting rights for residents living in adult care homes, giving legal force to Anne’s Law
ensure fair employment practices and national pay bargaining for the social care workforce;
focus on prevention and early intervention before people’s needs escalate;
create a new National Social Work Agency to promote training and development, provide national leadership and set and monitor standards in social work.

On a visit to Aberdeen-based charity VSA, which supports people with a wide range of social care needs, Cabinet Secretary for Health and Social Care Humza Yousaf said: “This is the most ambitious reform of public services since the creation of the NHS.

“People have told us they want a National Care Service, accountable to Scottish Ministers, with services designed and delivered locally. That’s exactly what we are going to deliver.

“The design of the NCS will have human rights embedded throughout, and the actual shape and detail of how the NCS works will be designed with those who have direct experience of accessing and providing social care.

“We are going to end the postcode lottery of care in Scotland. Through the National Care Service we’re going to ensure everyone has access to consistently high-quality care and support so they can live a full life. This is our ambitious goal and while it will not be easy to achieve it is vital that we do.”

Social Care Minister Kevin Stewart said: “One of the key benefits of a National Care Service will be to ensure our social care and social work workforce are valued, and that unpaid carers get the recognition they deserve.

“When this Bill passes we will be able to have the new National Care Service established by the end of this parliament. In the interim we will continue to take steps to improve outcomes for people accessing care – working with key partners, including local government, and investing in the people who deliver community health and social care and support.”

Chief Operating Officer of VSA Aberdeen John Booth, said: “We welcome the announcement that the National Care Service Bill has been published. With this being the biggest reform since the creation of the NHS we will now take the time to properly review the bill to understand the opportunities and challenges that lie ahead.

“We look forward to working with the Scottish Government to co-design the NCS to ensure the voices and needs of the vulnerable people who rely on our vital services are heard.”

Local government umbrella body COSLA has issued a statement:

A massive restructuring project, limited resources, local government opposition … Now, what could possibly go wrong?

National Care Service (Scotland) Bill