Invitation to help shape the new National Care Service

Adults with first-hand experience of social care services in Scotland are being invited to help design the new National Care Service (NCS).

Applications are now open for both the Lived Experience Experts Panel (LEEP) and Stakeholder Register, which will bring together people from across the country to help develop a care system that puts people first, in one of the biggest co-design exercises the Scottish Government has ever undertaken.

The new National Care Service will provide the national oversight and guidance that ensures community healthcare and social work services can be delivered locally in a way which best meets the needs of those who use them.

The panels launched today will allow people with direct experience of community health and social care the opportunity to help design these future services.

Anyone over the age of 18 living in Scotland who has views on how the future NCS should look can apply to take part in the Lived Experience Experts Panel.

Over the next few years the design work will consider a number of themes, the first of which are:

  • Information sharing to improve health and social care support
  • Realising rights and recognising responsibilities
  • Keeping health and social care support local
  • Making sure my voice is heard
  • Valuing the workforce

Organisations in Scotland with an interest in health and social care can note their interest in specific themes by joining the Stakeholder Register.

In the future, there will be additional targeted ways for people get involved – for example children and young people under 18, care experienced people, and young carers.

Minister for Social Care Kevin Stewart 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 in receipt of health and care support or delivering it, are the experts. We particularly need to hear those voices.

“These reforms are the biggest since the creation of the National Health Service almost 75 years ago and these Lived Experience Experts and Stakeholder Panels will make sure we deliver a service that puts people at its very heart. I encourage anyone with direct experience of social care to take part.”

How to join the Lived Experience Expert Panel or the Stakeholder Register

The first NCS Forum on 3 October in Perth will be another opportunity for individuals to engage and shape the NCS co-design process. Register to join the event online

This is not the only opportunity to get involved in co-design work. In the future, there will be additional ways for specific groups to get involved – for example children, young people and families, care experienced people, and young carers.

For this reason, we’re not asking children (under the age of 18) to join the Lived Experience Experts Panel right now. Instead, we will work with organisations that represent different groups of young people to make sure we reach as many different groups as we can and undertake research work in a way that best suits their needs.

Adult Social Care needs immediate funding injection and long-term plan, says Levelling Up Committee

The UK Government urgently needs to come forward with additional funding this year to help the ravaged adult social care sector meet immediate pressures, including inflation and unmet care needs, says the cross-party Levelling Up, Housing and Communities (LUHC) Committee in a report published last week.

Examining the Government’s charging reforms and local government finance, unpaid carers and workforce challenges, the report says the “message rang clear throughout our inquiry: the adult social care sector does not have enough funding either in the here and now, or in the longer-term”.

The Committee’s report outlines that:

  • On adult social care, the Government currently has nothing more than a vision, with no roadmap, no timetable, no milestones, and no measures of success.
  • The Government should come forward with 10-year plans for how it will achieve its vision outlined in the People at the Heart of Care White Paper and for the adult social care workforce
  • The Government should provide a multi-year funding settlement to give local authorities what they need in terms of their own sustainability and their ability to help shape sustainable local care markets.

Clive Betts, Chair of Westminster’s Levelling Up, Housing and Communities Committee, said: “As Prime Minister, Boris Johnson said he would fix the crisis in social care once and for all.

“The Government deserves credit for attempting reform and for acting to try to prevent the unpredictable and catastrophic costs which can be inflicted upon people for their care. However, the Government should be under no illusions that it has come close to rescuing social care and it needs to be open with the public that there is a long way to go.

“Ultimately, whether it relates to immediate cost pressures or on wider structural issues in the sector, the fundamental problem is that there continues to be a large funding gap in adult social care which needs filling. Those who need care, their loved ones, and care workers deserve better.

“The NHS and adult social care provision should not be pit against one another. The two systems are interdependent and each needs to be adequately funded to reduce pressure on the other. Wherever the money comes from—from allocating a higher proportion of levy proceeds to social care, or from central government grants—the Government urgently needs to allocate more funding to adult social care in the order of several billions each year.”

The report notes the additional pressures of Covid-19 as having exacerbated the underlying structural challenges of rising demand, unmet need, and difficulties in recruiting and retaining staff.

It also notes severe current pressures arising from increases in the National Living Wage and the National Minimum Wage, and from rising inflation. That most of the funding from the Health and Social Care Levy Levy will go to the NHS, and the money that will go to adult social care is for reforms, not cost pressures, is also highlighted in the report.

Addressing the Government’s sector reforms, the report notes the positive stakeholder reception to the vision outlined in the Government’s White Paper on long-term reform of adult social care, titled People at the Heart of Care.

The report commends the Government for introducing many welcome initiatives such as those relating to housing and data which could make a significant difference in the long-term to people’s lives.

The report calls on the Government to publish a 10-year plan for how its vision in the People at the Heart of Care White Paper will be achieved, taking into account how the different policies interweave and affect one another. The Government should also publish a 10-year strategy for the adult social care workforce which includes a clear roadmap with core milestones, outcomes, and measures of success.

The report expresses concerns about the sheer number of reforms and new ways of working in respect of adult social care that involve and affect local authorities. To help local councils deliver the numerous social care reforms, it’s important the Government provides a multi-year funding settlement to give local authorities what they need in terms of their own sustainability and their ability to help shape sustainable local care markets.

The report also calls on the UK Government to publish a new burdens assessment by the end of the year to determine the level of resource needed by local government in terms of staff, expertise, and funding to deliver the full package of adult social care reforms.

The Scottish Government has committed to establishing a functioning National Care Service by the end of this parliamentary term in 2026:

SCOTLAND’S SOCIAL CARE RIP OFF

STUC: WHY SCOTLAND CAN’T AFFORD PRIVATISED SOCIAL CARE

The Scottish Government’s approach to their new National Care Service has been declared “untenable” by Scotland’s largest trade union body.

Launching their report ‘Profiting from care: why Scotland can’t afford privatised social care’, the Scottish TUC (STUC) has accused the Scottish Government of “falling glaringly short” in their plans for a transformative National Care Service.

The trade union organisation, representing unions from across health and social care, is calling for the Scottish care home estate to be transferred out of private ownership in totality.

Research within the STUC report reveals that Scotland’s large private social care providers are associated with lower wages, more complaints about care quality, and higher levels of rent extraction than public and third sector care providers.

Under current Scottish Government plans, the proposed National Care Service would remain “ownership neutral”, embedding a role for the private sector in social care.

The research finds:

• Nearly 25% of care homes run by big private providers had at least one complaint upheld against them in 2019/20, compared to 6% of homes not run for profit.

• In older people’s care homes, staffing resources are 20% worse in the private sector compared to the not-for-profit sector. • Privately owned care homes only spend 58% of their revenue on staffing, compared to 75% in not-for-profit care homes.

• Over the last six years, the public sector has paid on average £1.60 more per hour to care workers.

• The most profitable privately owned care homes take out £13,600 per bed (or £28 of every £100 received in fees) in profits, rent, payments to the directors, and interest payments on loans. This compares to £3.43 in every £100 in fees for the largest not-for-profit care home operators.

The report argues that a truly transformative National Care Service must be based on a not-for-profit public service, delivered through local authorities with an ongoing role for the voluntary sector.

Roz Foyer, STUC General Secretary, said: “Our new STUC research clearly shows that large privately owned care homes perform worse than not-for-profit care homes at almost every level. They are worse for those receiving care, worse for the workers providing care and worse for the taxpayer.

“It simply isn’t the case that Scotland can’t afford to buy out private care homes, we can’t afford not to. As it stands, the Scottish Government are falling glaringly short in offering the transformative shake up to social care Scotland badly needs.

“As the National Care Service Bill makes its way through Parliament, politicians must focus their attention on the kind of organisations we want to provide care for our citizens, not as seems to be the case just now, the centralisation of commissioning and outsourcing procedures.”

The recommendations have been backed by Care Home Relatives Scotland. The influential group, set up during the pandemic, have been working to strengthen relatives rights as a result of care home visitation restrictions during COVID-19.

Catherine Russell, Care Home Relatives Scotland: “This report should be essential summer reading for every member of the Scottish Parliament.

“The research findings endorse everything Care Home Relatives Scotland said in our response to the NCS consultation. Our fear is that millions will be spent on upheaval and reorganisation when the priority must be to focus on improvements and with resources on the frontline where they are desperately needed.

“We also share the STUCs grave concerns about the further marketisation of social care and community health services.

“As the report demonstrates, private homes are not the most cost effective or highest quality. They are extremely costly for residents who need to pay and the profit motive tends to drive down staff conditions.

“Scotland can and should find a better, fairer way to do things and this research will be a very useful contribution to that debate.”

Reform of NHS key to pandemic recovery, says Audit Scotland report

The Scottish Government must focus on transforming health and social care services to address the growing cost of the NHS and its recovery from Covid-19.

Improving the NHS will be very difficult against the competing demands of the pandemic and an increasing number of other policy initiatives, including plans for a National Care Service.

The health service in Scotland is on an emergency footing and remains under severe pressure. There is a growing backlog of patients waiting much longer for treatment because of the response needed to Covid-19. That has made workforce planning and delivering on ambitious recruitment plans all the more important. But the Scottish Government has historically struggled to recruit enough people with the right skills.

The NHS’s ability to plan remains hindered by a lack of robust and reliable data, including workforce, primary care, community, social care, and health inequalities data.

Meanwhile the pandemic has increased the fiscal pressures on the NHS, which remains financially unsustainable. This is despite the Scottish Government allocating £2.9 billion for pandemic-related costs in 2020/21 and committing more funding in 2021/22 and beyond.

Stephen Boyle, Auditor General for Scotland, said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.

“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.

“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes. But better-informed policy decisions and services won’t be possible without better collection and use of data.”

A Fairer, Greener Scotland?

First Minister lays out her Programme for Government 2021/22

Leading Scotland safely out of the pandemic, urgently confronting climate change, driving a green, fair economic recovery, and boosting opportunities for children and young people are among the core priorities in this year’s Programme for Government (PfG), published yesterday. Oh … and there’s a referendum in there, too …

The programme sets out plans for a record increase in frontline health spending, new legislation for a National Care Service, a system providing low-income families with free childcare before and after school and during holidays, and actions to drive forward Scotland’s national mission to end child poverty.

The programme also includes plans to help secure a just transition to net zero – creating opportunities for new, good and green jobs, making homes easier and greener to heat, and encouraging people to walk, wheel or cycle instead of driving.

Speaking in Parliament, the First Minister said: “This programme addresses the key challenges Scotland faces, and aims to shape a better future.

“It sets out how we will tackle the challenge of Covid, and rebuild from it. It outlines how we will address the deep-seated inequalities in our society. It shows how we will confront with urgency the climate emergency, in a way that captures maximum economic benefit. And it details the steps we will take to mitigate, as far as we can, the damaging consequences of Brexit while offering a better alternative.

“In the face of these challenges, our ambition must be bold. This programme sets out clear plans to lead Scotland out of the greatest health crisis in a century and transform our nation and the lives of those who live here.

“We will deliver a National Care Service; double the Scottish Child Payment; and invest in affordable, energy efficient homes and green travel. We will ensure that businesses have the support, and people have the skills, to succeed in the low carbon economy of the future. We will show global leadership in tackling the climate crisis. And we will offer people an informed choice on Scotland’s future.

“To that end, I can confirm that the Scottish Government will now restart work on the detailed prospectus that will guide the decision. The case for independence is a strong one and we will present it openly, frankly and with confidence and ambition.

“This programme addresses our current reality, but it also looks forward with confidence and ambition to a brighter future. It recognises that out of the many challenges we currently face, a better Scotland – as part of a better world – is waiting to be built.”

Building on the progress from the first 100 days of this government, with the co-operation agreement with the Scottish Green Party at its heart, the PfG sets the scene for the next five years.

Key commitments for over the course of this Parliament include:

  • increasing frontline health spending by 20%, leading to an increase of at least £2.5 billion by 2026-27
  • undertaking the biggest public service reform since the founding of the NHS – the creation of a National Care Service – with legislation brought forward by June next year
  • improving national wellbeing with increased direct mental health investment of at least 25%, with £120 million this year to support the recovery and transformation of services
  • investing £250 million to tackle the drugs deaths emergency over the next five years
  • expanding the Scottish Child Payment to under-16s by the end of next year and doubling it to £20 a week as soon as possible after that, with a £520 bridging payment given to every child in receipt of free school meals this year
  • investing a further £1 billion to tackle the poverty-related attainment gap and providing councils with funding to recruit 3,500 additional teachers and 500 classroom assistants
  • providing free childcare to low income families before and after school and during holidays, and expanding free early learning and childcare to one and two year olds
  • investing £100 million over the next three years to support frontline services for preventing violence against women and girls
  • providing £1.8 billion to make homes easier and greener to heat, as part of a commitment to decarbonise 1 million homes by 2030
  • ensuring that at least 10% of the total transport budget goes on active travel by 2024-25, helping more people to cycle, wheel or walk instead of drive
  • delivering a revolution in children’s rights, including across the justice system
  • supporting a just transition to a low-carbon economy for people and businesses, including a £500 million Just Transition Fund for the North East and Moray
  • investing an additional £500 million to support the new, good and green jobs of the future, including by helping people access training
  • delivering 110,000 affordable homes by 2032 and investing an additional £50 million to tackle homelessness and rough sleeping
  • taking forward the democratic mandate for a referendum on independence to be held within this Parliament and, if the Covid crisis is over, within the first half of this Parliament, while providing the people of Scotland with the information they need to make an informed choice on their future.

Programme for Government 2021-22

First Minister statement to the Scottish Parliament, 7 September 2021

Commenting on yesterday’s Programme for Government announcement, Chris Birt, Associate Director for Scotland at the Joseph Rowntree Foundation said: “Alarm bells should already be ringing in both the Scottish Government and Parliament that we are currently set to miss our child poverty targets, with no clear plan on how to achieve them. 

“The Programme for Government published today pushes that plan further down the road, both to the budget later in the year and next year’s Tackling Child Poverty Delivery Plan. 

“Time is running out on the targets. Families on low incomes across Scotland are experiencing growing financial pressure and uncertainty .  They will hope the commitment to double the child payment “sooner rather than later” happens very soon and that our national mission to end child poverty gathers urgency and scale.”

The STUC welcomed the Scottish Government’s Programme for Government, specifically highlighting the commitments from the First Minister to implement national bargaining in the care sector, additional funding for the health service, gender recognition reform and justice for Scotland’s miners wrongfully arrested in the 1980s.

STUC General Secretary, Roz Foyer said: “Reform of our care sector cannot come quick enough and the STUC will engage fully in this legislation, campaigning for a National Care Service based on sectoral collective bargaining and not for profit delivery.

“The commitment of the First Minister to National Bargaining is therefore very welcome. However, the £800 million additional funding announced over the course of the Parliament is less than a quarter of the expenditure which the Feeley Review said was necessary for the social care sector.

“Yet we still have concerns that the Programme of Government tries too hard be all things to all people. It is simply not credible to raise the levels of investment required to tackle climate change, reduce inequality and create jobs while at the same time boasting about the lowest business taxes in UK and freezing income tax rates for the duration of the Parliament.

“The same lack of ambition is reflected in today’s Scottish Government response to the report of the Just Transition Commission which leaves much to be desired on future job creation and ensuring the burden of climate change is not carried by workers and the less well off.

“Fighting discrimination and inequality is at the heart of trade unions, we know trans people are some of the most disadvantaged and discriminated people in Scotland and the gender recognition bill is therefore extremely welcome in enabling trans people to access their human rights.

“Finally, I welcome the proposed Miners’ Strike Pardon Bill. It has been all too clear for decades that the miners were the victims of a politically inspired political attack and that organs of the state, including the police, were used to repress their legitimate industrial action.

“This Bill will help provide some relief to the thousands of lives were wrecked by wrongful arrest and is a testament to years of campaigning by working class families who refused to give up.”

GMB Scotland Secretary Louise Gilmour said: “The need to tackle the crisis in care is accepted, but the challenge is to end years of exploitation by giving care workers substantial pay increases. That’s how we’ll confront the understaffing crisis and transform the sector.

“It’s why GMB is campaigning for £15 an hour minimum for care workers. The prospect of staff remaining mired in wages of just under or over £10 an hour isn’t credible. 

“And there is a growing consensus supporting that view, including among Cabinet Secretaries as the Greens committed to a £15 minimum in their recent manifesto, so we need to make it happen. 

“If we are prepared to be bold and deliver proper value for workers across the social care sector then there is a huge opportunity to be grasped, everyone will benefit and Scotland will be fairer for it.” 

Joanne Smith, policy and public affairs manager for NSPCC Scotland, said: “Recovery and reform are very much needed as we move forward from the pandemic, and this year’s Programme for Government is the first step in this journey.  

“For children in Scotland to have the best start in life, it is vital that all families can access holistic support, where and when they need it, and so we are heartened by the Scottish Government’s announcement of a Whole Family Wellbeing Fund.

“In line with the Promise’s recommendations we would like to see that national spending prioritises early, preventative support for families, therefore stripping out demand for crisis-led services.

“We are also greatly encouraged by the Scottish Government’s commitment to review and redesign the Children’s Hearing System. Through our work with very young children and families in Glasgow, we see the limitations of current justice processes in meeting the distinct needs of infants and their families.

“Given that around a third of children who come into care in Scotland are under the age of five, we need to ensure justice processes are better aligned with infants’ developmental timescales. We look forward to working alongside the Review team to ensure that the rights of infants are upheld throughout the process.”

Mary Glasgow Chief Executive of the charity Children 1st said:  “Today’s Programme for Government has rightly prioritised the right of children and their families to know they can access the help and support they need whenever they need it.  

“Children 1st have long called for a transformation in the support available to families, which must be based on learning from the – often difficult – experiences of children and their families when they have needed practical, emotional or financial help.

“The proposed £500m investment in a ‘Whole Family Wellbeing Fund’ is a hugely welcome step forward and we are committed to working alongside children and their families, and the Scottish Government, to turn this significant investment into practical action.” 

Tracy Black, CBI Scotland Director, said: “With Glasgow hosting COP26 later this year, the Scottish Government is right to focus on its plans for a net zero economy. Yet given the need to cement Scotland’s economic recovery post-pandemic, businesses will feel there ought to have been a greater focus on boosting growth. While there were encouraging mentions of greater access to finance, the devil will be in the detail.

“Firms are already decarbonising their operations, and, by working alongside government, can help urgently transform net zero ambitions into action. Reforming the planning and business rates systems – enabling much needed in investment in low carbon infrastructure – would help achieve ambitious climate targets.  

“The First Minister is also right to highlight that COVID hasn’t gone away. Scottish firms have worked tirelessly throughout the crisis to keep staff and customers safe. Businesses are not calling for a rushed return to the workplace, though employers will rightly be speaking with their employees about a gradual return in line with the latest guidance.

“As the economy reopens, skills shortages remain a key concern, so employers will be frustrated not to hear more about plans for upskilling and retraining.

“Business investment is absolutely vital to Scotland’s economic recovery, and the government should do everything in its power to attract – not repel – investment and the very best talent. Ultimately, by working more closely with business to create sustainable economic growth, ministers will be able to achieve their goals of improving people’s living standards and public services.”

‘Biggest public sector reform for decades’: consultation launched

A National Care Service for Scotlandbut COSLA condemns proposals

A consultation has been launched to seek the public’s views ahead of the creation of a National Care Service, which will ensure everyone who needs it can expect the same standards of care, wherever they live in Scotland.

Local government umbrella organisation Cosla has criticised the government’s plan as another move to undermine local democracy.

The National Care Service will deliver person-centred care that supports people in a way that suits their needs, providing real benefits for those who are being cared for and the people who care for them. It will introduce ethical commissioning, based on fair work principles, for the benefit of everyone involved.

The consultation sets out some of the options for delivering social care in a way which changes the system from one that supports people to survive to one that empowers them to thrive. It recognises that this will involve significant cultural and system change that will need to be supported by new laws, and new ways of working.

In order to deliver these recommendations there will continue to be strong local accountability.  The consultation proposes Community Health and Social Care Boards to strengthen the voice of the local population, with people with lived experience and local elected members sitting alongside professionals.

Consulting on the proposals was one of the commitments for the first 100 days of this government. Implementation of the recommendations of the Independent Review of Adult Social Care, and the establishment of a National Care Service, will be one of the most significant tasks of the current parliament.

At a minimum the new National Care Service will cover adult social care services. However, the consultation document also recognises that if we want to build a comprehensive community health and social care system, we should consider extending its scope to other groups such as children and young people, community justice, alcohol and drug services, and social work.

Minister for Social Care Kevin Stewart said: “The importance of our social care services has never been clearer. We owe an enormous debt of gratitude to our nation’s carers, paid and unpaid, for the commitment and compassion we have seen throughout the pandemic.

“The Scottish Government commissioned the Independent Review of Adult Social Care during the pandemic, because it was clear we needed to do things better in future.

“We have already made significant improvements, with reforms such as the integration of health and social care, and implementation of the Real Living Wage Policy for Adult Social Care workers and this year the Scottish Government pledged £64.5m to fully fund the pay increase. But we can go further. What we are now proposing is the biggest public sector reform for decades, since the creation of the National Health Service.                                                                            

“I am committed to implementing the recommendations of the Independent Review  and staying true to the spirit of that report by building a system with human rights at the heart of it.

“The Review recommended the creation of a National Care Service, with Scottish Ministers being accountable for adult social care support. I believe however that it is right for this consultation to look beyond simply the creation of a national service for adult social care. The ambition of this government is to go much further, and to create a comprehensive community health and social care service that supports people of all ages. We are also committed to a ensuring there is strong local accountability in the system.

“Absolutely vital to this is ensuring that our invaluable social care workforce feel happy, respected and fulfilled in their role.

“We are at the beginning of a journey to improve social care in Scotland. We will only get this right with your support. I want to hear from as many people and organisations as possible over the next couple of months, so we can build a better system together.”

In a statement, the Social Covenant Steering Group which will advise on the creation of a National Care Service, said: “Most of us have waited many years to see plans for major improvements in the way social care support is delivered and we welcome the publication of this consultation.  

“Many people may feel they have been consulted before and are keen to see some action.  But this time it is an important legal step in in order that a bill can be put to Parliament. 

“So, it is important that as many people as possible including; current users of social care support, unpaid carers, the workforce and everyone else who cares about this vital support will take this opportunity to express their views on the kind of system we need to enable everyone to reach their potential.”

The Consultation on the National Care Service which was launched today cuts straight through the heart of the way Scotland is governed, says COSLA President Councillor Alison Evison:

“The Consultation launched today cuts through the heart of governance in Scotland – not only does it have serious implications for Local Government – it is an attack on localism and on the rights of local people to make decisions  democratically for their Place.  It once again brings a centralising approach to how decisions which should be taken locally are made.

“We welcomed large parts of the Independent Review of Adult Social Care and have been keen to get on and deliver, however the vision this consultation sets out goes beyond the Feeley Report. It isn’t evidence based and will take years to deliver – years when we should be making improvements which will benefit all users of social care services.

“Councils know their communities and all the evidence suggests that local democratic decision making works.  Councils have shown time and time again during the last 18 months of the pandemic that we can deliver for the communities we serve when we are trusted and resourced to do so.

“It is deeply concerning that the consultation is also a considerable departure from the recommendations of the independent review set up to look at Adult Social Care.

“The lack of prior engagement with Local Government is not new – the partnership between the Scottish Government and Local Government which we have been seeking to build, continues to elude us in practice and it is the communities we serve who are losing out.

“Let’s be clear – this is not a “thinly veiled” attack on Local Government – there is no subtlety to it and, sadly for local communities, the ‘onion peel’ of Local Government services by this Government shows no sign of letting up.

“On behalf of the communities we serve, COSLA and Local Government will engage constructively with the Consultation process.  People may be surprised by the extent of services covered by this Consultation and I would urge as many as possible to respond to it, as this could really be the end for anything other than central control in Scotland.

“We all want better services for our communities, nobody more so than Local Government and that is what Local and National Government should be working on collectively for our communities.”              

Consultation on a National Care Service for Scotland. 

A number of consultation events will be held throughout late August, September and October.

First steps towards a National Care Service for Scotland

Real life experts’ to help focus on what really matters to people receiving social care

Health Secretary Humza Yousaf and Minister for Social Care Kevin Stewart have welcomed the first meeting of a Social Covenant Steering Group, set up to help guide the development of a National Care Service.

Establishing the group, made up of people with day-to-day experience of social care, was a key recommendation of Derek Feeley’s Independent Review of Adult Social Care and marks the fulfilment of one of the commitments for the first 100 days of this government.

Initial membership of the group, which met for the first time yesterday, includes unpaid carers, disability rights activists, a care home resident, a campaigner for the needs of relatives of those in care homes, a social care worker and others with significant experience of the way services are currently delivered.

The diverse group includes people from across Scotland with a spread of ages, and social, cultural and ethnic backgrounds.

The group is expected to help establish a common set of values and beliefs – a social covenant – which will underpin the National Care Service, including treating people with dignity, prioritising the common good and ensuring there is strong oversight of the new service. It will establish underlying and unifying principles to help guide decision-making.

Mr Stewart, who will chair the group’s meetings, said: “We know there were problems in the social care system before  COVID arrived and we had already started to think about ways of reforming it, but the pandemic has shone a spotlight on the system and really highlighted the importance of making changes.

“Many members of this group have already heavily influenced the recommendations in Derek Feeley’s report and I am keen to ensure that we continue to listen to their expert views and act on what they tell us. 

A social covenant will enable us to develop a common set of values around social care; and see those systems as not merely a safety net, but a springboard to allow people to flourish.

“It is extremely important that we listen to people with lived experience – the real experts – to hear about the highs and lows of social care services. It is by doing this that we will really find out what’s good about the services people receive, more importantly, what needs to improve for those who use and deliver social care.”

“Only by listening to people with real-life experiences , and acting on what we hear, can we create a system that ensures that everyone in Scotland has the opportunity to live fulfilling and rewarding lives.”

Marion McArdle,  who has a  daughter with  complex needs said: “I feel privileged to be part of this group, since I’m fully expecting it to be a partnership between the government and the experts, people with real stories and real suggestions on how to change things for the better based on their lived experience of social care in Scotland.

“I’m optimistic that this can only be good thing and a great step forward in getting it right for Scotland’s citizens who are entitled to a social care system which at the very least meets their human rights.”

Adult Social Care: Scottish Government supports Feeley Review recommendations

Collision course with COSLA over National Care Service?

Health Secretary Jeane Freeman has accepted the findings of the Independent Review of Adult Social Care, and the Scottish Government is already working to implement key recommendations.

Ms Freeman told Parliament yesterday that Derek Feeley’s Independent Review, commissioned five months ago in response to the COVID-19 pandemic, was an “important opportunity” to be bold in reshaping how social care is planned, funded and delivered.

Speaking in a debate on the review, Ms Freeman set out a number of immediate measures in response, including a new £20 million Community Living Change Fund to redesign services for people with complex needs including intellectual disabilities and autism, and for people who have enduring mental health problems.

This will address some of the issues raised by the 2018 Coming Home report, about the need to avoid out of area placements and delayed discharge for people with learning disabilities and complex needs.

She said she accepted the principle of introducing a National Care Service but would continue to talk to the Convention of Scottish Local Authorities (COSLA) about how to address its concerns.

The Scottish Government is working to implement other measures recommended by Derek Feeley’s report. These include:

  • work with local partners to end charging for non-residential care
  • developing minimum standards for terms and conditions in the social care sector, to help organisations meet fair work principles by the end of May
  • work to ensure there is no delay in the annual Real Living Wage uplift for Adult Social Care workers

Ms Freeman said: “The independent review of social care gives us a clear roadmap for the future of care provision in Scotland and we believe in the recommendations in this report.

“There is immediate action that can be taken now to secure improvement. I am pleased to announce a new Community Living Change Fund of £20 million to deliver a redesign of services for people with complex needs including intellectual disabilities and autism, and those who have enduring mental health problems. We will work with local partners as quickly as practicable to end all charges for non-residential care.

“The report also recognises and highlights the critical and invaluable support that the social care workforce provide to people all over Scotland. We are looking to establish a new sector-level body to ensure an effective voice for the whole of the social care workforce to enable them to respond to local conditions and address matters of importance, and support an effective collective bargaining role in the sector.

“As a priority, we will work with our stakeholders to agree a national approach to implementing the real living wage for Adult Social Care workers – for 2021 and in future years.

“We want to move from a competitive market to collaboration and ethical approaches to commissioning and procurement to help embed fair work principles and improve the consistency of services.

“The National Care Home Contract should also embed changes which drive the Fair Work Agenda and I have asked that for the first time Union representatives should be party to the discussions on this contract.

“I understand the concern expressed by COSLA on the issue of accountability. Local government is a critical partner in taking forward the radical change the Review rightly calls for and I support. We need to work together to find the best way to secure the Review’s recommendations and the spirit of its intent.

“I believe, as the report sets out, that improving adult social care gives us an important opportunity – to improve people’s lives, to build our economy, and to invest in high-quality, fair work.

“This is just beginning of a process for improvement. It is now up to us to ensure a social care system that consistently delivers high quality services across Scotland – a system that is founded in fairness, equality, and human rights, and that puts lived experience at the heart of its redesign and delivery.”

Council Leaders have already rejected the idea of a Scottish Care Service.

Speaking following the launch of the Feeley report on 11 February, Councillor Stuart Currie, COSLA’s Health and Social Care Spokesperson, said:  “There was real and unanimous opposition to the recommendations on governance and accountability which would see the removal of local democratic accountability and a degree of centralisation, which Leaders rightly felt would be detrimental to the local delivery of social care and its integration with other key community services.

“They (council leaders) also felt that given the level of funding set out in the Review, Local Government would be well placed to deliver the human-rights based approach outlined at pace, whilst ensuring local democratic accountability remains front and centre of social care.”

Council leaders will consider a detailed report on the proposals and the Scottish Government’s response at the end of this month.

COSLA: Unanimous ‘No’ to National Care Service

There is much in the Feeley Report on Adult Social Care that Local Government and Scotland’s Council Leaders have been calling for, COSLA said yesterday.

Leaders have long advocated that that the lived experience of those who rely on social care should be embedded within the system and that social care should move to a more person centred approach, recognising the value of not for profit provision, and carried out by a workforce that is valued.

However Leaders unanimously expressed ‘grave concern’ at the recommendations around the future governance and accountability arrangements contained within the Report.

Whilst they agreed with a lot of the content within the Feeley Report, Council Leaders together voiced their opposition to the recommendation which proposes the removal of local democratic accountability from Adult Social Care and the centralising of the service under a National Care Service with accountability falling to Ministers, a move that they described as being detrimental to the local delivery of social care and its integration with other key community services.  

They also felt that given the level of funding set out in the Review, Local Government would be well placed to continue to deliver this vital service.

Speaking following a special meeting of Council Leaders Councillor Stuart Currie, COSLA’s Health and Social Care Spokesperson, said:  “Council Leaders noted the publication of the Independent Review of Adult Social Care and endorsed many of the principles set out in the report particularly in relation to  empowering people, valuing the workforce and embedding a human rights approach to social care.

“Leaders were also clear that the lived experience of those who rely on social care should be embedded within the system and that social care should move to a more person-centred approach.

“However, there was real and unanimous opposition to the recommendations on governance and accountability which would see the removal of local democratic accountability and a degree of centralisation, which Leaders rightly felt would be detrimental to the local delivery of social care and its integration with other key community services.

“They also felt that given the level of funding set out in the Review, Local Government would be well placed to deliver the human-rights based approach outlined at pace, whilst ensuring local democratic accountability remains front and centre of social care.”

A further detailed report on the proposals will be considered by Council Leaders at the end of February.

A National Care Service for Scotland?

Coalition of Care and Support Providers welcome Independent Review of Adult Social Care in Scotland

CCPS (Coalition of Care and Support Providers) has welcomed the publication of the Independent Review of Adult Social Care in Scotland and its call for a renewed purpose for social care with human rights at its heart.

CCPS are delighted by the commitment to a new narrative which replaces crisis with prevention and wellbeing, burden with investment, competition with collaboration and variation with fairness and equity.

We strongly endorse the call to put people front and centre of social care delivery – people who are supported by social care, their families and carers, and people who work in social care services.

We agree that Scotland already has strong foundations on which to build a National Care Service. We want to work with the Scottish Government, national and local stakeholders – including those who support people and people who are supported – to redesign the system to make the ambitions set out in the Review happen.

We wholeheartedly back the Review’s assertion of a duty to co-produce a new system with people who it is designed to support.

Over the coming weeks we will be working closely with our members to explore the Review’s recommendations in detail. As the membership body for third sector providers, we are especially interested in participating in the conversation about the Review’s recommendations on commissioning and procurement.

In 2020, we published our own contribution to that conversation, a series of Big Ideas about changing the way social care is planned, purchased, and paid for. We are grateful to the Review team for citing those ideas. In particular, we thank them for including as one of their recommendations, our suggestion to press pause on all current procurement in the context of a National Care Service, with a view to rapid, carefully planned implementation.

We agree with the Review team that implementation is the most significant challenge. Now is the moment for whole system change, hand in hand with the implementation of The Promise and the recommendations of the Social Renewal Advisory Board.

We would echo the Review Team’s own words – ‘If not now, when? If not this way, how? And if not us – who?

Annie Gunner Logan, Chief Executive of CCPS said: “CCPS congratulates Derek Feeley and the Review team on completing a mammoth task in record time and their willingness to listen to many voices including those of providers and the people we support.

“Reform of social care in Scotland is long overdue. The COVID-19 pandemic has exposed fault lines which require radical overhaul and long-term change. It has also revealed what can be achieved when obstacles are removed in a crisis.

“We are heartened by the direction of travel set out in the Review. The challenge now must be to turn aspiration into implementation. Change is needed urgently but how it is achieved matters too.

“The debate about a National Care Service must not become a bunfight at the expense of those who provide social care and the people they support.

“The upcoming election period provides an opportunity to discuss the Review’s recommendations openly and widely. But when the votes have been counted, and Scotland gets down to the series business of design and implementation, their voices must be in every room, every step of the way.”

Responding to the publication of the Independent Review of Adult Social Care in Scotland Report yesterday, GMB Scotland’s Women’s Campaign Unit Organiser Rhea Wolfson said: “Scotland has a once in a generation opportunity to transform social care, if the recommendations of this report are underpinned by proper value for the workers who will deliver it.

“We are pleased the report acknowledges our campaign for a £15 an hour minimum wage in social care and we would stress to the government and the industry this is very achievable with collaboration and political will.

“The report is clear that if government and the industry invest properly in the sector and its people, the economic multiplier effects of social care spending could have transformative effects not just for workers’ pay and the quality of care, but for the equalities agenda and the wider economy.

“The COVID-19 pandemic ruthlessly exposed the long-standing crises in social care which everyone well understood, and for a workforce of mainly low-paid and often exploited women this has meant a chronic struggle for proper value and respect.

“After the crises and tragedy of the last eleven months, and with tough times still ahead of us, there is hope in these recommendations.

“If we are serious about what we really value as a society, then we have a chance to finally get the social care agenda right.”