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.”

Scottish Pensioners’ Forum calls for creation of a National Care Service

The Scottish Pensioners’ Forum, the campaigning organisation for older people in Scotland, have today released a report calling for the creation of a National Care Service in light of the tragic number of deaths related to Covid-19 within care home settings.

The report is supported by the STUC.

Rose Jackson, SPF Chair, argued: “Covid-19 has had a disproportionate impact on the most vulnerable members of our society with many older people losing their lives prematurely due to the inadequate measures in place within residential care settings – things must change as a matter of urgency to ensure that more older people don’t lose their lives unnecessarily as a consequence of this.”

The report also highlights the profits being made by private companies and overseas investment in the care home sector and calls for an urgent review of this practice.

“We must replace a profit based system with something more akin to the NHS to avoid tax payers providing grossly inflated profits to shell companies and overseas speculators.”

The SPF, who have strong links with the STUC and its affiliates, have also set out a plan for a care service which would be beneficial for care home residents whilst also protecting the rights and welfare of employees in the care sector.

Roz Foyer, STUC General Secretary, welcomed the report stating: “Older people in Scotland have suffered greatly during this pandemic. Reports that half of all Covid deaths in Scotland have been from people living in care homes is a disgrace that should shame Governments and employers.

“The STUC has repeatedly called for a National Care Service, and while the Scottish Government have promised to review it, we must continue to push for a fully nationalised service that puts service users and care workers before profit and greed. That is why we continue to demand that the voice of care users and the voice of workers is directly represented on the Adult Social Care Inquiry.

“It is the least we, as a society, can do for our older population and for future generations to come.”

National Care Service? Review of adult social care

Expert panel will report by January 2021

An independent review is to consider the idea of a national care service.

The review, a Programme for Government commitment, will aim to ensure Scotland provides consistently excellent support for people who use these services, as well as their carers and their families.

It will be chaired by Derek Feeley, former director general of Health and Social Care in the Scottish Government, and will report by January 2021.

Adult social care comprises a wide array of services and non-clinical support in a range of settings, involving care homes, care at home, day services, and community support for people with a range of needs.

Social care supports more than 200,000 people across Scotland – those with disabilities, older people, people with mental health problems and those with drug and alcohol problems.

The review will take into account the experiences of those supported by, and who work, in social care, as well as looking at funding, governance, administration and delivery.

The review will consider the needs, rights and preferences of people who use services, their families, and their carers.

Health Secretary Jeane Freeman said: “This will be a wide ranging review of all aspects of a service which supports and involves so many people across Scotland. I am looking forward to recommendations that help ensure high standards of service and support into the future.

“This independent review will examine how adult social care can be most effectively reformed to deliver a national approach to care and support services – and this will include consideration of a national care service.

“It will also build upon our existing commitments to improving provision – long standing issues in adult social care have been thrown into sharp relief during the pandemic, and they demand our attention.

“We owe it to those who use and work in adult social care services to acknowledge these challenges, to learn from them, and to consider carefully how we can most effective plan for the future.”

The chair of the review Derek Feeley, a former director general of Health and Social Care in the Scottish Government, is also a former Chief Executive of NHS Scotland and former Chief Executive and President of the Institute for Healthcare Improvement.

Derek Feeley said: “I am grateful to the Health Secretary for the invitation to chair this independent review and to the advisory panel for agreeing to bring their considerable expertise to our work to recommend improvements to adult social care in Scotland.

“I look forward to views of everyone involved in our social care system and, in particular, to hearing from service users about what it will take for us to better meet their needs, rights and preferences.

“We have a broad remit that touches on every part of the social care landscape; from the experience of those using and working in the system to how it should be funded and regulated. We will look at every option and opportunity to bring about the improvements that I know everyone working in the system aspires to achieve.”

The panel of experts for the review includes: Malcolm Chisholm, former Scottish Minister for Health and Community Care, Anna Dixon, chief executive of the Centre for Better Ageing, Caroline Gardner, Auditor General 2012-2020, Councillor Stuart Currie, Ian Welsh, chief executive of the Health and Social Care Alliance and Göran Henriks, Chief Executive of Learning and Innovation in Jönköping, Sweden.

The possible remit and structure of a potential national care service has not yet been set out. It could cover a range of organisational, funding and delivery options, which will be for the independent review to consider.

The review will also consider previous and ongoing work, including:

  • the programme for social care reform currently being taken forward by the Scottish Government and COSLA
  • progress with integration of health and social care in Scotland, including the outcomes of the recent review undertaken by the Scottish Government and COSLA
  • work undertaken by the Care Inspectorate to consider opportunities for improving adult social care provision
  • work undertaken by wider partners including the third sector to understand people’s experience of care and support improvement
  • scrutiny by Audit Scotland of social care and progress with integrating health and social care
  • scrutiny by the Health and Sport Committee of the Scottish Parliament of reform of social care to date and progress with integrating health and social care