National Care Service in Scotland plans go out to views

A National Care Service, to deliver social care to everyone who needs it, is proposed in a new consultation released by the Scottish Government.

The aim of what the Government describes as "one of the most significant tasks of the current Parliament", is to deliver person-centred care that supports people in a way that suits their needs, while introducing "ethical commissioning", based on fair work principles. Ministers want the service to be fully functioning by the end of the parliamentary term in 2026.

A rights-based approach to care would be adopted, strengthening residents' rights in adult residential settings to include delivering "Anne’s law", giving care home residents the right to contact with their families and friends to support their overall health and wellbeing.

Based on 2018-19 figures, around 245,000 (one in 20) people in Scotland, of all ages, receive social care and support, with about 60,000 people receiving home care at any one point and around 35,500 people resident in care homes. Of the total, nearly a quarter (23%) were under the age of 65. They include those with physical disabilities, learning disabilities and mental health issues. There were 206,400 people employed in the social service sector in December 2019, and there are an estimated 700,000 to 800,000 carers in Scotland, including around 29,000 young carers.

The consultation sets out some of the options for delivering social care in a person-centred way. 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, with 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.

The proposals follow the outline recommended by the Independent Review of Adult Social Care, whose report was published in February this year.

However, the consultation document also recognises that 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.

On funding the service, the paper states: "This Government has committed to increase investment in social care by 25%, but public resources are still limited. As we consider the feedback from this consultation, all proposals will be assessed for value for money, to make sure the maximum impact is achieved from that investment. But in doing so we will look at the overall benefits of improving people’s experience of care and the outcomes they achieve, as well as the direct costs or savings of providing that care."

It observes that a focus on early intervention and prevention avoids the need for more costly action at a later stage, for example appropriate care to prevent deterioration or falls resulting in a need for hospital treatment.

Minister for Social Care Kevin Stewart commented: "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."                                                                         

He continued: "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."

Mr Stewart said he wanted to hear from as many people and organisations as possible over the next couple of months, in order to build a better system.

The consultation runs until 18 October 2021. A number of consultation events will be held through late August, September and October. Details, along with the consultation itself, can be found at this link.