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Consultation on radical shake up of social care in Scotland underway

social care


The Scottish Government is currently consulting on plans to improve social care and introduce a National Care Service – touted as the ‘biggest public sector reform’ since the creation of the National Health Service.

A ten-week consultation, which began in August, sets out the proposals for the delivery of social care in Scotland, following the Independent Review of Adult Social Care recommendations published earlier this year.

The National Care Service (NCS) would be responsible for adult social care services but could be extended to include children and young people and other community services such as community justice, alcohol and drug services, and social work. The new service would be accountable to the Scottish Government and would look to bring significant ‘cultural change’ to the social care system in Scotland.

Kevin Stewart, minister for mental wellbeing and social care, said: ‘What we are now proposing is the biggest public sector reform for decades, since the creation of the National Health Service.’

He added: ‘The ambition of this government is to create a comprehensive community health and social care service that supports people of all ages. We are at the beginning of a journey to improve social care in Scotland.’

Figures from 2018/19 show that around one in 20 people in Scotland receive social care and support, of which 23% are under 65 years of age.

The Scottish Government’s proposals would mean that new Community Health and Social Care Boards would replace Integration Joint Boards (IJBs) and work in partnership with the NHS, local authorities and independent sectors to plan, commission, and manage services, including community-based healthcare, such as GPs’ contractual arrangements and community nursing, including general practice nursing and district nurses, community mental health and learning disability nurses and health visitors.

The consultation document recognised the need for the social care workforce to feel valued and acknowledged the ‘compassion and care they bring every day to the job they do’, as well as noting the crucial role the service plays in the economy. The NCS proposals include implementing a national pay-band structure similar to that within the NHS.

Although the consultation stated the proposals ‘will have a cost to the public purse’, it failed to state how much money will be needed or where it will come from. The Scottish Government has already committed to increasing investment in social care by 25% but has highlighted ‘public resources are limited’, in the consultation document. 

Kevin Stewart added: ‘If we get social care delivery right, we can help people live the kind of life they want to live; going to college, getting a job, remaining in their own communities for longer. Peoples’ lives can be transformed.”

Commenting on the consultation, Julie Lamberth, chair, RCN Scotland Board, said: ‘The Covid-19 pandemic has brought into sharp focus many of the long-standing problems that those receiving and working in adult social care have faced. We must not miss out on the opportunity to create an adult social care system which recognises the importance of nursing in social care by providing safe staffing levels, improving terms and conditions for nursing staff and supporting recruitment and retention.’

She added: ‘The implications for community services, which are already under severe strain, will have to be properly thought through, and these services must be adequately supported to manage this change.”

The consultation process will close in October 2021 and new legislation will be introduced by summer 2022. 

After promises by successive administrations to solve the social care crisis in England, Boris Johnson promised he would ‘fix’ the issue when he came to power in 2019. No strategy has yet been delivered but it has been reported the current Government will publish a plan in the autumn with a long-term solution to fund social care in England adequately.