Health and Care (Staffing) (Scotland) Act 2019 2024/25 Ministerial Annual Report

Part 4 Ministerial Duties For Care Services

As set out earlier in this report, the Act places certain duties on Scottish Ministers to report annually on specific aspects of the Act.

In the above summaries, a number of key themes arise that impact several providers in ensuring compliance with their duties under the Act. Although the Scottish Government is not a care employer, through working with Local Authorities, Integration Authorities and the Care Inspectorate, the Government are taking measures where they can to support the system in achieving a more sustainable and skilled workforce. This section providers further details of that work.

Section 9 (1) (b) & (c): Effect of staffing levels and Supporting Staffing Levels

Staffing Levels

Section 9(1)(b) requires Scottish Ministers to set out the effect that staffing levels in care services have on providers meeting their duties of the Act.

Assessment of Effect

In this first year of reporting, it has been difficult to set out the effect that staffing levels in care services have had on providers meeting their duties of the Act. Scottish Government officials will review this with the aim to ask further questions about this ahead of future Ministerial reports.

However, as recognised elsewhere in this report, the Scottish Government are aware that providers and Authorities have experienced challenges with ensuring appropriate staffing levels, but no Authorities have indicated they are not meeting their duties under the Act. In addition, of the 89.9% of registered care providers who responded to the Care Inspectorate’s 2024 Annual Return, 3.7% self-assessed as not meeting their duties within the Act. Scottish Ministers note the limitations of this self-assessed data, as set out earlier in the report. We expect providers not meeting the duties within the Act will be considered and managed by Local Authorities who commission services, through contract management arrangements. The Care Inspectorate’s scrutiny and improvement work focuses on outcomes for people.

The Care Inspectorate works with services to support improvements for people experiencing care. If they find outcomes and experiences are not being met, they will take action to address this.

The SSSC ‘2024 Workforce Data Report’^[19] shows that at the end of 2024, the size of Scotland’s care services workforce, measured in terms of headcount, increased slightly to 195,490 (this excludes social work services); an increase of 0.9% since 2023. The overall increase in 2024 was driven by an increase in the care home for adults workforce, which saw an increase of nearly 2,000 additional workers. The report also sets out that there was a decrease in nurse agencies with just over 1,300 fewer workers reported in 2024 than in 2023. However, this reduction could in part be due to changes in the way providers record these workers.

The report provides details on headcount by Local Authority areas and shows that out of the 32 Local Authority areas, 21 (66%) reported an increase in headcount in 2024 compared to 2023. The largest percentage increases were in Aberdeen City, Scottish Borders and Renfrewshire. It is worth noting that of the care services workforce, 71.9%% in 2024 worked within the private and voluntary sectors which are often commissioned by Authorities to deliver services.

The report also sets out a number of challenges in the sector in 2024 including:

• The difficult wider economic and financial context impacting on budgets for Local Authorities and social care
• Financial challenges including the UK Government’s increase in employer National Insurance Contributions, ongoing high costs of fuel, increases in inflation and the general cost of living pressures which cause challenges for both Local Authorities and providers
• Changes to UK immigration policies, including the ban on newly arriving care workers bringing immediate family

The SSSC ‘Have Your Say Workforce Wellbeing Survey 2025'^[20] highlighted that the most common reason for workforce leaving the sector were that they were overworked (24%). The other main reasons raised related to the worker retiring (23%), poor employment and working conditions (22%), and/or relationships with managers/senior staff (21%).

A review of recent Care Inspectorate inspection reports across children’s secure care services, adoption services, fostering services, and school care accommodation services stated the main reasons by providers in the difficulty of filling vacancies were: too few applicants; too few applicants with experience; and too few qualified applicants. Having vacancies does not mean that there are not appropriate numbers of staff within services but could mean that services are unable to expand.

Considering the information provided within the Authorities reports, it is clear that although staffing level challenges were raised, no Authority reported that they were unable to comply with the duties within the Act. In addition, of the 89.9% of registered care providers who responded to the Care Inspectorate’s 2024 Annual Return, 3.7% self-assessed as not meeting their duties within the Act. Scottish Ministers note the limitations of this self-assessed data, as set out earlier in the report. We expect providers not meeting the duties within the Act will be considered and managed by Local Authorities who commission services, through contract management arrangements. The Care Inspectorate’s scrutiny and improvement work focuses on outcomes for people.

The Care Inspectorate works with services to support improvements for people experiencing care. If they find outcomes and experiences are not being met, they will take action to address this.

Looking towards the future, it will be important to ensure the approach to workforce planning, recruitment and retention reflects our broader aspirations for Scotland’s care services, as described in our Health and Social Care Service Renewal Framework^[21]. The Health and Social Care Service Renewal Framework provides a high-level guide for change, to ensure the sustainability, efficiency, quality, and accessibility of health and social care services in Scotland.

The National Care Service interim Advisory Board was also established in May 2025 and is taking an evidence-based approach to help drive meaningful improvements across social care, social work and community health services. The Board’s role will include working with people and organisations to understand what needs to be improved and why, exploring options for making improvements that are needed in the delivery of care services.

Scottish Ministers, Council Leaders, Integrated Joint Boards and Health Boards are the people who might receive advice from the National Care Service Advisory Board because they are the people with legal responsibilities and powers under the existing legislation.

Supporting Staffing Levels

Section 9(1)(c) requires Scottish Ministers to set out the steps taken to support staffing levels in care services to support providers to meet the duties under the Act.

Summary of Support

Whilst Scottish Ministers have to report annually to Parliament on staffing in care services, they do not provide or commission care services directly.

Therefore, Scottish Ministers are not responsible for employing staff within care services and have no direct role in the staffing of services. However, the Scottish Government plays a critical role in enabling and shaping the workforce through funding, regulation and policy, recognising that a critically important driver of quality in experience and improved outcomes is a dedicated, highly skilled, and well-qualified workforce.

The Scottish Government is fully committed to enabling sustainable care services supported by committed professionals who demonstrate the necessary skills and knowledge to delivery high quality care to the people of Scotland.

The Scottish Government continue to take forward a number of initiatives designed to support the attraction and retention of a highly skilled and qualified workforce across our care system. These initiatives are described below.

Social Care

The Scottish Government have continued funding to enable all social care providers to advertise vacancies on the MyJobScotland recruitment website at no cost.

My Job Scotland hosts an interactive map, enabling prospective users to find location specific posts and there are 529 unique employers using the website to advertise positions in adult social care.

Between February 2021 and April 2025, 32,299 adult social care jobs have been posted on MyJobScotland under this contract and this has saved providers £2,635,460.

Additionally, the Scottish Government funds the caretocare.scot website which provides information and tools on careers in the adult social care sector, including a free career guide, information and stories on different roles and information on qualification and interview questions. The caretocare website includes a stakeholder toolkit, which enables providers to use a range of materials to support their own local recruitment efforts.

Jointly with COSLA, the Scottish Government recognise the value of the workforce and are fully committed to working collaboratively to improve the experience of the social care and social work workforce. The Joint Social Services Taskforce (JSST) was established to address priority issues affecting Social Care and Social Work workforces in the short to medium term, focusing on supporting recruitment and retention and providing an enhanced working experience.

Workstreams have included; development of a Portable National Induction Framework, pilot of a Care Technologist Role, development of Social Care Career Options Tool, Earn and Learn workstream and a Funding Landscape workstream making it easier for staff to apply for funding to pay for mandatory qualifications.

Childminding

The Scottish Government have funded the Scottish Childminding Association (SCMA) to deliver a new national 3-year programme of childminder recruitment and retention, known as the Programme for Scotland’s Childminding Future, which launched in June 2024.

From launch until March 2025, the programme supported the creation of over 40 new childminding businesses, with a further 144 potential new childminders completing their training and now being supported with Care Inspectorate registration. Backed by a further £1.6m in Scottish Government funding, the Programme will expand in 2025-26, with the recruitment programme now available in 27 Local Authority areas.

Fostering services

Through the Future of Foster Care work and the forthcoming Children (Care, Care Experience and Services Planning) (Scotland) Bill, the Scottish Government is exploring further measures to support the fostering workforce, which could include improved training pathways, support networks, and national oversight mechanisms. This includes exploring a national register of foster carers and options to strengthen the status and support provided to the fostering workforce across Scotland.

Childcare

Standards for the Scottish Childcare profession are among the best in the world. The minimum qualification requirements for staff are greater than other UK nations at all levels. This has led to Scottish childcare staff being the most qualified across all care services. They also have fewer fitness to practice issues than any other part of the register.

Section 9 (1) (d) Considerations for determining future supply of care professionals

Section 9(1) (d) requires Scottish Ministers to set out how the matters relating to section 9, mentioned above, will be taken into account when determining the future supply of care professionals such as:

• Registered nurses
• Medical practitioners
• Other care professionals as relevant to the discharge of duties of sections 3 and 7 of the Act.

Assessment of future supply of workforce

Under the Health and Care (Staffing) (Scotland) Act 2019, Scottish Ministers are required to set out how they are determining the future supply of care professionals. While this Duty remains, the context in which workforce planning takes place has evolved. Developments since the Act was established include:

• the impact of UK Government legislation changes on international social care visas which has drastically reduced the availability of social care workforce in some regions.
• the introduction of the Care Reform Scotland Act which repeals the uty of national workforce planning from the Scottish Social Services Council (SSSC) and introduces the National Care Service interim Advisory Board.
• the introduction of the Service Renewal Framework and Population Health Framework which sets out Minister’s vision for preventative care and a 10-year reform of service delivery.

Therefore, to meet their obligations under the Act, through the Service Renewal Programme, Ministers will take a broader, integrated approach to workforce capacity planning, which looks beyond modelling of workforce numbers.

The Health and Social Care Renewal Programme, and its resulting changes to service design and skill mix, means it is not sensible to produce workforce projections at this point. Workforce planning assumptions will provide parameters under which the renewal agenda and service planners can operate as they re-design services.

This work will include improving the quality and use of workforce data, integrating local workforce plans with financial plans, strengthening collaboration with partners across the sector, enhancing reporting mechanisms, addressing skills gaps through targeted initiatives, and supporting the adoption of technology-enabled care solutions.

This workforce capacity planning will also deliver on the National Workforce Strategy^[22] commitments, a joint strategy committed to by both COSLA and the Scottish Government which sets out the visions for ‘a sustainable, skilled workforce with attractive career choices where all are respected and valued for the work they do’.

The Strategy recognises that although we have seen continued growth in our workforce, we know that increasing the workforce alone will not deliver the services the people of Scotland need now and will need into the future.

It should be noted that the National Workforce Strategy does not cover all care services covered in this Ministerial report.

In relation to Early Learning and Childcare (ELC) and School Age Childcare (SACC), the Scottish Government are working with Local Government and our partners in the sector to support the development of long-term workforce plans that address workforce issues and ensure sustainable delivery of the 1,140 hours of funded ELC, and wider critical childcare services which support employment for families. The ELC 1140 policy has been in place in Scotland for all eligible 3- and 4-year-olds, and some 2-year-olds, since August 2021 and provides free early learning and childcare, typically 30 hours a week in term-time, to give children a strong start and to support families. The programme is fully funded by the Scottish Government and delivered by Local Authorities.

Section 9 (1) (e) Ministerial steps taken to ensure availability of funding

Section 9 (1) (e) requires Scottish Ministers to describe the steps taken to ensure funding is available to any person who provides a care service, in order to assist the discharge of those duties. This section sets out funding which has been provided by Scottish Government over the period of 1 April 2024 to 31 March 2025 and planned funding for 1 April 2025 to 31 March 2026.

Summary of available funding

The Scottish Government invested significant levels funding in the 2024/25 financial year to support the care sector.

Real Living Wage pay policy

Since 2016, the Scottish Government has provided funding to enable adult social care workers, delivering direct care in the third and private sectors, to be paid at least the Real Living Wage (RLW) rate. This was expanded to workers delivering funded ELC services in 2018, and to workers delivering children’s social care in the 2024-25 financial year

In the 2024-25 financial year, the Scottish Government made a significant investment of over £265 million to ensure that adult and children’s social care workers, as well as workers in ELC, in commissioned services were paid at least the RLW rate.

In adult social care, the uplift to the RLW rate of £12 per hour from April 2024 cost the Scottish Government £230 million, whilst for children’s social care the cost was £20 million and for workers in commissioned ELC this uplift cost £16 million.

As a result of how funding for the RLW uplift is delivered for workers in the adult and children’s social care sectors, many providers may have funding remaining once the policy intent to enable an uplift for the lowest paid workers providing direct care is fully delivered. The Scottish Government have stipulated that any additional funds that remain must be spent on uplifting pay for the directly employed workforce working within services, which could be used to contribute towards stabilising or maintaining differentials.

Adult Social Care

The Scottish Government invested over £2 billion in the 2024/25 financial year for adult social care and integration, delivering on a commitment to increase spending in this area by 25% two years ahead of target. As well as funding for the Real Living Wage pay uplift for these workers, this funding included up to £9 million to re-open the Independent Living Fund (ILF), to enable up to 1,000 additional disabled people with the most complex needs to access the support they need and deserve to live independent lives, and £11.5 million to support the inflationary uplift in Free Personal Nursing Care.

For the 2025/26 financial year, the Scottish Government are continuing to invest in the adult social care sector, with almost £2.2 billion in investment in social care and integration. This has included an additional £125 million to continue funding the Real Living Wage uplift for adult social care workers, a further £13.4 million to support growth in the ILF, £5.9 million of additional investment into the Care Inspectorate, over £88 million in local carer support through council Carers Act funding and £13 million for voluntary sector short breaks in 2025-26.

Early Learning and Childcare (ELC) and School Age Childcare (SACC)

In the 2024-25 financial year the Scottish Government provided around £1 billion to support the delivery of funded ELC. In addition to funding for the Real Living Wage pay uplift, this included over £8 million to Skills Development Scotland to support Modern Apprenticeships in childcare in 2024-25, as well as £1.6 million to fund the Programme for Scotland’s Childminding Future

In addition, the Scottish Government continues to provide baselined funding to all 32 Local Authorities to recruit additional graduate level posts for ELC settings in Scotland’s most disadvantaged communities. In 2024-25, a nominal £23.4 million was provided to Local Authorities to cover funding for Equity and Excellent Lead posts based on 491 SIMD 1 settings.

Over the 2024/25 and 2025/26 financial years, the Scottish Government has provided £16 million funding to design and deliver additional funded childcare for priority families within six ‘Early Adopter Communities’ (EACs) – aligned with our fairer futures partnerships and offering easier access to the support families need. The EACs are working with communities to understand families’ needs (with children from early years to the end of primary); develop better local systems of childcare to meet those needs; and support parents to better access existing entitlements to childcare subsidies through Universal Credit and Tax-Free Childcare. Early delivery has been focused on SACC services.

For the 2025/26 financial year, the Scottish Government is continuing to invest around £1 billion to support the delivery of funded ELC, with an additional £9.7 million being made available to Local Authorities to fund the uplift in the Real Living Wage for funded providers.

The Scottish Government have also invested £3 million in 2025/26 to expand and enhance breakfast club provision across Scotland through our Bright Start Breakfasts fund – to help deliver 9,000 new breakfast club places for primary school children. The fund was open to a range of breakfast club providers including schools, Local Authorities, registered childcare services, childminders, and third sector delivery partners.

School Care Accommodation

Local Authorities have responsibility for the provision of education in their areas, and this includes school care accommodation connected to education authority schools. Care workers in the residential special school care accommodation sector will benefit from a pay uplift so that they are paid at least the Real Living Wage as set out above.

Whilst Scottish Ministers have responsibility for the regulation of independent schools, this role is limited. These are independent businesses, and Scottish Ministers have no role for directing or providing funding for independent schools.

Offender Accommodation

The model for community justice allows for decisions around services to be taken locally. This includes prioritising funding to deliver justice statutory services and local priorities aimed at reducing reoffending. Direct grant funding from the Scottish Government is provided to one offender accommodation service.