Interim National Care Service Advisory Board: Advice to Scottish Ministers and Council Leaders - Coming Home

Advice to Scottish Ministers

The interim Board considers it essential that there is some nationally coordinated and funded action taken to accelerate progress in securing appropriate, community-based placements for those on the Dynamic Support Register.

The interim Board recommends the following actions:

• re-open the previously developed proposal by the Independent Living Fund to establish a national top up scheme for complex care needs. This would allow bespoke services to be commissioned that meet people’s needs and deliver their choices effectively and safely
• provide appropriate additional grant funding to the Independent Living Fund for the development and delivery of this scheme and for any national top ups
• work with health boards and local partnerships to identify savings and consider the potential for budget transfers - recognising that in the longer term, community-based support should be more cost effective than complex hospital-based care. This aligns with the Principles and Major Changes set out in the Health and Social Care Service Renewal Framework, which aims to shift funding and workforce capacity into primary and community care and embed prevention across all care.

The interim Board notes the difficulties in measuring the impact of actions taken in support of Coming Home so far, and recommends that Scottish Ministers work through the Social Care Data and Intelligence Programme Board to:

• agree a mechanism for measuring the provision of independent advocacy to support those on the Dynamic Support Register
• evaluate the adoption of guidance on DSR review meetings for urgent cases and how effective those meetings are
• evaluate the adoption of learning disability annual health checks and how effective they are in supporting the prevention of placement breakdown