The establishment of a National Care Service (NCS) and new local care boards for social care support services which will be directly accountable to Scottish Ministers was introduced in the Scottish Nationalist Party's (SNP) manifesto in 2021. Following the election, the Scottish Government committed to launching a public consultation within the first 100 days and to introducing the bill to the Scottish Parliament by the end of the first parliamentary session.
The NCS will be responsible for social work and social care support, including support for carers. It will also be responsible for planning and commissioning primary care and community health services, including mental health services. To ensure services are joined up, from a community healthcare context General Practitioners (GPs), Nurse Directors and other clinical and healthcare leaders will engage in the development of locality plans.
Our commitment is that the NCS will:
- enable people to access timely, consistent, equitable and fair, high-quality health and social care support across Scotland;
- provide services that are co-designed with people who access and deliver care support, respecting, protecting and fulfilling their human rights;
- provide support for unpaid carers, recognising the value of what they do and supporting them to look after their health and wellbeing so they can continue the caring relationship;
- support and value the workforce;
- ensure that health, social work and social care support is integrated with other services, prioritising dignity and respect, and taking account of individual circumstances;
- ensure there is an emphasis on continuous improvement at the centre of everything we do;
- provide opportunities for training and development, including the creation of a National Social Work Agency (NWSA) providing national leadership, oversight and support;
- recognise the value of the investment in social care support, contribute to the wellbeing economy, make the best use of public funds, and remove unnecessary duplication.
In September 2020, the Scottish Government commissioned the Independent Review of Adult Social Care (IRASC), chaired by Derek Feeley and supported by an Advisory panel of Scottish and international experts.
Taking a human-rights based approach, the review recommended improvements to adult social care, focussing on people who use social care support services, their carers and families, and the experiences of those who work in the social care sector.
The review recognised that in Scotland there is much to be proud of in the provision of social care support but that we can still do better. It recommended three things that must change in order to secure better outcomes:
- A shift in the paradigm by challenging some of the prevailing narrative around social care support and underpinning a human-rights based approach.
- Strengthening the foundations that are already in place and closing the gap between policy and implementation. Nurturing and strengthening the social care workforce and supporting the contribution from unpaid carers.
- Redesigning the system to establish a NCS to provide a consistent service across the country, set national standards and drive national improvements, improve integration with the NHS and bring national oversight and accountability to social care support.
The IRASC report was published on 3 February 2021. Although it focussed on adult services most Integration Authorities have delegated authority for a wider remit that may include health, children and families, and justice delivery. The report recognised that adult social care support does not stand alone and has strong links to wider services, such as social work and children's services.
The report contained 53 recommendations, a key one of which was the establishment of the NCS.
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