National Care Service Forum 2025: report

National Care Service National Forum 2025 Report

1.1 About the National Care Service

The Independent Review of Adult Social Care in 2021 recommended a National Care Service.

The National Care Service is about what we do to improve the system for everyone in Scotland - it is a programme of work that will bring about the change that people want to see. It is action that is important – not a set of structures in how we’re organised.

We are committed to doing all we can so that those with experience of social care and community healthcare can continue to share their views and help shape the future of social care in Scotland.

That is why we hold an annual NCS Forum, as it brings people together to discuss the future of social care in Scotland.

Following the passing of the Care Reform (Scotland) Bill, it became an Act on 22 July 2025. Once a Bill becomes an Act of the Scottish Parliament it means that it forms part of law. The reforms brought about by the Act will strengthen the rights of care home residents, support unpaid carers, and improve the rights to advocacy and information.

We have also established a National Care Service (NCS) Advisory Board, to drive improvement and make sure services are consistent, fair and high-quality. The Board provides the strong independent oversight and coordination the sector needs. The diverse range of Board members, from unpaid carers to NHS leaders, ensures voices from different perspectives are heard.

The Care Reform (Scotland) Act 2025 and the NCS Advisory Board, alongside several other national improvement programmes listed below, are all playing a part to ensure a better social care system for Scotland.

• Getting it Right For Everyone (GIRFE)
• Coming Home
• Self-directed support improvement plan
• Support in the Right Direction

1.1.1 About the annual NCS forum

We have hosted an NCS Forum each year since 2022. This is a chance for us to share updates on the progress of the NCS and to hear people’s views and ideas. The forum is open to everyone and free to attend.

The 2025 NCS Forum was held at the Edinburgh International Conference Centre on 19 November.

You can find the reports from our past forums by visiting the Scottish Government website on www.gov.scot/ncs.

1.1.2 Lessons from past NCS forums

We used feedback and our experiences from past events to plan this year’s forum.

We:

• hosted the in-person event at Edinburgh International Conference Centre, due to its accessibility, facilities and good transport and accommodation links
• had options to take part fully online or in person at the venue
• shared the programme with attendees ahead of the event and made alternative formats available
• gave handouts to each in-person attendee at the event. For those attending online, we shared these materials in advance
• provided a mailbox and telephone helpline for any pre-event questions
• covered expenses for accommodation, travel and other support, as needed, for those with lived experience of accessing social care in Scotland
• made sure accommodation we booked for attendees was accessible
• provided British Sign Language (BSL) interpretation and electronic live captions online and in person
• gave people with lived experience of accessing or providing social care in Scotland early access to tickets
• sent all attendees a feedback survey after the event

Some changes from last year’s forum included:

• basing discussion questions on specific areas of the NCS, to reflect the progress over the last year and on areas that we knew people wanted to discuss
• giving everyone the opportunity to discuss all 3 of the topics
• assigning people to tables, to ensure a mix of individuals and representation from organisations
• not producing BSL and audio formats for event materials, due to low uptake last year, but making these available on request

1.2 About the NCS Forum 2025

1.2.1 How people took part

We offered people three ways to take part:

• in person at the venue, where they could listen to the speakers and take part in discussion groups
• online using Zoom, where they could listen to the speakers and take part in discussion groups
• online using Vimeo, where they could listen to the speakers only

1.2.2 Who took part

More than 200 people joined the event online and in person, including:

• stakeholders
• people who access social care support
• the social care workforce
• carers and unpaid carers

From the feedback we received in the post-event survey:

• 61% said they attended in person
• 28% said they joined the Zoom call
• 2% said they watched the live stream on Vimeo

Of the people who attended in person:

• the majority used public transport
• 36% of people travelled less than 10 miles
• 55% travelled between 20 and 40 miles
• 9% travelling more than 60 miles
• attendees found the venue very accessible

1.2.3 What happened on the day

Chair and speeches

The event was introduced and chaired by Susan Douglas-Scott, Chair of the NCS Interim Advisory Board. 

We also heard speeches from:

• Tom Arthur, Minister for Social Care and Mental Wellbeing 
• Councillor Paul Kelly, CoSLA Spokesperson for Health and Social Care

You can read the Minister’s speech by visiting the Scottish Government website on www.gov.scot/ncs.

The Chair interviewed Sandra Auld, who volunteers on her local Integration Joint Board and Health Board, and is a member of the interim NCS Advisory Board. She advocates for community involvement in shaping policy and believes care should always centre on people.

1.2.4 Panel discussion

This year’s panel members were:

• Tom Arthur, Minister for Social Care
• Councillor Paul Kelly, CoSLA Health and Social Care spokesperson
• Shubhanna Hussain, a carer and Partnership Development Officer at the Coalition of Carers in Scotland
• Eireann McAuley, NCS interim Advisory Board lived experience member
• Luke Murphy, Glasgow Disability Alliance member
• Fiona Davies, Chief Executive of NHS Highland and NCS interim Advisory Board member
• Iona Colvin, Chief Social Work Adviser for Scotland and NCS interim Advisory Board member

The panel shared their thoughts on where they:

• had seen or experienced collaboration working well
• could see room for improvement and opportunities

1.2.5 In-person stalls

At lunchtime, in-person attendees could visit stalls in the main foyer to:

• explore key developments in social care and social work
• share their views
• find out how to get involved in shaping the future of Scotland’s social care. You can read about how to join the Lived Experience Experts Panel and NCS Stakeholder Register on gov.scot/ncs.

1.2.6 Interactive discussions

There was an interactive session for people attending in-person and online. This was an opportunity to discuss and respond to questions on 3 topics:

• Right to Breaks for Carers
• Self-Directed Support 
• National Social Work Agency

You can read a summary of the discussions points below.

For those who experienced technical difficulties during the interactive session, we provided an opportunity for them to share their views in the post-event survey. These have been included in the findings below.

2.1.1 What you told us – Right to Breaks for Carers

What are the positives for carers if the right to breaks is introduced first to carers providing the highest level of care?

Overall, people were supportive of the right to breaks and highlighted that caring without rest creates a risk of burnout.

Whilst the benefits of breaks are widely understood, people stressed that the right must be introduced carefully.

A phased approach was seen by many as practical due to funding and service‑capacity constraints, although it raises challenges around how carers would be prioritised and how need would be evidenced.

There was strong agreement that transparent and fair eligibility criteria would be essential, and that it must be well-designed and clearly communicated.

People highlighted that any carer who does not initially meet the criteria should be given a clear explanation and information about when they might receive a break, without needing to reapply repeatedly.

2.1.2 What are the potential drawbacks of introducing the right to breaks first to carers providing the highest level of care?

Some people raised concerns about prioritising carers based on the level of care they provide, rather than the carer’s own needs.

Many people favoured a person‑centred approach to prioritisation, taking into account an individual carer’s circumstances, support networks, and ability to cope, recognising that someone providing less intensive care may still be near breaking point.

A minority of people disagreed with a phased approach altogether, saying that a right should apply to everyone equally and that phasing carries risks of exclusion and frustration.

2.1.3 How would a phased, prioritised approach like this benefit others?

Many people agreed that phasing could help prevent Health and Social Care Partnerships (HSCPs) and carer services from becoming overwhelmed. It would also provide an opportunity to test and refine the policy before wider rollout.

Gradual implementation was viewed as supportive for carer centres and short‑break providers, allowing them to sustainably build capacity.

Overall, people felt that if the right support is in place at the right time, carers can continue to provide care effectively, but the phasing must be managed carefully to ensure fairness and avoid unintended divisions.

2.1.4 What challenges might carers, cared-for people, HSCPs and delivery partners face if the right is introduced in a phased way? What might the negative impacts be?

People felt strongly that all unpaid carers should be valued equally. Some worried that creating priority tiers could leave certain carers feeling overlooked or less appreciated. Whilst targeted rollout may be practical, people felt it could lead to inequitable support and the exclusion of hidden carers.

Many emphasised that if all carers have a right to a break, prioritising some over others - even temporarily - could feel contradictory, and that breaks should be allocated according to individual circumstances.

Assessing who is “high priority” may also place emotional strain on carers, who could feel pressured to prove the severity of their situation.

Despite this, others highlighted concerns about whether services could cope with a universal entitlement from day one, given pressures on carer services and local authority budgets.

2.1.5 What other factors could impact the successful implementation of the right to breaks?

Many people felt the right to breaks had to be adequately funded and staffed to work in practice. Clarity about how funding is safeguarded and monitored was seen as essential.

Many people highlighted that without sufficient resources and a high‑quality care system underpinning the policy, introducing a right to breaks could create more stress for carers rather than relieving it.

Some people highlighted the need for fair and transparent decision‑making in setting:

• a priority hierarchy
• how levels of need are defined
• a clear and fair process to challenge decisions

2.1.6 To ensure the successful implementation of the right to breaks what other challenges need to be addressed?

People emphasised that clear communication about the right to breaks is crucial, particularly because many carers do not identify as carers and may therefore be missed in a phased rollout.

Communication should involve a broad range of organisations (not just carer organisations) to reach hidden carers and promote existing support.

Concerns were raised about ensuring reliable replacement care, both to protect the wellbeing of the person cared for and to allow carers to take meaningful breaks.

People stressed that processes in accessing a break must feel fair and accessible.

Carers are already navigating complex systems and being passed between organisations was highlighted as a common frustration. This is especially problematic for those with the highest needs, who may lack the time or capacity for complex forms or assessments.

2.1.7 How we will use these findings – Right to Breaks for Carers

Responses to the Scottish Government’s public consultation on the right to breaks (which is being held in spring 2026), along with evidence gathered at the NCS Forum 2025 and wider engagements sessions, will be analysed.

This will help Scottish Government to develop the final regulations and associated guidance, which are needed to support effective delivery of these new right to breaks, as laid out in the Care Reform (Scotland) Act 2025.

This work will be overseen by the Right to Breaks Implementation Steering Group, which was set up last year to help with the implementation of the right. The group is made up of diverse stakeholders, including carers, third sector and statutory organisations, to ensure that the voices of experience from many groups are heard.

3.1.1 What you told us – improving Self‑Directed Support (SDS) flexibility of spend

Have you ever had a positive or negative experience accessing flexibility of spend, either for yourself or someone you care for?

Overall, experiences of flexibility of spend under SDS are mixed and highly dependent on knowledge, advocacy and local implementation.

Positive experiences show that SDS works best when:

• people have a strong understanding of SDS options and are supported to advocate for themselves
• care packages are genuinely flexible and based on outcomes rather than fixed hours or tasks
• individuals can shape support around their lives, improving wellbeing and independence
• advocacy is available to help people navigate complex systems and challenge barriers

Negative experiences highlight that:

• SDS is often implemented in a rigid, time‑and‑task way, undermining person‑centred care
• choice is frequently constrained by budget protection, gatekeeping and restrictive local rules
• people are treated as “options” rather than individuals, with limited ability to adapt support as needs change
• awareness of the 4 SDS options is inconsistent among both staff and individuals, resulting in limited or ill‑informed choice
• fear of being the decision‑maker, administrative burden and employer responsibilities deter people from more flexible options
• eligibility criteria, workforce shortages and variation between local authorities limit access and equity

3.1.2 If you have had a negative experience accessing flexibility of spend, can you please briefly describe what happened, and the impact this had on you and/or the person you care for?

Negative experiences often have a significant emotional impact on individuals and families – affecting their wellbeing.

Key issues include:

• limited local resources and budgets meaning flexibility exists in theory but not in practice, with reductions in hours and loss of respite
• poor information and guidance, leaving families to manage complex systems without support or an understanding of their rights
• fear of losing support, which discourages people from questioning decisions or exploring alternative options
• confusing and overwhelming processes, including complex paperwork, inconsistent decision‑making and unclear communication
• lack of real choice, with people being told what they can spend money on, restricted to approved providers or blocked by blanket rules
• emotional strain, anxiety and family tensions caused by uncertainty, financial management pressures and lack of clarity around responsibilities

3.1.3 What would have helped make this a positive experience for you and/or the person you care for?

Participants consistently identified changes that would have improved their experience and outcomes.

These include:

• a stronger person‑centred approach, with planning focused on individual needs, preferences and outcomes rather than budgets or hours
• adequate and protected funding for SDS, recognising that early investment and prevention improve long‑term outcomes
• early, clear information and advice, enabling people to understand SDS before reaching crisis points and to plan ahead
• better support and training, including training for staff in SDS, learning disabilities, and person‑centred practice
• practical support for individuals and families managing SDS responsibilities
• improved recognition and support for carers
• simpler and more flexible processes, with reduced bureaucracy, clearer assessments, transparent decision‑making and flexibility around spending timeframes
• consistency across areas, reducing postcode variation and ensuring equitable access regardless of location

3.1.4 How we will use these findings - improving Self‑Directed Support (SDS) flexibility of spend

We will share these findings with our key delivery partners:

• CoSLA
• Self‑Directed Support Scotland
• Social Work Scotland
• In Control Scotland
• third‑sector organisations funded through our Support in the Right Direction programme.

These insights are deeply valued and form an essential part of understanding how SDS is working in practice for people and families.

This rich information will be considered alongside other evidence gathered through our collaboration groups and networks, helping to inform policy development as we move into the final year of the Self-directed Support: Improvement Plan 2023 to 2027.

4.1.1 What you told us – the National Social Work Agency

What needs to change about social work in Scotland?

• improve access and timeliness: people reported long waits to be allocated a worker (sometimes months) and difficulty reaching someone in crisis. People said that named contacts or small teams could improve continuity and trust
• reduce bureaucracy and restore professional judgement: administrative tasks, panel and budget overrides and form‑driven assessments crowd out person‑centred work and demoralise staff
• establish consistency across Scotland: variation between workers, teams and areas creates a postcode lottery for assessment, SDS options and decisions. People called for clearer national standards and accountability
• clearer roles and remit: people want a clear definition of social work, how it differs from social care and what the National Social Work Agency will do nationally
• address workforce pressures: people highlighted high caseloads, turnover and limited Continuous Professional Development (CPD) time. They also called for training in SDS, disability, equality and human‑rights‑based practice
• change in public perception and language: stigma and unhelpful terminology discourage engagement. People want respectful, plain English communication and recognition of carers as partners
• improve resilience of the workforce: better training, more social workers to reduce delays and a return to relationship‑based practice, “putting the social back into social work”

4.1.2 What should social work look like in the future?

• relationship‑based and rights‑anchored: decisions should make dignity, empathy and human rights visible in day‑to‑day practice, not just as words in policy
• person‑led and outcomes‑focused: move away from transactional, time‑and‑task processes to outcomes that matter to people and families
• preventative and continuous: named worker and small‑team continuity, early help and co‑location with partners (schools, third sector, health) to intervene before people hit crisis
• joined‑up and community‑based: social workers embedded locally, collaborating with carers, advocacy and community organisations to address whole‑person and whole‑family needs
• clear, consistent SDS: everyone should understand SDS options, with flexible, equitable implementation across areas and support to navigate choices
• rights and advocacy: rights and equalities embedded; clearer information and accessible formats to empower self‑advocacy

4.1.3 What values matter most – and how should they be lived?

• values: compassion, dignity, excellence, respect, integrity, collaboration and equity alongside autonomy and accountability. People stressed that values must be lived, and not be just well-meaning words
• making values real: people asked for manageable caseloads, protected reflective time, supportive supervision/mentoring and safe ways to raise concerns. Without these, values feel business‑like
• skills and learning: sustained CPD (including disability, equality, human rights, SDS and outcomes planning) and opportunities to specialise, e.g. elective pathways like Allied Health Professionals (AHPs)
• trust and transparency: people want clarity on how values will be monitored, what redress exists when they are not upheld, and how decisions are explained

4.1.4 What does success look like in 5 years – and how will we protect rights in everyday practice?

• success in 5 years: trusted, relationship‑based social work that people are confident to contact; consistent access and standards across Scotland; timely assessments; stable workforce with clear CPD and career pathways; and real choice/control through SDS
• protecting rights day‑to‑day: clear, plain English rights information; straightforward routes to independent advocacy; transparent complaints and feedback (“you said, we did”); respectful communication; and practitioner autonomy to act on professional judgement
• people don’t mind structures, as long as they work: the test of success is whether support is accessible, coordinated and outcomes‑focused

4.1.5 How we will use these findings - the National Social Work Agency

We will use what people told us to shape how the National Social Work Agency develops and operates.

We will embed these insights into our systems, processes and culture. This includes using the feedback to inform national workstreams on education, learning, professional governance, workforce planning and improvement, ensuring that rights‑based, relationship‑centred and consistent practice are built into our guidance, data, planning cycles and day‑to‑day ways of working.

The leadership of the social work profession by the National Chief Social Work Adviser, together with their influence in the health and care sector, will raise the profile of the profession and enable the National Social Work Agency to lead excellence and drive change that is person-led and rights-based.

5.1 What’s next

Following the event, we asked in-person and online attendees to share their feedback on the event. We will study the responses and use them to improve future engagement.

The Scottish Government remains committed to driving forward work to improve adult social care.

That work involves listening to the views of:

• people who use and work in support services
• the wider public
• stakeholders
• political parties

Whilst the Scottish Government is working to implement the Care Reform (Scotland) Act, we are focusing on driving improvement against existing statutory responsibilities, which will be enhanced by the additional legislative powers in the Care Reform (Scotland) Act.

We will continue to work with people with lived experience and stakeholders from across the sector, to ensure that implementation of the new legislation is practical and meets the needs of people who draw on services.

Delivering a strong and sustainable social care sector in Scotland is a priority and we are absolutely committed to delivering positive changes for people.

5.2 Request the report in other formats

To request the report in another format:

• email NCSCommunications@gov.scot
• or phone 0808 196 1507 (open Tuesday 9am to 12pm and Thursday 1pm to 4pm)