Chapter 3: Scope of the National Care Service
Children's services are services that benefit children. These include services for those who are in care or have left care, children with complex health conditions, young people involved in offending behaviour, or those with additional support needs.
Children's social work and social care services is linked to adult services. It is important to have a whole family view.
Just now, local Integration Authorities and councils are responsible for children's services. We plan for children's social work and social care services to be in the National Care Service (NCS).
Primary and community health care is how most people first contact the NHS. These services, include GPs, dentists, pharmacists and district nurses.
Integration authorities are responsible for planning health and social care. They want to avoid people needing hospital care. For example, better social care could help a person to manage their health condition at home.
We therefore plan that the National Care Service could take responsibility for a range of community health services.
Social Work and Social Care
Social work has a key role in services to support adults, children, and families. They manage risk as part of care planning. Social care services are then provided on the needs.
Social workers have a responsibility for checking and reviewing care to make sure needs are met. They also make sure people are safe.
We plan that all responsibilities for social work are under the National Care Service. This could make things easier and make transitions better.
Registered Nurses have an important role in delivering health and social care services.
It is important the conditions for nurses employed in social care are the same as nurses employed by the NHS.
Executive Directors of Nursing in the NHS provide leadership and check on standards of nursing. During the pandemic they have also given advice to care homes. The National Care Service could take over these things for social care nursing staff. It could plan for nursing in social care. It could also make sure nurses in social care have the same access to training as in the NHS.
Justice Social Work
Justice Social Work (JSW) services are important in managing and preventing offending behaviour and keeping communities safe. JSW works with people with a variety of complex needs. It works with partners to support area based plans. However, services are not the same across Scotland.
Including JSW services in the new NCS could be positive. Services would be more consistent and have stronger links to health services.
However, including JSW may be difficult. It would mean changing complex funding and delivery methods. We would not want to mess up ongoing work. Therefore, if JSW is included in the NCS, it may be transferred later.
Mental Health Services
Mental health services include a wide range of activities and professionals.
Only some services are managed by Integration Authorities and this varies across Scotland. This can cause issues for staff and mean different standards of care for people
We plan that mental health services should be in the National Care Service to make sure they are the same across all of Scotland.
In prisons Healthcare is the responsibility of the NHS, Social care is arranged by the Scottish Prison Service.
We plan that the NCS oversees social care for people in prison.
Alcohol and Drugs Services
Alcohol and drugs services are run by integrated authorities.
Each council area has an Alcohol and Drugs Partnership (ADP). The ADP is responsible for planning across issues such as education, treatment, and support for family members., People with alcohol/drugs problems can have complex needs that overlap services. Care and support should be joined up.
Many feel the system is focused on treatment. It should also be on prevention, recovery and wider integrated support services. People moving between services means they may also fall through gaps.
We are thinking about making changes to ADPs to make them more effective and whether they should become part of the National Care Service (NCS).
National Social Work Agency
Social work is complex. Social workers support people and families in their most challenging times. Most social workers are employed by councils.
Different organisations provide support for social workers. There are differences in pay and terms and conditions. There is no national workforce planning. This can make it difficult to have enough student placements.
More pressure on social work services also means the focus must be on people in crisis or with significant needs. This leaves less time for work to prevent difficult situations and for social worker training.
We plan that a new National Social Work Agency should be made. This would have national leadership on areas including social work qualifications, workforce planning, getting better, training and pay and grading.
Question 12: Do you agree all the areas should be in the National Care Service?
- No preference
Question 13: What parts of mental health care should be delivered in a National Care Service? (Tick all that apply)
- Primary mental health services,
- Child and Adolescent Mental Health Services,
- Community mental health teams,
- Crisis services,
- Mental health officers
- Mental health link workers
- Other – please explain below