National Care Service: statement of benefits

Sets out the benefits of the National Care Service that can be achieved, through legislation and co-design. Highlights where further evidence gathering and consideration may still be required to help inform future decisions around its design and delivery.

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Ministerial Foreword

The establishment of a National Care Service will be one of the most ambitious reforms of public services since the creation of the National Health Service. It is necessary to deliver the consistency and quality of care and support across Scotland that people deserve and reinforces our commitment to Scotland's people to take long term action to change our society and make it a fairer and more equal place to live.

From the end of this Parliament, the National Care Service will be directly accountable to Scottish Ministers for care and support. It will promote local responsibility for the design and responsiveness of care and support to the needs of our communities. It will champion quality and embrace improvement across all aspects of the system. It will embed a human rights-based approach to everything it does. A change of this scale will take time. The sooner we start, the sooner we will be able to deliver better support for everyone.

Care and support are an investment; they must work to remove barriers, tackle inequalities and allow people to flourish and live their lives as they want to. Let us ensure that people can thrive rather than simply survive. People are vital to creating thriving communities and a thriving economy across Scotland. Community health and social care support is there to help people do that. We have heard repeatedly from people with lived experience that the system must change so that we can tackle the postcode lottery of care and drive up quality.

Whilst there are existing good examples of where support provided is simply life-changing, there is clear evidence of a need for improvement in how social care, social work and community health work for people. People want and need services delivered at a time and by a method that best suits their needs and that builds on their strengths. The National Care Service must be responsive to that.

We want to build on previous work to integrate our health and care systems by:

  • Delivering a system that is genuinely accountable to people
  • Promoting best value across care and support by driving up quality
  • Embedding a human rights-based approach
  • Recognising the breadth of value in the workforce
  • Developing preventative strategies and avoiding crisis interventions
  • Smoothing artificial transitions
  • Building strong and resilient communities
  • Supporting localism and partnership

Community health and social care must deliver as one for people, drawing in other services that make a difference in people's lives, education, transport, and housing in support of outcomes. It shouldn't matter where you live – in the Highlands or island communities, the central belt, or the Borders. Everyone should have access to consistent quality care and support, whatever their age and wherever they live with localism at the heart of our approach. That care and support should provide what people need to live a full life.

To achieve that, we need to ensure that the social care and social work workforce are valued along with the healthcare workforce, who through the provision of community healthcare provide a substantial role in people's support and care. This value can be progressed through the principle of Fair Work, where pay, terms and conditions, skills development and career pathways are delivered ambitiously across all providers and employers. Unpaid carers, including young carers must also be recognised for the essential contribution they make to the lives of others and also the economy. It is vital that unpaid carers, including young carers can easily access the information and support they need to maintain their health and wellbeing.

Throughout the National Care Service development, we will work together with people with experience in accessing and providing community health and social care support and those who deliver social work and community healthcare and unpaid carers, including young carers.

Establishing a National Care Service is a huge undertaking, and we must get it right. Working together, we can bring about the significant improvements we all want to see.

Humza Yousaf MSP

Cabinet Secretary for Health and Social Care

Kevin Stewart MSP

Minister for Mental Wellbeing and Social Care



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