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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Smoothing artificial transitions and further consideration around the integration of services
People's lives do not fit neatly into categories. Different services – for example, social care, social work, and healthcare – need to work together to effectively support people and families. The transition from children's to adult social care and social work services can be a complex process for young people and their families, which could be improved by better coordination, planning and communication.
The integration, review, and transition between services for adults can also be traumatic and challenging. As a result many individuals fail to get the care and support needed across the system at a time that enables them to achieve outcomes and live well.
Young carers are one such example as they navigate the gap between adult and children's services, and their support also requires coordination with education.
People who are engaged with social work and social services who regularly require healthcare are often engaged in complex – often overly complex – relationships and experiences, whereby having to navigate them adds to the challenges and difficulties that they experience.
The NCS will aim to minimise the perceived divides and transitions across and between the different types of care and support. Placing people at the centre of discussions about care and support at both a local area and individual level.
The IRASC found evidence that Integration Joint Boards where children's social care and social work services and justice social work had been delegated to them had performed well in relation to those services. However, we recognise that children's social care and social work services and justice social work were not examined in detail by the Review. The primary objective for children's social care and social work services is to deliver The Promise, with work already underway. Consideration is also being given to how the future model for justice social work may be evaluated and explored on a collaborative basis.
The Independent Care Review, which led to The Promise, identified the need for change in order to improve the lives and outcomes for our children, young people and families who are care experienced. In Keeping The Promise, we must ensure services, working together, provide what our children and young people need to thrive and in so doing improve the level of support from birth through to adulthood to significantly reduce the number of children, young people and families coming into the care system.
Through work with partners, stakeholders and those with lived experience, an evidence base will be developed to understand the best governance, financial arrangements and models of care to deliver services for children and those within the justice system, whether within the NCS or outside it.
The NCS will be designed to facilitate inclusion of both children's and justice social work services, subject to evidence that shows whether it is more likely to be the best approach for each.
For children's services, this will involve assessing the current different models of integration, given that establishment of the NCS will bring change to existing structures. This assessment will inform a decision as to whether children's social services should be included within the NCS. Central to this work will be consideration of which service model will enable the Promise to be delivered most effectively, with clear consideration of the impact on children's transitions to adult services. A decision on whether to include children's services in the NCS will be taken following this evidence building exercise. The Scottish Government commits to further public consultation as part of that decision-making process and to the involvement of those with lived experience, including children and young people accessing services, and those who work across the sector.
Similarly, in relation to justice social work services, the Scottish Government intends to work closely with stakeholders to examine in detail the benefits and risks of inclusion and to co-design a possible new delivery model, to inform a final decision around the transfer of these services. As in relation to children's services, a public consultation will be held as part of this work, and the transfer itself will be subject to parliamentary scrutiny and approval.
It should be noted that while many of the core elements and underlying principles of the NCS will span all potential services – such as the importance of early intervention and a holistic approach to meeting people's needs – other aspects may require further examination if and when additional services are added to ensure their relevance in different contexts.
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