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.

Why care and support matters

Currently social care services cover the wide range of support that enables people to lead a full life and achieve the outcomes that are important to them. People may need support for many reasons, for example, as a result of illness, physical disability or frailty, learning disabilities or mental health conditions, addiction or experience of homelessness. Social care and support services also support unpaid carers, including young carers in their caring role. They provide help for children and families who may need additional support, or where children are unable to live with their own families, and work with people to address offending and its causes.

Social care support is an umbrella term for adult, children's and justice services which directly support people to meet their personal outcomes. Social work is a statutory role which involves assessing need, managing risk and promoting and protecting the wellbeing of individuals and communities.

The population receiving social care and social work support is diverse, with wide-ranging needs and circumstances.

The data shows us that the relationships between health and social care issues are many, varied and often very complex. Many people need to access and transition between services – and often multiple services at the same time – from across the health and social care spectrum. This serves to highlight the need for people to be able to access social care, healthcare or an integration of health and social care services when they need them, in the place they need them and at the time that they need them. This will empower people to make the choices that are right for them.

In January - March 2020 there were 5330 new people aged 65 and above who received a new community care assessment (for the 22 local authorities (LAs) that submitted data). Over the same time period there were 1489 new people aged 18-64 who received a new community care assessment (for the 22 LAs that submitted data).

In January - March 2021 there were 5391 new people aged 65 and above who received a new community care assessment (for the 23 LAs that submitted data). Over the same time period there were 1366 new people aged 18-64 who received a new community care assessment (for the 23 LAs that submitted data).[1]

It is worth noting that the data is not complete for all local authorities and therefore should be considered as indicative rather than comprehensive.

The latest data (2020/21)[2] for the population receiving social care and social work support tells us that:

  • around 232,000 (1 in 25) people receive social care support in Scotland;
  • 1 in 5 (20%) were under the age of 65;
  • around 77,000 people receiving social care, social work and local authority occupational therapy support have a physical or sensory disability, while approximately 21,000 have a learning disability;
  • over 14,000 people are receiving social care support due to mental health issues;
  • an estimated 68,000 people in Scotland received home care on 31 March 2021;
  • people residing in a care home tend to be in older age categories, with around 90% of residents aged 65+ and nearly 50% aged 85+;
  • people can be receiving support for more than one reason, for example, substance use, neurological conditions, dementia, palliative care, autism or other vulnerabilities;
  • in addition to formal social care support, the results from the 2020 Scottish Health Survey telephone survey suggest around 839,000 people aged 18 and over are providing unpaid care and support to people across Scotland. Approximately 3% of these unpaid carers are estimated to be receiving carer support from the system.

While forecasting demand for social care is extremely challenging, several projections made by National Records of Scotland[3]are of relevance here. The country's population is expected to age considerably across the coming decades, with a substantial increase in the proportion of those over 65. The trend towards an increasing number of one adult households is also set to continue.

The latest available data (2020/21)[4] for the child population receiving social work/care support tells us that:

  • 2,104 children were on the Child Protection Register (rate of 2.3 per 1,000 of population aged 0-15 years) – the largest proportion of children on the Register were under 4 years or not yet born (52%);
  • 13,255 children were looked after (1.3% of Scotland's population aged 0-18 years) – the highest proportion were aged 5-11 years (36%) and 12-15 years (30%);
  • 90% of looked after children were placed in the community (e.g. at home with parents, with family and friends, foster care, adoption) and 10% were place in residential accommodation.

In the justice system, social workers support numerous aspects of a person's journey through the system. The main data collected involving the work of social workers is on the preparation of criminal justice social work reports, court services, home leave reports, bail information and home detention curfew assessments. Social workers may also provide a supervision element for individuals on bail, community payback orders, drug treatment and testing orders and statutory and voluntary throughcare.

The data from 2020/21 was directly impacted by the national lockdowns and other measures put in place to limit social contact during the Coronavirus pandemic. This has had a substantial impact on social work activity since March 2020. Therefore while the main data provided is for the most up to date year of 2020/21, some are also provided for 2019/20, where there is a marked difference:

  • Around 15,100 full criminal justice social work reports were submitted to courts covering approximately 12,400 different people. This was a drop of 10,700 reports (7,900 people) from 2019/20 pre-pandemic figures.
  • 85% of criminal justice social work reports submitted were for males.
  • Over half of all criminal justice social work reports submitted were for people aged over 30
  • Same day reports for court services decreased to 1,500 (3,500 in 2019/20) and post sentence interviews to 4,100 (15,300 in 2019/20) due to impact of lockdown restrictions.
  • Of the 8,200 community payback orders imposed in 2020/21, 73% had a supervision requirement. This was substantially higher than the proportion in 2019/20 (62%). This was heavily influenced by the reduction in unpaid work or other activity requirements issued across 2020/21 due to face-to-face delivery of unpaid work having to be suspended for periods during 2020/21.
  • 3,400 requests for bail information from courts (5,700 in 2019/20)
  • 240 individual people given bail supervision (460 in 2019/20)
  • 830 people had a home detention curfew assessment given
  • At end March 2021 there were 5,800 statutory throughcare cases in force
  • In 2020/21, there were 1,400 voluntary throughcare case commenced with 1,300 people receiving assistance



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