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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Recognising the breadth of value of the workforce and unpaid carers
Community health and social care support reaches into all our lives – many of us, or many of our family members or friends, will already use social care, and many of us will do so in future. An estimated 231,925 people in Scotland were reported as receiving social care support and services at some point during 2020/21, and an estimated 839,000 people were caring for a relative or friend.
Most health and social care challenges are solved in the community by professionals and agencies working together to find a person-centred approach that maintains an individual's choice and independence. It is the delivery within the community, close to or within an individual's home, which makes it distinct to care and support offered by our hospitals.
Community health and social care supports people of any age who need or are provided with assistance for day-to-day living. The breadth of care and support offered is extensive and will relate to health issues, illness, physical disability, learning disabilities, neurodevelopmental conditions, mental health conditions, or issues relating to older age frailty, dementia, end of life care and more. It is equally essential for unpaid carers as it is the same services that help them look after their own health and wellbeing.
We must do more to improve the understanding of the breadth of services offered and the range and age of people who are supported. Community health, social care and social work, support people with or who are recovering from alcohol or drug addictions, those within our justice system and those who are or have been homeless or are at risk of becoming homeless. Children's social work and social care services help children and families who may need additional support or where children are unable to live with their own families. Justice social work supports individuals to address their offending behaviour while assessing risk and ensuring robust measures are in place to deliver community sentences and to protect the public.
Vital to achieving our ambitions is ensuring that our community health, social care and social work workforce feel happy, respected and fulfilled in their role. By rewarding, respecting and valuing our workforce, we recruit and retain great staff. This means ensuring Fair Work is central to a NCS. Work to improve pay, conditions and opportunity for the workforce will help us do that, showing that a career in care is valued as much as it is valuable.
We know that people who work in social care and social work services can often feel overworked and undervalued. To attract people into the social care profession and make it a rewarding career people want to continue in, we will ensure that the terms and conditions and pay are based on Fair Work principles. National pay bargaining that looks at terms and conditions and the Fair Work agenda, will be central to building a workforce that is fit for the future to deliver the best possible service for the people of Scotland.
We will also ensure that people working in social care and social work services can be heard, whether that is through unions, as individuals or through other employee representative groups. Ensuring workers have an effective voice will be a key aspect of ensuring we are building a service which responds to the needs, ambitions and ideas of the people who work within it.
The NCS will ensure, where possible, that no matter if someone is working for a third or private sector organisation, a local authority or in an NHS Board, or directly for the NCS, everyone will experience Fair Work in their employment.
The NCS will have national oversight of workforce planning for the social work (through the National Social Work Agency) and social care workforce. Currently, workforce planning is fragmented across a wide range of providers. The NCS will provide an opportunity to improve national, integrated workforce planning and modelling for the whole social services sector – linking this to identifying skills and training gaps so that we have an appropriately skilled and professional workforce for those who require care and support. Training and skills development will be viewed as an integral and essential part of service delivery which will be supported within workforce planning considerations.
The National Social Work Agency will support and invest in the social work profession by providing national leadership, overseeing and supporting social work education, improvement (by establishing a Centre of Excellence), social work workforce planning, training and development, terms and conditions, improving consistency and the scaling up of good practice. It will enable social workers to work with people to transform their lives and implement rights-based practice as part of the overall objectives of the NCS.
As the plans for the NCS develop, while national and local NCS structures will have the ability to employ staff, we do not anticipate that people who work in the services commissioned by the NCS will change their employer. For those involved in healthcare provision we do not expect the responsibility for clinical governance in the NHS to change or to be duplicated in the new arrangements.
In line with our commitment to public protection, we will ensure that new groups of currently unregistered workers can be added to the Scottish Social Services Council (SSSC) Register, where it is in the public interest to do so. We will improve information sharing to inform misconduct cases and streamline the Register to improve movement between sectors and reduce bureaucracy for the registered workforce.
The Scottish Government is aware of the sensitivities around the full registration of Personal Assistants (PAs). It recognises the unique relationship between the PA employer and the PA. Before taking any decision regarding the full registration of PAs, the Scottish Government will consider the effect of changes to the PVG scheme, as well as NCS consultation responses and also broader sensitivities and considerations.
It's vital that we have genuinely integrated teams working to resolve problems when they arise and to anticipate needs. To ensure further integration we are keen for services to reach out to and from the hospital and provide more agile and responsive services in the community. We want to support existing teams to reduce the perceived barriers between services that many people experience.
It is also crucial that unpaid carers, including young carers are supported to continue to access education and activities that are important to them alongside caring and that they can sustain and improve their health and wellbeing. They must be involved in the decisions that affect them and those they care for.
We know that unpaid carers provide vital support to the people they care for and are fundamental to the sustainability of the whole health and social care system. However, we know that they can often feel invisible, undervalued and unable to take rest or breaks.
To support people to protect their wellbeing, sustain caring relationships and recognise and value the immense contribution of unpaid carers, we will ensure that all carers have rights to rest and breaks. To ensure that carers are recognised and involved as equal partners in care, we will also ensure that carers are fully engaged at all levels in shaping and operating the NCS and individual-level decisions that affect them. We will continue to focus on ensuring people's existing rights to support under the Carers Act 2016 are understood and delivered.
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