The Scottish government is to backtrack on its plans to set up separate care boards as part of the creation of a National Care Service and will instead fall back on the existing network of integration joint boards (IJBs) which could now be funded directly by ministers.

The major rethink of the original proposals in the long delayed National Care Service Scotland Bill are revealed in a letter from social care minister Maree Todd MSP to the convener of the parliament's Health, Social Care and Sport Committee.

MSPs had asked the minister for more detail and clarity on a series of issues suggesting that, without this, their continuing scrutiny of the legislation would be impossible.

In her letter, Ms Todd says that the vision of the National Care Service remains that of everyone everywhere in Scotland having access to timely, consistent, equitable and fair, high-quality health and social care support.

However, the original proposal for an unspecified number of ‘care boards’, all answering to a minister-led National Care Service Board, has been scrapped.

Instead, Scotland's 31 integration authorities that oversee health and social care partnerships – only created in 2016 – will remain in charge of social care and primary and community health services.

In the letter, Ms Todd states:

“We have been examining whether the intended outcomes could be achieved by putting forward amendments to the public bodies (Joint Working) (Scotland) Act 2014 under which the integration authorities were created.

“We are now of the view that this is a reasonable approach, and would achieve the intended reforms in a manner proportionate to the aim. Therefore, we no longer expect to abolish integration authorities and establish care boards."

The letter repeatedly refers to these bodies as "reformed integration authorities", stating that there is “a clear case for reform, with significant changes needed at local level to realise the intended quality and consistency. In other words, the status quo is not acceptable.”

Scotland’s integration authorities, thirty IJBS and the Highland lead agency arrangement bring together local authority and NHS representatives as equal partners in decision-making, will now be answerable to a new national public body, the National Care Service Board.

One of the biggest challenges since the creation of the integration authorities has been their funding, with both the local council and NHS board having to divert money from their budgets to deliver services.

This has led to tensions and, arguably, a lack of recognition of their role.

Ms Todd letter suggests that this may change as ministers seek greater direct control over their operation:

"Given the Bill provides for Scottish ministers to exercise strategic framework accountability for NCS services which will include a role in setting policy, having oversight and providing direction, it remains the intention that it should be possible to directly fund reformed integration authorities in order for Scottish Ministers to ensure their duties are met.

“It is not the intention that all community health and social care funding would be routed through integration authorities. However, the potential for direct funding in specific, agreed circumstances is considered a reasonable consequence of the shared accountability agreement."

Read more: Editorial: A resolution for social care; Action for social care workers “can’t wait”; Outstanding questions stall NCS scrutiny

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