The Scottish government has begun to set out the changes it wants to make to its original plans for Scotland’s National Care Service (NCS).

A board made up of representatives from the Scottish government, local authorities, health boards, carers, people in receipt of care, and care staff will take on responsibility for NCS oversight and improvement, according to updated proposals.

A list of long-awaited amendments sent to the Scottish parliament’s health committee details plans to set up a National Care Service Board.

Ministers now want to see a single type of local body responsible for social care across Scotland, scrapping alternative models of health and care integration, ending Highland’s lead agency model.

Social care minister Maree Todd has also told the committee that it is still her intention for all children’s services to be eventually included in the National Care Service.

Details of exactly which services will come under the new NCS, and how and when this will be put in place, remain unclear. Ms Todd says these will be detailed in more amendments to the Bill, which she will send to the committee before the stage 2 deadline.

It comes after government-commissioned research on children services’ inclusion in the NCS concluded that any structural reform should only flow from a clear vision supported by time, resources and support from effective national and local leadership.

Issues around how reformed integration authorities – now to be known as NCS local boards – will be funded, how Anne’s Law will be delivered, and whether Justice Social Work will be included in the NCS are also still being considered by government.

Discussion on these will now take place without COSLA and local government colleagues, according to a letter sent by Ms Todd to the health committee, so they can be ‘freed up’ to allow them to take a greater focus on tackling delayed discharge.

In her letter, Ms Todd says that she will wait to hear what the committee and stakeholder think about the proposed amendments before they are finalised and formally lodged. 

The health committee has confirmed that it will give the public another chance to share their views on the new proposals, likely over the summer and autumn.

A number of members of an Expert Legislative Advisory Group set up by the government to advise on changes to the Bill have already voiced concern about the way the amendments have been written, saying they had little input to the drafts.

National Care Service Board

Shared national accountability for social care, agreed by Scottish ministers, NHS boards and local authority group COSLA, will be recognised within the National Care Service Board, according to the proposals.

At least one representative from each of these groups will sit alongside unpaid carers, care staff and those who use care services to oversee strategic planning and overall responsibility for the National Care Service, including local boards.

A chief executive will be appointed, initially by ministers, to lead the work of the National Care Service board, and the board will be able to appoint and hire staff.

The national board will be responsible for monitoring and improvement, but amendments say its works must complement rather than duplicate the work of bodies already responsible for regulating care services – namely Healthcare Improvement Scotland, Public Health Scotland, and Social Care and Social Work Improvement Scotland.

The end of Highland’s lead agency model

Unlike the rest of Scotland where social care and community health services are overseen by an integration joint board, Highland council and NHS Highland instead opted in 2016 to retain their existing arrangement that split between them responsibility for certain functions.

This ‘lead agency’ model sees NHS Highland take on responsibility for adult health and social care services and Highland Council have responsibility for children’s health and social care services.

The amended Bill would end this unique arrangement, with the government also wishing to see greater consistency of local planning and delivery of reformed integration authorities.

Highland Council has previously criticised attempts by government to try and achieve consistency across Scotland at all cost, saying in an earlier consultation response that the unique needs of the region require a flexible approach to service delivery.

 

Read more: A timeline of Scotland's National Care Service Bill; Outstanding questions stall NCS scrutiny; Carers leave a stepping stone, says minister; Millions less needed to deliver NCS; Feeley: NCS still an opportunity for transformation; Care services at risk from delayed payments; Questions for “fundamentally changed” NCS 

 

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