3rd December 2021
In our latest blog, SAMH Senior Policy and Research Officer Craig Smith talks about what the Scottish Government's proposed National Care Service will mean for social care and what SAMH is doing to ensure the needs and views people with mental health problems are recognised.
The Scottish Government’s flagship commitment for the current term in parliament is the creation of a National Care Service. Currently local government is legally responsible for the provision of social care, though design and delivery is delegated to local Integrated Joint Boards (IJBs).
What is changing?
The Government’s proposals will see Scottish Government Ministers becoming accountable for social care through the National Care Service, with a focus on improvement and national consistency. Locally social care will be organised by Community Health and Social Care Boards (CHSCBs) which will replace IJBs.
Importantly, a National Care Service does not mean that third sector organisations like SAMH will stop delivering social care. We will continue to do so, working with CHSCBs to design and deliver local services. The first step towards this was a consultation on the system, which SAMH submitted a comprehensive response to earlier this month.
As a large social care provider, SAMH knows social care today is not working as well as it needs to, so we’re really supportive of plans to create a National Care Service for Scotland. The coronavirus pandemic has thrown the importance of social care into sharp focus. Social care is essential to supporting people – including people experiencing mental health problems - to live independently as full members of their communities. It’s a life line, and needs greater prioritisation, consistency, investment, and support. A National Care Service for Scotland has the potential to provide this.
So do the Scottish Government’s proposals fit the bill?
There is a lot to welcome in the government’s plans, but in too many areas there is a lack of detail and a lack of ambition. For example, we warmly welcome a commitment to a national approach to quality improvement, with national minimum quality standards. Currently social care provision is patchy across the country with quality too often a postcode lottery. We also warmly welcome the proposed approach to support planning – focusing on desired outcomes for people receiving care. We hope this approach will lead to people having much more genuine choice and control over decisions about their care – something we know can positively improve people’s mental health. We are happy that proposals on support planning will be aimed at greater coordination of care, and portability of care plans. This should make a real difference where someone is supported by various organisations, or moving to a new area, reducing the stress of people having to retell their story.
But we are concerned that in some areas the plans don’t go far enough or have too little detail. We warmly welcomed the Independent Review of Adult Social Care, which provided the framework for the proposed reforms; but as they stand, these proposals don’t fully implement the recommendations of the review. For example, we welcome a commitment to ‘human rights based’, ‘ethical commissioning’ of services. Yet there is little in the detail of the proposals that gives us confidence that services won’t – as is too often the case today – still be designed and commissioned around local budgetary constraints. We need to urgently move away from service procurement based on competition between providers, to one where service user needs are prioritised over cost. We are clear that people with lived experience of the social care system need to be at the heart of service design and commissioning; as do people working in the frontline of social care, and service providers.
The Government’s proposals have a strong focus on the structure of the new system – including where responsibility will sit, and how the national service will be structured locally. This is important and we must get it right; but we also need to see a greater focus on how the services will be experienced by the people supported by them and working in them.
As the development of the National Care Service moves into the next stages, SAMH will continue to champion the importance of lived experience involvement and the specific needs of people living with mental health problems. This is a once in a generation opportunity to radically improve social care in Scotland, and it must be grasped.
You can find out more information on our full response to the National Care Service consultation, as well as other work by our Public Affairs team to stand up for the rights and needs of people living with mental health problems on our website.