Create a national care service, says independent review

A national care service (NCS) should be established to improve the consistency, quality and equity of social care in Scotland, an independent review has concluded.

It has called for a NCS to be placed on a statutory footing to sit alongside the NHS to deliver health and social care.

The Independent Review of Adult Social Care said there must be greater investment across the sector to remove charges for non-residential social care and increase free personal and nursing care for self-funders using care homes.

In the foreword of the report, chair Derek Feeley said a new system would require “structural change” and a different “narrative” around social care to deliver preventative and wellbeing services rather than crisis support.

He said: “In her programme for government speech that launched this review, the First Minister said ‘this is a time to be bold’.

“The good news is that everyone we spoke to agrees with her. What follows is a plan for how.

“It will take time. It has taken over 50 years for our current system to form.

“It will take investment. It will take partnership. But we have an opportunity to create a system of social care support where everyone in Scotland has the opportunity to flourish.

“If not now, when?”

The review said the NCS should oversee local delivery via reformed integrated joint boards, using local authority and third and independent sector providers.

It would be expected to address gaps in social care and social work relating to the workforce, service planning and data.

It also recommended the NCS oversee care of those with complex or highly specialist needs, including those in prison.

The creation of a ministerial post with the specific responsibility of social care and the appointment of a chief executive of the NCS, equivalent to the NHS chief executive role, was called for.

Its work should be supported by a national improvement programme to improve self-directed support, the safety and quality of care in care homes, and the commissioning and procurement process, the review said.

Nicola Sturgeon announced the independent review in September following the deaths of just under 2,000 care homes residents from coronavirus.

Scottish Labour, which has campaigned for the creation of an NCS for several years, welcomed the report.

Interim leader Jackie Baillie said: “A national care service that puts people before profit is the only way forward.

“The Scottish Government must now listen and take steps to make this happen.

“We cannot allow our care service to be further weakened by inaction and slow responses to urgent need.”

The review report was also welcomed by trade union UNISON.

Mike Kirby, Scottish secretary, said: “The report carefully reflects the workforce issues to be addressed if we are to have a quality, rights-based service, with universally applied standards of fair work.

“For too long the care system has been weighted towards price and profit.

“A national care service, with the NHS as its inspiration, would make quality of care and fair work its focus.”