Scottish Budget 2020-2021: Equality and Fairer Scotland budget statement

Annex B Level 3 Spend Line Analysis Template

As noted in Chapter 2, new tools were utilised this year to help portfolios develop their impact analysis. One of the tools was a template for budget lines of more than £100 million.

The following examples from this year's trial show the type of material that could be put together to explain the impact of a high-spend policy.

Example One - General Dental Services

Is budget line name, broad content and portfolio the same as last year? Yes

Purpose of spend in this budget line:

What does the budget pay for?

What does it seek to achieve?

The budget pays for the provision of NHS General Dental Services. The purpose of the budget is to ensure that people who wish to have access to NHS dental care are able to do so.

As at 30 September 2019, 94% of children and 92% of adults were registered for NHS General Dental Services.

Budget 2019-20	Budget 2020-21
£416.6 million	£428.6 million

Progress on Outcomes

• Our children have the best start in life and are ready to succeed.
• We live longer, healthier lives.
• We have improved the life chances for children, young people and families at risk.

Inequalities in Outcomes by Protected Characteristic

All patients receive free NHS check-ups (only available in Scotland). In addition, the following groups are already entitled to free NHS dental treatment:

• Children;
• Young people under 18 years of age;
• Young people under 19 years of age and in qualifying full-time education;
• Expectant mothers and those who have given birth in the last 12 months;
• Adults in receipt of certain benefits;
• Income support;
• Universal credit
  • And had no earnings or net earnings (take-home pay) of £435 or less during the most recent assessment period
  • Which includes an element for a child and/or limited capability for work or limited capability for work-related activity, and had no earnings or net earnings (take-home pay) of £935 or less during the most recent assessment period
  • Where the claimant is a member of a couple it should be the combined earnings of the couple that are considered when determining the relevant threshold.
• Income-related Employment and Support Allowance;
• Income-based Jobseeker's Allowance;
• Pension Credit Guarantee Credit;
• or holders of an NHS Tax Credit Exemption Certificate.

Approximately 40% of all patients, including children, are exempt from paying a contribution towards the cost of their NHS dental care.

Inequalities in Outcomes for People Who Are Socio-economically Disadvantaged

For adult patients who do not meet any of the criteria for free NHS dental treatment, they may qualify for help towards the cost of their NHS dental treatment through the NHS Low Income Scheme. This is an income-related scheme which considers the applicant's (and partner's) weekly income and expenses to calculate how much, if anything, the person should pay towards the cost of their NHS dental treatment.

Around 20,000 applications were made to the Low Income Scheme for the 12-month period to September 2019.

If helpful – Short Case Study of one specific policy or programme within this Level 3 budget line which specifically addresses inequality for one of the above dimensions.

Oral Health Community Challenge Fund

In January 2018, the Scottish Government published the 'Oral Health Improvement Plan'. A key action from the Plan, incorporated into the 'Programme for Government 2018-19', was to introduce an Oral Health Community Challenge Fund.

The Fund was launched on 1 July 2019 with funding for 22 projects across Scotland. The purpose of the Fund is to enable third sector organisations to deliver projects that support families with young children living in areas of multiple deprivation in order to reduce oral health inequalities and support better early years oral health.

The Scottish Government has committed £2.5 million from July 2019 to March 2022 to the Oral Health Community Challenge Fund.

Care-experienced People

We have recently been tasked with a new Programme for Government (PfG) commitment: to extend the eligibility for free NHS dental care to care-experienced people between the ages of 18 and 26 to reduce the negative impacts that poor dental health can have on physical health, mental wellbeing and self-confidence.

Example Two - Early Learning and Childcare Expansion

Is budget line name, broad content and portfolio the same as last year? Yes

Purpose of spend in this budget line:

What does the budget pay for?

In 2019-20 the budget includes funding to prepare for the near-doubling of the statutory entitlement to funded early learning and childcare (ELC) hours for all 3 and 4 year olds, and around a quarter of 2 year olds from August 2020.

During 2019-20 (Year 2 of a four-year funding agreement between the Scottish Government and COSLA which was based on local authorities' own financial plans for the ELC expansion), the revenue budget is supporting local authorities to offer the additional funded hours early as part of a phased implementation through in-house provision and private and third sector providers including childminders; to expand their early learning and childcare workforce to provide additional hours; and to manage their own change programmes. The capital budget is enabling local authorities to create new ELC provision and to extend and refurbish existing ELC settings.

What does it seek to achieve?

The ELC expansion aims to deliver three main benefits for children and families:

• children's development improves and the poverty-related attainment gap narrows;
• parents' opportunities to take-up work, training or study increase; and
• family wellbeing improves through enhanced nurture and support.

Budget 2019-20	Budget 2020-21
£286 million revenue £175 million capital	£488 million revenue £121 million capital

The revenue budget is due to increase in 2020-21 to reflect the new statutory requirement for local authorities to ensure all eligible children can access up to 1,140 hours per year of funded early learning and childcare. The equivalent statutory requirement in 2019-20 was 600 hours, but local authorities were also funded to start phasing in the additional hours early.

Progress on Outcomes

Scottish ELC Census

There is already very high uptake of funded ELC in Scotland; our latest ELC census data shows near-universal uptake of funded ELC by 3 and 4 year olds. Given that children growing up in disadvantaged circumstances stand to benefit the most from high-quality ELC, eligibility criteria for the 2-year-old offer intends to capture children facing the most disadvantage and includes looked-after children and children who are subject to a kinship or guardianship order. It also includes children in families receiving support under Part VI of the Immigration and Asylum Act 1999 and children whose family are in receipt of a 'qualifying benefit'. Approximately 11% of the total population of 2 year olds are registered for funded ELC (compared to the roughly 25% that are eligible). While this has increased gradually over the last few years, it is still relatively low and the Scottish Government and local authorities are working to raise awareness and introduce data-sharing powers that will help local authorities target likely eligible families. Our work includes developing a toolkit for stakeholders including trusted professionals such as health visitors and family nurses, which they can draw on when communicating with parents and carers about ELC.

A data transformation project is underway that will improve the data available nationally on the provision of statutory ELC. A significant part of the project is to improve the ELC census, which currently collects information about funded ELC registrations rather than individual children. The future ELC census (available from 2021) will be based on individual child-level data collection, and will collect data on the characteristics of children accessing funded ELC, including: sex, ethnicity, disability status, whether the child has any additional support needs, and the home postcode of the child (to enable analysis by the Scottish Index of Multiple Deprivation). This will allow for more substantive research on how different families use ELC in Scotland and will help to identify if there are any particular groups where uptake is not as high and where the Scottish Government and local authorities may need to focus attention on promoting uptake.

Scottish Study of Early Learning and Childcare

The Scottish Study of Early Learning and Childcare (SSELC) is a cross-sectional and longitudinal study that will evaluate the expansion of the funded entitlement to 1,140 hours. Baseline data is being collected from both children and the parents of those children accessing 600 hours of funded ELC. In 2022-23, data will be collected from those accessing 1,140 hours. Measuring before and after the expansion allows for an assessment of the extent to which the expansion's long-term benefits have been achieved.

Inequalities in Outcomes by Protected Characteristic

To support the ELC expansion we have published the following EQIAs:

• ELC Expansion: https://www.gov.scot/publications/equality-impact-assessment-expansion-early-learning-childcare/
• ELC Workforce: https://www.gov.scot/publications/equalities-impact-assessment-considering-barriers-employment-early-learning-childcare-sector/
• ELC Learning and Wellbeing Project: https://www.gov.scot/publications/equality-impact-assessment-expansion-early-learning-childcare-learning-wellbeing-project/

Some findings from these assessments have been summarised below:

Sex

The most significantly under-represented group in the ELC workforce is men, who make up only 2% of the current workforce, compared to 48% of the population in Scotland. However, since 2015 the proportion of male teachers within ELC has doubled from 3% to 6%. Subsequent to our establishment of a £50,000 challenge fund with our colleagues at the Scottish Funding Council, a 'Men in Early Years' seminar was held in September to share learning and best practice in recruiting and retaining men to the ELC sector. At the event it was also agreed to develop a network to support men already in the sector as well as those coming through training programmes.

Our research on 'Parents' Views and Use' of ELC in Scotland found that two-thirds of the parents surveyed who were using ELC for a 3 or 4 year old mentioned working or looking for work as a reason for using ELC.^[1] Research has found that typically, higher-paid jobs and career progression come with less flexibility and may require someone to work full-time. The expanded ELC offer with more flexible provision aims to remove a potential barrier for parents wishing to access work, training or study opportunities, especially those who need help with finding sustainable employment.

Women are still more likely to be the primary carers in the family, which can restrict the type of work and working patterns they can take-up. The ELC expansion therefore presents further opportunity to enable more women to work, train or study, and to help to close the gender pay gap, while broader policies in other portfolios such as the Gender Beacon Collaborative, the What Works? Gender Institute and work to promote fair and inclusive workplaces all aim to shift broader gender stereotypes around work and caring.

Research, including studies from Scotland, recognise the negative impacts that gender stereotyping can have on children, and the importance of gender-equal play. The guidance on the National Standard signposts readers to the Care Inspectorate and Zero Tolerance resource to promote gender-equal play in ELC. By promoting this, there will be lasting positive impacts on equality between those of different genders.^[2]

Disability

To ensure that disabled children and children with additional support needs are able to access high-quality ELC, the National Standard for ELC, which all providers delivering funded ELC, from August 2020 will have to meet, has a criteria explicitly on inclusion which reads:

• The setting must comply with the duties under the Equality Act 2010.
• The setting will be willing to provide appropriate support, including making any reasonable changes to the care and learning environment, to ensure that children's additional support needs do not provide a barrier to them accessing a full range of experiences and meets their individual needs.

In addition, the ELC Inclusion Fund was launched in 2018 and provides funding to ELC settings to support children with additional support needs access their funded ELC entitlement. Funding can be awarded to pay for staff in ELC settings to receive appropriate training and funds resources, equipment and adaptations. The fund is worth £2 million over four years and invites bids from settings delivering funded ELC. A total of £521,145 was awarded to 455 applicants in 2018-19.

Race

The data currently collected through the ELC census does not allow us to measure uptake of ELC by ethnicity, however, the new ELC census (to be in place from 2021) will collect information about a child's ethnicity and enable us to assess impact on this protected characteristic.

There is some evidence that some minority ethnic parents are more comfortable using ELC where there is a mix of cultures and ethnic backgrounds in the ELC setting. Comparing the ELC workforce demographic data with data from the 2011 Scotland population census indicates that a number of minority ethnic groups are under‑represented in the ELC workforce. However, around 10% of those responding to the Care Inspectorate annual return do not provide their ethnicity, making it difficult to be precise about whether minority ethnic communities are proportionately represented in the workforce.

We recognise the importance of the ELC workforce reflecting the diversity of Scotland's population. In addition to our ongoing national recruitment campaign, we are actively promoting the diversification of the ELC workforce by funding the Council for Ethnic Minority Voluntary Organisations (CEMVO) to promote career opporunities in ELC with minority ethnic communities.

Age

'Funding Follows the Child' will increase parental choice, supported by our parental communication strategy which is designed to raise awareness of the funded ELC entitlement, support take-up, and help families make informed decisions about their child's ELC entitlement.^[3] By increasing awareness and uptake of funded ELC, we expect that more ELC settings will benefit from having a wider range of young children, including children with a protected characteristic. This means there is the opportunity for relationships between children who do, and do not, share a protected characteristic to flourish at a young age.

Inequalities in Outcomes for People Who Are Socio-economically Disadvantaged

We have published a Fairer Scotland Duty Assessment to support the ELC expansion.^[4]

Some findings from our Fairer Scotland Duty Assessment are summarised below:

• A socio-economic gap in cognitive attainment is apparent well before children attend primary school. Children from less advantaged families perform less well at age 3 than children from more advantaged backgrounds. Studies have also established that early cognitive ability can influence later outcomes. Children with early poor cognitive ability can have poorer education, employment, health, and social development outcomes later in life.
• Accessing high-quality ELC is associated with improved outcomes in language, cognitive and other essential skills and, importantly, these benefits have been found to be greater for children from disadvantaged backgrounds. Since children from disadvantaged backgrounds may benefit more from government-funded ELC, universally available ELC can contribute to narrowing the poverty-related attainment gap.
• There is also evidence of links between the availability of affordable and accessible ELC and employment opportunities for parents and carers.
• In addition, analysis of Growing Up in Scotland data has shown that children from disadvantaged backgrounds are no less likely than those from advantaged backgrounds to attend a high quality ELC provider.

The expansion to 1,140 hours intends to maximise the opportunity to ensure that all children in Scotland get the best possible start in life. Given the transformative impact ELC can have on children's development, particularly for children growing up in more disadvantaged circumstances, a key aim of the expansion to 1,140 hours is to close the poverty-related attainment gap. With this at its heart, policy design and implementation have considered inequalities of outcome throughout. For example, the ELC expansion aims to ensure:

• all children have access to high-quality provision;
• children who stand to benefit the most also benefit first;
• household income is not a barrier to children accessing their entitlement; and
• those children who stand to benefit the most have access to an enhanced offer.

Evaluation plan – What circumstances would allow you to 'switch off' spend on this line?

How will you know if and when you have achieved your intended outcomes?

The Scottish Government and COSLA have agreed a multi-year revenue and capital package to fully fund the expansion of funded early learning and childcare, and we have put in place legislation to require local authorities to make available up to 1,140 hours of funded early learning and childcare for every child.

The Monitoring and Evaluation Strategy for the expansion, including the Scottish Study of Early Learning and Childcare referenced above, will provide us with a rich evidence base to evaluate the impact of this significant investment on the intended outcomes and consider any refinements to policy and practice which could further improve realisation of these outcomes.

We are making a long-term commitment to increase investment in the early learning and childcare of Scotland's children.

If helpful - Short Case Study

Ensuring families who benefit most also benefit first

Local authorities have already started to 'phase in' the expanded offer. Our expansion planning guidance issued to local authorities in March 2017 asked that plans for 'phasing in' the expanded offer in the period to August 2020 reflect the Scottish Index of Multiple Deprivation. This means that families and communities who stand to benefit most from the expansion also benefit first. As a result of 'phasing in', nearly 50,000 children, including over 3,600 eligible 2 year olds, were already benefiting from more than the minimum 600 hours to which they are currently entitled, as of the end of September 2019.

The 'Tackling child poverty: first year progress report' published on 26 June 2019 also featured a case study showing the positive impact of the funded early learning and childcare for 2 year olds for a family in challenging circumstances – see Lucy and Jemma's story on page 48.

Footnotes

1. https://www.gov.scot/publications/exploring-parents-views-use-early-learning-childcare-scotland/

2. https://www.careinspectorate.com/index.php/news/4706-gender-equal-play-in-early-learning-and-childcare

3. https://www.gov.scot/publications/funding-follows-child-national-standard-early-learning-childcare-providers-principles-practice/

4. https://www.gov.scot/publications/early-learning-childcare-expansion-fairer-scotland-duty-summary/