National Care Service: business and regulatory impact assessment

Enforcement, sanctions and monitoring

There are several mechanisms built into the Bill itself that provide a means of making sure that the intentions behind the Bill are achieved.

The Bill sets out the overall principles that Scottish Ministers and the local care boards must work within when delivering services within the scope of the NCS. It also requires both Scottish Ministers and the local care boards to consult on and produce strategic plans and ethical commissioning strategies for the delivery of community health and social care. Through these plans, Parliament and the public will be able scrutinise the activities of the NCS and hold Scottish Ministers and the NCS to account for the way the NCS principles are put into practice.

The Bill sets out that Scottish Ministers will be responsible for monitoring and improving the quality of community health and social care services provided to people. This will involve the setting of standards and frameworks at national level and the effective use of data, evidence and lived experience to make sure that the national standards and expectations are being met.

Scottish Ministers will also have an important role to monitor the performance of the local care boards. We anticipate that this will be done administratively in the same way that Ministers oversee the performance of health boards. However, the Bill enables Scottish Ministers to take steps to address poor performance by the local care boards through the ability to set legally binding Directions to them. In extreme cases, Ministers can abolish a local care board and ask another local care board or another body to take over their functions.

In relation to Anne's Law, the proposals are designed to follow the existing regulatory and inspection framework and neither providers nor the Care Inspectorate raised any issues with this. Several providers did however note that it would be helpful if, where possible, the guidance that follows on from the legislation encouraged early resolution with the care home direct as opposed to immediate escalation to the Care Inspectorate. This is in the spirit of care home providers seeking to build positive relationships with residents and their families and resolving any issues before they intensify.