National Care Service: fairer Scotland duty assessment

Overview of social care support in Scotland

The population receiving social care and support is diverse, with wide ranging needs and circumstances. An estimated 1 in 25 (232,000) people of all ages in Scotland were reported as receiving social services during 2020/21. There are also an estimated 700,000 to 800,000 unpaid carers in Scotland,^[1] and over 200,000 people employed in the social service sector. Overall this means that around one fifth of the population are affected by the quality of social services, including the conditions offered to the workforce.

Over many years, various issues have demonstrated that social services and the integration of health and social care services are not working as well as they should. The Scottish Government commissioned Derek Feeley (a former Scottish Government Director General for Health and Social Care and Chief Executive of NHS Scotland) to chair the Independent Review of Adult Social Care (IRASC) in September 2020 to consider the problems in a systematic way.

In February 2021, the IRASC report was published. The IRASC report concluded that whilst there were strengths in Scotland's social care system, it needed revision and redesign to enable a step change in the outcomes for the people accessing care and support.

The changes needed were summarised by IRASC into three main challenges:

• Shift the paradigm - from viewing social care support as a burden to seeing it as an investment in society; moving from services that manage needs in a crisis to preventative support that enables people to flourish, and ensuring consistent and fair provision.
• Strengthen the foundations - to ensure consistent and effective implementation of the ambitious legislation already in place, strengthening and valuing the workforce, and giving unpaid carers the support they need to continue in their vital role.
• Redesign the system - creating a NCS "to drive national improvements, to ensure strategic integration with the National Health Service (NHS), to set national standards, terms and conditions, and to bring national oversight and accountability" to the sector; creating a commissioning and procurement system based on partnerships rather than competitions, and crucially, amplifying the voice of lived experience in the process of redesign.