National Care Service: island communities impact assessment

Island Communities Impact Assessment

Title of Policy: National Care Service (Scotland) Bill

Purpose: To provide the legislative framework necessary for the creation of a National Care Service

Scottish Government Directorate: Directorate for Social Care and National Care Service Development

Date: June 2022

Introduction

This is a summary of the Island Communities Impact Assessment (ICIA) conducted on the National Care Service (Scotland) Bill. This ICIA has been carried out in accordance with the provisions of the Islands (Scotland) Act 2018. Section 13 of the 2018 Act obliges the Scottish Ministers to prepare an ICIA in relation to legislation which, in their opinion, is likely to have an effect on an island community which is significantly different from its effect on other communities in Scotland.

The findings in this summary are based on desk-based research, the formal analysis of the consultation on the NCS, and further stakeholder engagement and feedback that took place after the NCS consultation.

The NCS Bill sets out the provisions necessary for the Scottish Ministers to establish a National Care Service to exercise responsibility for planning, commissioning and delivering social work and social care support services and for planning and commissioning of community health services, with Health Boards continuing to deliver community health services. The details of the design of the NCS will be established by working collaboratively with people with lived and living experience of the social care system to ensure that it operates in a way that supports those it is designed to help. The input of current delivery partners and stakeholders will be important to the co-design process. Many of the provisions in the Bill relating to the NCS are therefore powers to introduce secondary legislation, which will be based on the outcome of that further engagement and co-design with people with lived experience, delivery partners, and key stakeholders. Certain elements of the structures of the NCS, such as establishing the national structure as a directorate within the Scottish Government or an executive agency, do not require legislation and so provisions relating to these elements are not contained in the Bill, but are still addressed below.

In addition to setting out the provisions necessary to create the structures and governance arrangements for the NCS, the Bill also sets out provisions relating to: transfer of functions to the NCS; information standards and care records, complaints, breaks from caring, visiting rights in care homes, ethical commissioning, and the regulation of social services.

The ICIA process demonstrates that the Bill, as introduced, will likely have a positive impact and that the impact on island communities will be similar to those living in mainland Scotland. However, it also highlights that most impacts from these reforms to social care will come from regulations developed on the basis of the provisions of the Bill. As set out in this impact assessment, these regulations will be developed in conjunction with further engagement with people with lived and living experience of social care alongside delivery partners and key stakeholders, including those in island communities, and will be subject to further impact assessment, where appropriate. This approach will allow for details of the NCS to be co-designed with those who access support and those who provide it in order to close the historic gap between legislative intent and delivery. This, in turn, will help to ensure that the actions needed to realise the benefits of the reforms and to mitigate potential negative impacts for island communities are identified.

While the details of the NCS will be developed in conjunction with people with lived and living experience, the overarching approach of the NCS will be to:

• Provide leadership, oversight, and accountability for community health and social care, including by providing strategic direction and planning at the national and regional levels;
• Uphold the NCS principles and develop and adhere to the charter of rights for people who access care and support and ensure human rights are embedded throughout its work;
• Develop and maintain a national system for effective complaints and redress for NCS services;
• Create, manage and promote national social care policies, setting national standards and developing practice standards, models and guidance to improve access to care;
• Create a Structure of Standards and Processes for ethical commissioning and procurement to support the NCS principles and other important priorities, such as decarbonisation and the circular economy;
• Support Fair Work in social care, and carry out workforce planning;
• Include the National Social Work Agency to support and invest in the social work profession;
• Procure complex and specialist services at the national level;
• Plan and commission social work, social care support, and community health services via geographically-based local care boards;
• Deliver social work and social care via geographically-based local care boards.