National Care Service: questions and answers - engagement sessions

Local Structures

Care boards: what are they and will they be integrated?

• The Independent Review of Adult Social Care and Audit Scotland found the current ways of working have not fully delivered the improvements intended to be achieved by integration of health and social care and recommended the creation of a National Care Service.
• As proposed the care boards will have responsibility for design and delivery of community health, social work and social care functions at a local level.
• Local care boards working together as part of the National Care Service and with the NHS, local authorities, third and independent sectors, will improve support for people at a local and national level.
• Through co-design we will consider how best to ensure effective joint working with other services such as housing, education, and policing with those with lived experience and stakeholders.

What will happen to Integrated Joint Board's (IJB's) and Health and Social Care Partnership's (HSCP's)?

• The care boards will have responsibility for social care functions that currently are the responsibility of local authorities, and will also have responsibility for planning and commissioning community health services.
• We intend to co-design and consult extensively with partners and stakeholders on how best to provide a National Care Service that delivers both national consistency and local flexibility.
• The proposals will have implications for HSCP's that we will want to work through as part of the co-design process and in consultation with partner organisations.
• Care boards will provide the new interface between the National Care Service at national level, local decision-makers and the teams that deliver integrated functions. The way in which future services are delivered will be developed during co-design and further consultation.
• At a national level the National Care Service will establish consistency of quality and access to social care across the country. It will set the strategy and direction including on ethical commissioning and Fair Work.
• At a local level care boards will have the duty and flexibility to plan, design and commission services locally to meet the needs of their community with the input of those with lived experience.
• The Scottish Government considered a number of alternative options described in the policy memorandum. We are confident that care boards build on the successful elements of integration while shifting accountability for social care to Scottish Ministers at the request of the Scottish public.
• Achieving the right balance between securing national consistency of service quality, and local flexibility to respond to circumstances is a key priority.
• Local government is an important partner in delivering social care currently and will remain so as we develop new ways to deliver improved care across the country.

How will people be employed by care boards?

• The proposal is that care boards will have their own budgets, ability to employ their own staff and will be directly accountable to ministers.
• The National Care Service Bill provides for Scottish Ministers to pay members of a care board remuneration and allowances.
• We will co-design the detail of the National Care Service to develop the final scope, duties, function, governance structures, number, geographical area, composition, and membership of care boards in addition to discussing how we can maximise collaboration and co-operation with other public bodies.

How will care boards be funded?

• A Financial Memorandum was published alongside the Bill which sets out a range of potential costs of the National Care Service.
• Scottish Ministers made a manifesto commitment to increase social care spend by 25% over the course of the Parliament, resulting in at least £840 million additional investment. This will support a range of investment including areas which will move towards a National Care Service. The increased investment in social care relates to a range of areas including workforce, the recommendations of the Independent Review, ongoing rising demand pressures and a move towards the National Care Service.

How will you ensure care boards work well on the Islands?

• The Islands Equality Impact Assessment was published in June and acknowledges the specific circumstances our Islands communities face.
• The Scottish Government is committed to engaging in a co-design process with stakeholders including people lived experience, service providers and health and social care workers to ensure the design and delivery of care boards. This will include consulting with representatives of the Island Communities on the best approach to take.

How will membership, remit and governance of care boards work?

• The National Care Service Bill makes some provision in relation to care boards, but provides for the care boards to be fully established via secondary legislation, which can only be brought forward once the Bill has been passed.
• The detail to develop the final scope, duties, function, governance structures, number, geographical area, composition, and membership of care boards will be co-designed.
• This will be enhanced by discussions about how we can maximise collaboration and co-operation with other public bodies.
• Priority will be to ensure that the boards are constituted so that they can deliver high quality services that reflect local circumstances.

Will care boards manage GP contractual arrangements?

• Following a consultation on the recommendation of the Independent Review of Adult Social Care the Scottish Government has decided that GP contracts will continue to be held by NHS Health Boards.
• We are not proposing any changes to the contractual arrangements of other independent contractors (such as dentists, community pharmacies etc).