Social care - defining, evidencing and improving: mixed-methods qualitative study

3. Background

The National Care Service (Scotland) Bill (2022) was introduced to Parliament on 20^th June 2022, following recommendations from an Independent Review of Adult Social Care in Scotland (Feeley 2021) and a public consultation on a proposed National Care Service (NCS) between August and November 2021. As introduced, the NCS Bill sought to reform existing social care in Scotland under a single national body, setting the standards for how community health, social care and social work are delivered and giving accountability to Scottish ministers for improving quality, consistency and equity of social care provision. In July 2023, a partnership agreement was established between Scottish Government, Local Government and the NHS to share joint responsibility for people's care under the NCS and, at the time of writing this report, work is ongoing to detail how this will be operationalised. A programme of national co-design work with people and partners in social care is underway to design an NCS that matches the diverse needs of the population and to minimise potential gaps between legislative intent and actual delivery and care experience. The NCS Policy Memorandum also initiated work on the development of a national vision and a co-ordinated, evidence-informed approach to social care improvement under the NCS.

The NCS public consultation (n=1291 responses, including 575 organisations) highlighted that, although respondents welcomed a national approach to improving social care experiences and outcomes, many were concerned about losing existing 'good' practices in local areas under what they saw as a centralised system (Scottish Government 2022). Academic think tanks have similarly called on policy makers to build upon the existing evidence base for 'what works' in social care, drawing on local expertise, and devising more sensitive and effective ways of evidencing what 'good' social care looks like (Dalzell et al 2022). Accordingly, the NCS Policy Memorandum identified the importance of addressing knowledge gaps about "how areas for improvement are identified, how data requirements are recognised or data is collated, how good practice is shared and how impact is evidenced on a national basis" (para 67).The research presented in this report has been designed in response to these issues and developed using a consultative co-design process with several policy teams within the social care directorate who helped to identify, refine and agree the research aims and objectives. The co-design process highlighted that research on how policymakers can identify 'good' social care, build evidence of 'good' social care into national policy planning, and share and sustain 'good' practice to support continuous improvement in the NCS would be beneficial and timely.