National Care Service - Expert Legislative Advisory Group minutes: 11 April 2024

Attendees and apologies

The meeting was attended by:

• Scottish Government staff
• stakeholder organisations
• people with experience of community health, social work and social care services

Items and actions

Welcome and introductions

The Chair thanked everyone for attending and set out the terms of engagement for the group. The Chair explained that this was the first of two meetings on the National Care Service Board (NCSB). The Chair apologised that the papers were issued a few days in advance and said that in the future we will aim to provide these earlier. The Chair asked for members to share feedback on how meetings can be improved as we progress.

The ELAG website is now in operation and will be used to record relevant details around meetings. Notes of meetings will include a summary of attendees but will not attribute statements to individuals.

Minutes of the previous meeting and Terms of Reference

The Chair provided an update on the actions from the previous meeting.

The minutes of the previous meeting were agreed.

There was a discussion about how long the group would meet. There would be an initial two-month period of work by the group. There would be a review at this point to consider the ongoing role of the group during the passage of the Bill.

There were concerns about the recent call for evidence from the Health, Social Care and Sport Committee and whether this meant further delays to NCS. The Chair said that Ministers and the committee were both keen to make progress on the plans for the NCS as quickly as possible.

It would be important for the group to identify provisions that must be made in the Bill in time for them to be included. There would be other things that the group would discuss about the detail of how the NCS would work that would not have to be included in the legislation.

Target Operating Model (TOM) for the NCS and Policy Instructions for Stage 2 of the NCS Bill

The Chair moved to the main substantive item for discussion. The Chair explained that the TOM would be circulated with the papers for the meeting next week. A high level presentation was given on the policy instructions for the NCSB. People made the following comments about the plans for the NCSB:

• the Verity House agreement fundamentally undermined the original purpose of the NCS. Why was it possible to nationalise Police and Fire services and not social care? People accessing care and support were not well served by the current system and it was felt that the shared accountability agreement would not change that. There should not be a postcode lottery in the quality of services that people receive
• the NCS Bill was vastly different from the one that was envisaged when it was initially presented to Parliament, and the Scottish Government need to acknowledge this more clearly. There was a danger that another level of accountability was being created. There were concerns in the social work profession about the lack of clarity about the of role Children’s Services and Justice Social Work in the National Care Service and that if these services were not included there would be fragmentation. In general, there were concerns about the complicated process and lack of clarity on important details
• there was a lack of detail about the membership of the NCSB. Although the details would be set out in regulations, the Scottish Government should make clear what the intentions were for membership whilst the Bill was being looked at in Parliament
• it was appreciated that there would need to be a balance between having a board that was the right size to be effective as well as being inclusive. These suggestions were made about membership:
  • members of the board should include representation from all those with roles and responsibilities in the system and not only those with statutory responsibilities.
  • the professions, including nursing should be represented
  • the third sector should be represented on the board
  • disabled people’s organisations should be represented on the board
  • lived experience involvement should include unpaid carers and people who work in care services as well as people accessing care and support
• people wanted to know when there would be a decision about whether Children's Services and Justice Social Work would be included in the NCS
• the paper should be clearer about what role the NCSB would have in relation to fair work, sectoral bargaining and workforce planning
• it was felt that the name of the National Care Service did not fully reflect what it would do. The name should reflect that it would look at health and social care together and not just care. Some people felt that there was an impression that the National Care Service was only about social care or only about older people, for example

Breakout sessions

Attendees were then placed into breakout sessions. Each had five suggested questions with groups advised to focus on two or three of these. The questions are provided in the 'Breakout sessions: discussion questions' section at the end of this page.

Close of meeting

After the breakout sessions everyone came back into the main room. There was not time for the planned feedback from the breakout groups. The Chair said that the SG would share the notes from the breakout rooms with all members before the next meeting.

The Chair again invited members of the group to let the SG have any suggestions for improvements to the meetings. Members were very welcome to provide their comments in writing.

The Chair thanked everyone for their participation and closed the meeting.

Action points from the second meeting

• the SG will change the Terms of Reference to make sure that the expectations about the length of time that the group would meet was clear
• the SG will share the notes of the breakout sessions with the group before the next meeting
• the SG will circulate the NCS Target Operating Model (TOM) with the papers for the next meeting

Actions points from the first meeting

• the SG will consider further how best to pull together evidence from other ongoing NCS engagement and co-design, and feed it into this group: this is ongoing
• the SG will consider issues raised around confidentiality for membership organisations, and how best to reflect this in the group’s ToR: completed and updated Terms of Reference circulated for discussion at this meeting
• the SG will take feedback around accessibility on board, and take up the member’s offer of advice separately: Completed: invitations were sent to organisations in ELAG who expressed an interest in joining a discussion on accessibility. This took place on 3 April and various actions have been implemented following discussions at the meeting
• the SG will look to incorporate existing analysis around the Bill’s interaction with other pieces of legislation in a future agenda item: this is ongoing

Breakout sessions: discussion questions

• is there anything unclear about our plans for the NCS Board? Is there anything that does not make sense
• will the board’s functions enable it to carry out its aims? Are there any gaps? The aims are:
  • more consistent outcomes for people who access services (consistent means similar or the same)
  • improving these services ·
  • better support for the workforce and unpaid carers
• do the plans for the board show that, in the NCS, there should be shared accountability for social work, social care support and community health services?
• have we chosen the right things to co-design? Does our plan for the Bill include the powers and flexibility we need to co-design more details later?
• could our plans for the NCS Board affect other bodies? Who should be involved in development work in the future?