National Care Service - Expert Legislative Advisory Group minutes: 18 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. They reminded the group that this was the second meeting to focus on the National Care Service Board (NCSB). The Chair also set out the terms of engagement for the group and explained that the papers for the meeting had been sent out earlier in the week. They advised the group that we will continue to learn and welcome feedback on how the meetings can be improved. Housekeeping, meeting etiquette and using Zoom were also discussed by way of a reminder to the group.  

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 explained that the Terms of Reference have been updated to include new members and incorporate comments received.

The actions from previous meeting were then reviewed:

• 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. Cleared
• the SG will share the notes of the breakout sessions with the group before the next meeting. Cleared
• the SG will circulate the NCS Target Operating Model (TOM) with the papers for the next meeting. Cleared

There are still two outstanding actions from the first meeting. These are:

• 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. Ongoing
• the SG will look to incorporate existing analysis around the Bill’s interaction with other pieces of legislation in a future agenda item. Ongoing

The minutes and actions of the previous meeting were agreed.

Target Operating Model 

The Chair explained that the Target Operating Model (TOM) had been circulated with the papers for the meeting and encouraged anyone who wished to comment on this to do so via email.

Feedback from last week’s breakout group  

A high-level summary of the feedback from last week’s breakout sessions was provided. The group heard that the notes from the previous week’s breakout sessions showed that most groups only managed to cover questions 1 and 2 from the set questions. Feedback was given on the main points that arose from the session. Those were around:

• the National Care Service Board membership
• the scope of the National Care Service Board
• concerns around ensuring the voice of lived experience is heard
• accountability - what that meant and how it will operate in practice

Other points reported to the group included:

• members felt proposed NCS Board members were being tied together from a political position, not a professional one
• clarity was needed around the role NHS, councils and Scottish Government reps will have on the board as there could be conflicts of interest
• the proposed committee structure for the board should be explained - clear commitment to the board having committees would be helpful
• lived experience members of the board – a lot of thoughts on who would be represented, what voting rights they would have, and how they would be supported
• need more clarity around the responsibilities
• need to know the scope of National Care Service
• questions on working with others particularly working groups and other regulators in the system

Thanks were given for the full and insightful comments made and assurance given that the team working on this will continue to use these points in the development work on the policy. The group were also advised that their point around more clarity in our messaging was heard and will be given consideration.    

Breakout sessions

Attendees were then placed into breakout sessions. Each group was asked to discuss the five set questions provided at last week’s session. Groups were asked to look at questions 3-5 in particular, as these had not been discussed in detail in the previous week’s breakout sessions. 

The questions are provided in the section named Breakout sessions: discussion questions.

Main meeting

After the breakout sessions everyone returned to the main meeting space. The Chair thanked all for their input and asked if anyone would like to highlight any key points or reflections from their breakout session.

No one commented at this stage.

Close of meeting

The Chair said that the SG would share a minute of the full meeting and an output note from the breakout rooms with all members before the next meeting.

The Chair advised that the next meeting would focus on local reform.

It was suggested that it would be helpful if the group could have a review of proposals and a brief on what the focus will be in the breakout discussions ahead of the meetings. This would lead to more meaningful conversation in the breakout rooms. While some members may have been present at previous meetings it can be difficult to recall discussion.

It was suggested that choice and control is important and everyone having the opportunity to contribute for example, Independent Living Fund and Self-Directed Support . The language that we use is important as it holds people to account.

It was suggested that Control Scotland should be invited to future meetings as they cover Self Directed Support.

It was asked if the group could be sighted on the timescale for Stage 2 of the Bill. The Chair advised that once they have that information it would be shared with the group.

It was asked if information could be provided to the group on engagement and other stakeholder meetings. The Chair answered that this is currently an ongoing action item.

It was pointed out that assumptions were being made about what stakeholders understood about the NCS and what was included in it. There was less clarity about plans than the Scottish Government assumed. There is a nervousness among disabled people led organisations about what is at the heart of all of this work. The plans for the National Care Service had changed from what was originally intended. It is clear that there is a real commitment from all to work together, but we cannot assume we are all on the same page. We need to make sure we have a clear shared vision and principles for this work.   

A point was raised on the regularity of the meetings for this group and the expected commitment. The group was advised by the Chair that weekly meetings were scheduled and that this is a short life working group. It was explained that the intention of this group was to focus on Stage 2 amendments for the National Care Service Bill going through Parliament. That meant the timescale was set by the Bill process and did not leave much room to spread meetings any further apart. The time commitment from members was very much appreciated.

The Chair reminded members that there is a standing offer of reaching out to the National Care Service Communications Team, if anyone felt that they needed a catch up prior to meetings. Anyone who wanted to have separate discussions should use the email address to get in touch.  

There was feedback from the group that the comfort break was too long and it would be better not to have one and shorten the meeting instead.

The Chair explained that a 15 minute break was needed to make sure the meetings were accessible for all members. They acknowledged that the break was timed wrongly for this meeting and would ensure this was rectified for future meetings.  

The final point raised was on feedback from the breakout sessions. It was suggested that it would be good to hear the thoughts from the other rooms. The Chair agreed that this should be set up in a more structured way for future meetings.  

The Chair again invited members of the group to share any further thoughts on the proposals for the National Care Service Board after the meeting. Members were very welcome to provide their comments in writing and the email address was shared.

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

Action points from the third meeting

• ensure comfort break scheduled halfway through the meeting
• the Scottish Government will share the notes of the breakout sessions with the group before the next meeting
• ensure any update on Stage 2 amendments are shared with the group

Breakout sessions: discussion questions

• is there anything unclear about our plans for the National Care Service 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 National Care Service, 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 National Care Service Board affect other bodies? Who should be involved in development work in the future?