Elderly man and caring sitting on a couch

The National Care Service, there can be no empty promises

Our Chief Executive, Lesslie Young, looks at the development of a new National Care Service in Scotland and how real meaningful change is needed and only comes from a true understanding of what social care is.

COVID-19 highlighted and continues to highlight one of Scotland’s greatest failings, the poor management, and delivery of social care.

Decades of underfunding and disregard for those who need and those who deliver social care, combined with endless discussion and little action, resulted in thousands of the most vulnerable in society being put at significantly higher risk of a deadly virus, with many paying the highest price.

The way COVID-19 ripped through social care settings of all descriptions is yet another clear sign significant change needs to happen.

How many signs do we need? We have been listening to the same messages, albeit phrased differently for decades. Why does it need another crisis, which usually involves unnecessary deaths, to evidence the need for immediate change?

Many working with or living with those who require social care are hoping this change is embodied in the development of a National Care Service. We also hope we are not disappointed yet again.


National Care Service

The Independent Review of Adult Social Care, published in February this year, stated Scotland needs a National Care Service “to achieve the consistency that people deserve. Also, to drive national improvements where they are required, to ensure strategic integration with the National Health Service. To set national standards, terms and conditions, and to bring national oversight and accountability to a vital part of Scotland’s social fabric.”

Describing social care as “a vital part of Scotland’s social fabric” could not be more accurate. This challenge is not one simply to be met by the government. It has to be understood and met by society.

What is too often forgotten by many is that people who require the support of social care often have no choice. They are in that position through no fault of their own.

We all live with the impact of the natural aging process, some may have an intellectual disability, develop a condition like Motor Neurone Disease, or be involved in a life-altering accident. It is unlikely anyone can say they do not know of someone who falls into any of these groups.

Also, it is likely social care will play an integral part in all of our lives, either for ourselves or for someone we love. It is essential therefore we all participate in the conversation about a National Care Service. Without exaggeration, your life may depend on it.

The Scottish Government are currently consulting on what the new National Care Service might look like. The consultation is 135 pages long and tries ambitiously to set out how social care delivery should change in Scotland.

Realistically, it will take several years before we see a fully functioning National Care Service.

Meaningful change does take time. Meaningful change is dependent on relevant information. It is up to all to participate and provide that much-needed information or lived experience to facilitate real change.


Name change must mean service change

We cannot allow the repackaging and renaming of original structures and methods of delivery. To do so, risks the development of a hugely expensive National Care Service which underdelivers again, change is not realised, and the same mistakes are made.

And most importantly lives are lost again either through unnecessary deaths or wasted opportunities for those who are not given the support to reach whatever their potential is.

Change comes in the way services are structured, financed, and delivered. However, real, meaningful change comes from a true understanding of what social care is, why it is an essential part of all our lives.

That understanding comes from education, communication, and the sharing of best practices. Defensive, precious, and territorial attitudes and approaches are no longer acceptable.

It is important expectations are managed realistically. This is so people understand exactly what the National Care Service is designed to do, and so resources are used as efficiently as possible. Education and understanding of the system are vital to ensure it meets people’s needs.

A lot is being promised. It will not be easy to implement or finance. Nonetheless, we must not waver in our determination to ensure the National Care Service knows what it has to deliver to improve social care in Scotland.

You can read and participate in the Scottish Government’s consultation on a National Care Service. The consultation closes 2nd November.