Social workers and leaders call for pause to the National Care Service Bill

Organisations representing the social work workforce have called for more detail on the proposals to introduce a National Care Service in Scotland.

The National Care Service (Scotland) Bill would allow Scottish Ministers to transfer social care responsibility from local authorities to a new national service. Currently, the proposals could include adult and children’s services, as well as areas such as justice social work. Scottish Ministers will also be able to transfer healthcare functions from the NHS to the National Care Service.

The Scottish Government introduced the Bill after conducting its Independent Review of Adult Social Care (IRASC) (sometimes referred to as ‘The Feeley Review’) to improve the quality and consistency of social work and social care services in Scotland. The Bill is currently at ‘Stage 1’ where committees examine the Bill and gather views to produce general principles guiding the legislation.

Responding to this consultation, Social Work Scotland said “significant work” needs to be done before the Bill should be passed and suggested that the Bill should be paused while detailed financial work is carried out.

The organisation, which represents senior social work leaders, says that while the Bill represents an “historic opportunity to put Scotland’s social work and social care systems on a road out of crisis”, the current draft of the Bill does not provide a robust process to deliver those aims.

This view is echoed by the Scottish Association of Social Workers (SASW), whose members suggested in a consultation on the proposals that the “lack of detail around funding, workforce, and how adult social work and social care will operate are significant omissions.”

“As it stands, this Bill is unlikely to deliver improved quality and consistency of social work services. It lacks sufficient detail to determine whether it might meet the vision of the Feeley Review or the purpose the Bill as set out in the Policy Memorandum,” SASW said in a summary of the responses it had received.

Social Work Scotland said that it is “particularly concerned” with the financial impact of the Bill, coming at a time when social work, social care and health services are in the midst of the most “serious capacity and delivery crisis in living memory”. Social Work Scotland said its members report that waiting times for assessments, support and treatment are all increasing, and in some social work teams over 30% of posts are unfilled, with vacancies receiving no applications over multiple recruitment cycles.

Social Work Scotland also warned that professionals are experiencing the cost of living crisis in tandem with the continued adaptation to a post-pandemic world and that these contextual factors could undermine the Bill’s aims.

“Social care staff, and the many para-professionals and administrative staff that support social work, are likely to be on relatively low rates of pay, and therefore under acute stress. In that context, co-designing a National Care Service risks adding to existing stress and undermining the wellbeing of the very people this Bill is about; staff, carers and supported people,” the group said.

Alison White, Convenor of Social Work Scotland, called for more detail on the proposals.

“The ambition of a National Care Service is going to be set by the resources it has available, and frustratingly, there’s little detail in there about the reforms that will really matter to people. Up to £500 million has been allocated for purely organisational reforms.

“Based on the information that’s been published, we can’t say if a National Care Service is really going to address the systematic underfunding of social work and social care. Nor can we say whether the aims the bill sets out are actually deliverable, from the perspective of the public finances.”

Social Work Scotland’s members have also put forward alternative options based on a partnership between those who are supported by social work and social care, and the professionals who provide it. The body says that, if the Bill was paused, everyone with lived experience – either receiving or providing support – would have more time to have “meaningful involvement” in designing the service and give opportunity for considered decisions around children’s and justice services reform to be made.

“We agree with the aims the Scottish Government is working towards and putting social justice and human rights at the centre of social work and social care is critical. But we need this pause for more work to be done, so we can understand in much more detail how a National Care Service would work, and how it will [be] funded, so that we can make sure we secure the best outcomes for the people we support,” Alison said.

SASW National Director Alison Bavidge echoed support for the Bill’s ambitions but warned that a ‘laser focus’ would be required.

“I am optimistic that Scotland can achieve this, but the Bill in its current form lacks important details about the role of social work and the operation of a National Social Work Agency. These details are fundamental to the future of the social work profession and must be addressed immediately to ensure that people are able to fully consider what the Bill means.

“If Ministers are committed to passing the Bill in the current parliamentary term, then a laser focus is needed from everyone involved to make these substantial changes and deliver greater effectiveness and a more caring society. This must include mapping out a clear, robust strategy for the co-design process.”

The Health, Social Care and Sport Committee will now commence evidence sessions in a process that will take months as they examine the Bill from all angles.