An independent review into the future of adult social care has recommended that a National Care Service, similar to the NHS, be set up in Scotland to tackle the crisis in the sector.
The report, led by former Scotland director general of health and social care Derek Feeley, published more than 50 recommendations to the Scottish Government, including making care services free at the point of need for non-residential care in communities or at home.
The National Care Service would work in close co-operation with the NHS to “establish a simplified set of outcome measures to measure progress in health and social care support”.
A chief executive would be appointed to the National Care Service, equivalent to the chief executive of the NHS and accountable to ministers.
The National Care Service would oversee local commissioning and procurement of social care and support by reformed Integration Joint Boards, with services procured from local authorities and third and independent sector providers.
Integration Joint Boards would manage GPs’ contractual arrangements, whether independent contractors or directly employed, to ensure integration of community care and support provision, to respect and support professional interdependencies, and to “remove the current confusion about where responsibility for primary care sits”.
Derek Feeley, said: “This is a time to be bold and radical. Scotland needs a National Care Service to deliver the high quality, human rights-based services people need to life fulfilling lives, whatever their circumstances.
“Scotland has ground breaking legislation on social care but there is a gap, sometimes a chasm, between the intent and the lived experiences of those who access support. We have a system that gets unwarranted local variation, crisis intervention, a focus on inputs, a reliance on the market, and an undervalued workforce.”
If we want a different set of results, we need a different system. That’s why I want to see a National Care Service, delivered in partnership with the people who rely on it and with the workforce, which provides the opportunity for everyone in Scotland to flourish.”
The review’s recommendations also include an end to charging for non-residential services so that social care can be free at the point of need for those receiving care in their own homes or community settings.
In addition, it calls for enhanced pay, conditions, training and support for the social care workforce.
First Minister Nicola Sturgeon welcomed the report in parliament and said the SNP government will respond shortly.
She said: “The pandemic has shown us more starkly than ever before just how much our care services matter, so the review report provides us with a basis for significantly improving these services, as a vital first step towards the creation of a national care service.”