National Care Service Bill - Call for Views and Future Planning
North Lanarkshire Council · 29 September 2022
Back to Policy and Strategy Committee — 29 September 2022 and its agenda
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North Lanarkshire Council Report Policy and Strategy Committee Does this report require to be approved? ☒ Yes ☐ No Ref AG/RM/EK Date 29/09/22 National Care Service Bill – Call for Views and future planning From Alison Gordon, Head of Children, Families and Justice Service/Chief Social Work Officer E-mail gordonal@northlan.gov.uk Telephone Executive Summary Following the Independent Review of Adult Social Care led by Derek Feeley, the Scottish Government undertook a consultation on the proposal to establish a National Care Service (NCS) in Autumn 2021, subsequently committing to progress this within the lifetime of this parliament. Attached to this report is the Council’s response to a Call for Views made following the publication of the National Care Service (Scotland) Bill in June 2022. The NCS Bill will be considered at Stage 1 of the process by four parliamentary committees, reflecting the fact that this represents potentially the biggest public sector reform in decades with substantial impacts for local authorities and the future delivery of support to individuals and families. The response, which was agreed by the Corporate Management Team due to the narrow submission deadline of 2nd September precluding consideration by Committee, draws on the Council’s response to the NCS Consultation which was agreed at Policy and Strategy Committee on 27th October 2021, whilst raising additional concerns arising from the framing of the legislation and proposed Bill process. In view of the significant and wide-ranging impact on the Council of NCS proposals as framed within the Bill and, in line with the approach taken during the consultation period, it is proposed that a Member Officer Group be established, both to guide the Council’s future engagement with the Bill process and to support planning and management of the potential impacts for the Council. Recommendations It is recommended that Policy and Strategy Committee: (1) Note and homologate the Council’s response to the Call for Views, as attached as Appendix 1 (2) Approve the establishment of a Member Officer Group to guide future engagement with the Bill process and future planning with respect to NCS. The Plan for North Lanarkshire Priority All priorities
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1. Background 1.1 On the 9th August 2021 the Scottish Government launched a consultation on a ‘National Care Service for Scotland’ as its principle response to the Independent Review of Adult Social Care (IRASC) which it has commissioned the previous year and which reported in February 2021. The Council’s response to the consultation was guided by a short- life Member Officer Group and agreed at Policy and Strategy Committee on the 27th October 2021. 1.2 The National Care Service (Scotland) Bill was introduced to parliament on 20th June, and its accompanying documents on the 21st June, 2022. The Bill seeks to provide a framework for the establishment of a National Care Service within the lifetime of the current parliament. 1.2 The Bill sets out provisions which would enable Ministers to transfer responsibility for social work and social care from local authorities to local care boards reporting to Scottish Ministers. The Bill establishes a National Care service; sets out provision for the processing of health and social care information and sets out provision for the regulation and delivery of social care. It specifically proposes a charter of rights and responsibilities for social care, as well as rights for unpaid breaks for carers, along with visiting rights to adult care homes, both of which may be introduced in advance of other Bill provisions. 1.3 Reflecting the significance of the Bill as the vehicle to facilitate the most significant public sector reform in decades, four Scottish Parliament Committees issued a ‘Call for Views’ on the Bill on the 8th July 2022 with a tight timeline for submission before 2nd September 2022. The Health, Social Care and Sport Committee is leading on the scrutiny of the Bill, with the Finance and Administration; Education, Children and Young People and Local Government, Planning and Housing Committees also considering evidence. 1.4 It is proposed that much of the detail of the National Care Service will be worked through within a process of ‘co-design’ and effectively shaped by secondary legislation/regulation. There remains a critical lack of clarity on the shape and governance of the co-design process with the Minister, Kevin Stewart, writing to stakeholders on this on 21st June noting only that ‘the process of co-design of the National Care Service will begin this summer with people with lived experience, workforce, trade unions and NHS Boards’ 1.5 In parallel to the proposed co-design work it is proposed that in response to the earlier consultation, and recognising that these were not examined within the Independent Review of Adult Social Care, a further independent evidence review is progressed to determine the appropriate future arrangements for children and justice social work services. The Bill establishes the need for further public consultation to be held on this with the results to be laid before parliament alongside any proposed regulations. 1.6 Notably whilst the Bill allows for the transfer of functions relating to both social care and health to the proposed care boards, it allows for workforce and resources to be transferred only from local authorities, specifically excluding the transfer of NHS staff. 1.7 The Bill is accompanied by a financial memorandum however this is focussed primarily on the costs of structural reforms, estimated to be in a very broad range of 200-600 Ambition statement All ambition statements
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million, and some on smaller Bill commitments rather than the greater investment in services required to meet its aspirations. 2. Report 2.1 The Bill has significant implications for the Council both with respect to the proposed transfer of functions and staffing and its wider impacts on service delivery and on the aspirations and the future functioning of the council. An initial calculation suggests up to 27% of the council’s workforce/resource base could be in scope to transfer to the NCS. 2.2 In view of this Corporate Management Team agreed on 16th August that it would be beneficial to establish two working groups to deal with planning (1) with respect to broader impacts for the council including Financial, Legal and HR and (2) continuing service provision and operational arrangements. In the interim Heads of Service across all of these functions have contributed to the formation of the response to the Call for Views. 2.3 The response draws on the Council’s previously agreed consultation response but additionally highlights a wide range of concerns with respect to the Bill and proposed Bill process including: • The inappropriateness of the use of skeleton/framework legislation to progress change of this complexity and magnitude • The lack of clarity around the proposed co-design process and its governance • The challenge associated with the disconnect between the Bill timeline and the decision-making process on children, families and justice work. • The lack of attention to the delivery and governance of key statutory social work functions, in particular public protection • The lack of attention to prevention, recovery and re-ablement • The lack of attention to connection with other local services • The differential approach to the local authority and health workforce and the impact of this on the aspiration to further integration • The inadequacy of the financial memorandum, in particular with respect to the investment in services needed to achieve the aspirations of the IRASC • The potential for significant disruption though the change process at a time when communities and councils remain heavily impacted by pandemic recovery and the cost- of-living crisis. • The longer-term impact on the functioning of the council 2.4 Whilst a briefing on the Bill was prepared for Elected Members shortly after its publication in June, the timing and timescale of the Call to Views has not allowed for Committee consideration prior to the submission of the response. Given this and the criticality of the proposed changes, not only for the future delivery of health and social care but for the wider council impacts it is proposed that it would be most appropriate for workstream (1), as referenced above, to be taken forward though the establishment of a Member Officer Group to both guide future engagement and response to the Bill process and to support planning for the wide-ranging impacts for the Council. 2.5 It is noteworthy that COSLA Leaders met on 2nd September 2022 to consider their collective response to the Bill and their approach to engagement with the Bill and proposed co-design. This also clearly has relevance to the approach taken by the Council moving forward.
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3. Measures of success 3.1 N/A – Consultation Response 4. Supporting documentation 1) Appendix 1 - Call for Views on the National Care Service (Scotland) Bil Alison Gordon Head of Children, Families and Justice/CSWO
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? As outlined in response 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☐ If Yes, have all relevant HR impacts have been discussed and agreed with People and Organisational Development? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☐ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic Solutions? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☐ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact
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Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? Where the impact identifies a requirement for technology, has an assessment been carried out (or scheduled) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed?
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Appendix 1 - Call for Views on the National Care Service (Scotland) Bill Required by 2 September 2022 The Policy Memorandum accompanying the Bill describes its purpose as being “to improve the quality and consistency of social work and social care services in Scotland”. Will the Bill, as introduced, be successful in achieving this purpose? If not, why not? A human-rights approach is welcomed As previously noted, where there has been major change to national bodies, they have had to look inwards for a period to address organisational concerns which can impede progress towards a national agenda, and as such improvements will be impacted. This in turn may jeopardise the national strategy to implement The Promise, particularly impacted by the ongoing decisions around whether children and family / justice services are included in the NCS or not. North Lanarkshire Council would like clarity around the opportunities that will be afforded in co- designing the detail of the NCS. Because the focus of the Bill is around social work and social care, with only functions of community health (NHS staff will not be transferred into the NCS), it is difficult to see where the benefits of integration will be progressed or further realised. In North Lanarkshire, an outcome focussed approach has been a priority with services being delivered through a whole system approach to Self-Directed Support. The number of people supported at home is one of the highest in Scotland, as choice and control is promoted widely alongside innovative approaches in working with communities, and it is currently unclear if this level of choice and control will be protected in the Bill. There is an acknowledgement that there is a need to address unjustified variation in access to support across local areas but there is concern that standardization is being proposed. Further detail is required as to what elements of practice or process would be standardised. There needs also to be a recognition of the differences, for example, between urban and rural communities, island communities, more and less affluent communities. There are also some risks in considering a rights based, almost consumerist approach to access to support and care without a clearer acknowledgement that not all people are equally able to articulate their needs or aspirations or that these can at times conflict with best interests or the rights of others. Equally the consultation is relatively silent on the impact of poverty, its links with other needs and the role of social work and social care in addressing this. We have a broader concern regarding the lack of detail in the Bill and the reliance on secondary legislation. The Bill is silent on key areas therefore providing no reassurance regarding key areas of service delivery and diminishing opportunities for scrutiny during the parliamentary process, In addition the financial memorandum address only the cost of the change process and does not address the investment required to address the stated aspirations of the NCS.
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Is the Bill the best way to improve the quality and consistency of social work and social care services? If not, what alternative approach should be taken? The Bill also does not adequately address the implications of splitting the profession across different delivery and accountability structures (i.e. adult social work in the National Care Service, children’s social work in local government, with the added complication of NHS staff remaining managed within the NHS). In addition, it is difficult to see how a co-design process can progress with uncertainty about what is in scope pending the completion of the planned evidence review on children’s and justice social work services. A viable and attractive alternative is to retain a focus on local accountability governed through a single plan such at The Plan for North Lanarkshire, bringing together all local partners with a unified goal. Learning from the pandemic has already shown the strength and impact that partners coming together working on an agreed collective priority can make. The ambition for further improvement is a shared one, however, the model for improvement presented within the Bill draws heavily on a health model and the quality improvement approach. Whilst this has value and there is learning to gain from what works well in health, a single model for improvement is not appropriate for the particular complexities and dynamic nature of social work and social care. There also has to be recognition that scaling up and embedding practice and service improvement requires sufficient support and time given the complex systems involved. The achievements with respect to Self -Directed Support in North Lanarkshire, for example, draw on work of over a decade to get to the current position. It is important to recognise the inter-connectedness of the range of services wider than health and social care that impact on health and wellbeing, i.e., housing, employability support, education etc. and the importance of maintaining and improving these connections so services work in tandem to support the best outcomes for people and communities. It is important therefore, that further consideration is given to how these connections can be maintained and strengthened in this new approach to prevent any potential eroding of broader, effective, collective partnership working which improves health and wellbeing. Are there any specific aspects of the Bill which you disagree with or that you would like to see amended? An uplift in funding through existing arrangements for the local partnership to enable a renewed focus on improved outcomes, which is the expressed aspiration of the Plan for North Lanarkshire, and which enables the improvement model which has been described in this overall response, would be a viable alternative that removes the significant risks of structural change. Social work and social care services are currently in crisis nationally, with waiting times for assessment and support growing, low morale, and long-term structural challenges now manifesting. The Bill has frontloaded disruption and tension into an already unstable system. The lack of detail on the human resource impact for staff is concerning. Work at a National level to review levels of pay, role standardisation and improved support for building future workforce resilience through funded training and practice would be welcomed as part of a wider solution to the longstanding problem of workforce pressures.
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As previously stated, the potential removal of such a large workforce from North Lanarkshire Council will impact on wider roles and employees at many levels. Scope, scale, and TUPE arrangements are all unclear. The role of Social Work has not been fully represented within these proposals and the analysis of current practice does not reflect the complex interventions that take place with individuals, their families and carers within challenging environments. There is no recognition that the role of Social Work is not merely transactional or that of a gatekeeper to services but is based on developing strong working relationships. The statutory role of Social Work to balance rights, sometimes conflicting rights, and risks is not sufficiently acknowledged. The focus of the Bill is the interface between social work and social care, however, there is no reference to the positive existing work that goes beyond case management with a greater focus on outcomes. The work that Social Workers undertake with those people who are hard to reach, is very much defined by local knowledge and local relationships and not always the provision of a support package. The role social workers play in empowering individuals and their families, working towards self-actualisation, independence and life without ongoing paid support is hard to define but has the most significant impact on people’s lives. The risk in the consultation is that the criticism of gatekeeping and bureaucracy overlooks and oversimplifies the need for conversations which encourage and raise expectation and ambition. The need to continue to focus on recovery, rehabilitation and reablement are not currently prominent enough in the Bill. The public protection structures, a clearly critical role, are also not fully clear in the Bill. The need for local arrangements is critical in this area, to ensure that this work remains a priority. The work undertaken in North Lanarkshire across the public protection agenda to improve practice and outcomes for people should be recognised and valued. It will be essential that local arrangements such as Chief Officer Groups continue to provide the necessary leadership. There is no reference to the excellent practice and learning that is produced through COGS any reflection on how the impacts on governance nor on how the checks and balances essential to rights based practice within the current system could be addressed within a structure of direct accountability to Scottish Ministers. Is there anything additional you would like to see included in the Bill and is anything missing? There is a need to define the role and expectations of the National Social Work Agency and how this will interface with local arrangements. There is no reference to the Chief Social Work Officer or to the unique responsibilities the individual holds. Similarly, there is no reference to the roles and responsibilities of Care Boards’ Chief Finance Officers or existing Local Authorities’ S95 Officers roles in respect of future Social Work Services. There is insufficient reference to the importance of recovery, rehabilitation and reablement which needs to remain a focus. The over focus on services rather than wider community resources, promoting easier access to service based on wants runs the significant risk that more people will end up with service where change responses would promote greater independence and improved quality of life. It is also important to remember that in support of current legal and statutory roles, such as that of the Chief Social Worker, and in advising generally and in representing through court proceedings, there
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is a considerable specialist legal support in local government. This support is not subject to commercial drivers and manages costs associated with legal activity proportionately, in critical areas such as permanency planning, child protection and adult support and protection. Removal of this support would see a detrimental impact on outcomes for a range of vulnerable individuals. Detail of the impact on the service or the Council is difficult to understand from the Bill. Most legislative responsibilities fulfilled by social work are currently framed as duties on the local authority and in some areas, including public protection, these do not fall exclusively on social work but also on other services. Again, there remains a lack of clarity on this within the Bill. The opportunity to develop an evidence base against which to decide on the inclusion of children and family social work and justice social work, as a consequence the risk of splitting service remains unclear. Any future proposed pay and grading model for the NCS would need to consider the existing SSA agreement, which was made directly with Trade Unions, factoring in how this would be incorporated in any future model. Given the likely size of workforce involved, the need to agree what job evaluation approach would be agreeable to all parties, the need to ensure that it was “equal pay proof” and to apply this to all roles in scope, we would envisage that this would be a significant piece of work which may take several years to complete and would require expert input to manage associated risks. North Lanarkshire Council’s concerns remain related primarily to the fact that the Bill does not reflect the scale and complexity or costs of the workforce changes which would be required to deliver the NCS within 5 years through the establishment of a single employing entity and the transfer of large workforces from 32 local authorities under TUPE. Nor does it acknowledge that there are significant existing and historical workforce risks, which need to be recognised and evaluated as the proposal goes forward for more detailed consideration and potential legislation. The introduction of a single record is a welcome aspiration but there is little detail as to how this will be implemented and the associated costs are not addressed within the financial memorandum. Given the multiple databases currently used both within the NHS as a single organisation and across local authorities and the complexity of change in this area, it appears highly unlikely that a single record would be achievable within the proposed timeframe for the establishment of the NCS. There is a risk of loss of local intelligence and relationships which are key to supporting providers and investing in organisations that will target local population needs. Work is needed to ensure that smaller, more local provision and providers are not inadvertently disadvantaged in a standardised approach. Whilst a select range of “once for Scotland” resources for particularly complex and unusual circumstances is supported, significant work is needed to ensure national consistency on thresholds is maintained. Using the North Lanarkshire context as a frame of reference, the consultation paper somewhat underplays the role that the NCS will play in tackling poverty, specifically in terms of income maximisation and the assessment of people’s ability to pay charges/contributions. The Bill does not cover the emergent Homelessness Prevention Duties for public bodies which seeks to ensure the appropriate care, support and collaborative working required to ensure whole system change.
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The Scottish Government proposes that the details of many aspects of the proposed National Care Service will be outlined in future secondary legislation rather than being included in the Bill itself. Do you have any comments on this approach? Are there any aspects of the Bill where you would like to have seen more detail in the Bill itself? Please refer to our earlier comments, as noted above the approach in providing only framework legislation raises significant concerns on the opportunity for scrutiny during the Bill process and fails to provide assurance on future service delivery in particular given the lack of clarity on the proposed co-design process and how decisions will be made going forward, The Bill proposes to give Scottish Ministers powers to transfer a broad range of social care, social work and community health functions to the National Care Service using future secondary legislation. Do you have any views about the services that may or may not be included in the National Care Service, either now or in the future? The Care Boards can employ staff, and it is expected that this will include the transfer of adult social work and (some) social care staff from local employers to the NCS (although, again, this is not stated in the Bill itself). NHS functions can be transferred to Care Boards, but not the staff; the Bill explicitly prohibits the formal transfer of NHS employees into the NCS structures. The rationale for this position has not been adequately explained and appears to be a regressive step with respect to integration. The distinction that NHS staff will not transfer raises significant concerns around the potential impact on existing integrated services and the future direction of travel for integrated working The evidence base for the inclusion of services of those where economies of scale suggest a national approach is required is weak and appears to rely on as desire for consistency which could more appropriately be delivered though a focus on standards rather than standardisation. The boundaries of what is included and what is not included must be made clear at the earliest stage. The proposed position with respect to many supporting functions of the Council including procurement, finance, HR, and legal support for example, remains unhelpfully unclear. Do you have any general comments on financial implications of the Bill and the proposed creation of a National Care Service for the long-term funding of social care, social work and community healthcare? It is recognised that historic underfunding has impacted on service delivery and development in both social work and social care and we have a concern, particularly in the current financial climate. that the cost of restructuring and set up will both be disruptive to current improvement work and divert investment from those areas where investment is required to meet the desired outcomes of the legislation. There is a huge margin of error within the estimated set up costs as expressed within the financial memorandum and no estimate of, or commitment to the investment required to meet the aspirations of Feeley. The significant financial and staffing impact on the Council remains a significant concern The Bill is accompanied by the following impact assessments: • Equality impact assessment • Business and regulatory impact assessment • Child rights and wellbeing impact assessment • Data protection impact assessment • Fairer Scotland duty assessment • Island communities impact assessment
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Do you have any comments on the contents and conclusions of these impact assessments or about the potential impact of the Bill on specific groups or sectors? Financial memorandum questions • Did you take part in any consultation exercise preceding the Bill and, if so, did you comment on the financial assumptions made? Yes comments were provided on the financial assumptions. • If applicable, do you believe your comments on the financial assumptions have been accurately reflected in the financial memorandum (FM)? Not all comments or concerns raised previously have been addressed. More information on the areas which lack detail or substance are provided in the final point below. • Did you have sufficient time to contribute to the consultation exercise? The original consultation document contained little financial information. The response provided highlighted where further detail was required. • If the Bill has any financial implications for you or your organisation, do you believe that they have been accurately reflected in the FM? If not, please provide details. The Financial Memorandum is lacking sufficient detail to assess the financial implications at an organisational level. The financial projections have been completed at a very high level and there are a number of areas which lack clarity. It is, therefore, difficult to make a fair assessment of the impact locally or on individual Local Authorities. Some key issues which require increased clarity and transparency are as follows: At this stage no decision has been made on the number of Care Boards that will be established. Without this information, it is not possible to assess the impact on existing areas. Paragraph 26 the FM states “for services currently provided in-house by local authorities, that may continue under a procurement arrangement with the care board, or the care board may take over direct delivery, with staff transferring to the care board. These will be decisions to be taken locally as the care boards are established, following careful options appraisals”. Paragraph 29 - “the transfer of functions may take place immediately on establishment of care boards in 2025-26 or may be phased with different functions transferring gradually over a number of years. A phased approach may result in a period of double running costs or transfer costs in addition to the costs set out below”. In relation to services transferrin to the NCS, no detail has been provided on whether funding would be transferred based on existing budget provision or actual costs. Given the level of historic underfunding reference above, this distinction is critical. Paragraph 28 states: “Table 2 sets out the approximate current and projected costs of the services that could be transferred to care boards and to the Scottish Ministers. In terms of the total costs to the public purse, it is assumed the transfer of services itself has no effect: the costs of providing these services will simply transfer from local authorities and health boards to the NCS”. This is significant as there are existing variances across current service provision. It is; therefore, misleading suggest transfers
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will be at nil cost. This was raised in the initial consultation response but has not been addressed. • Do you consider that the estimated costs and savings set out in the FM are reasonable and accurate? The high-level assumptions which have been made throughout the FM have not been clearly defined. It is not possible to assess how the figures have been calculated and it is, therefore, not possible to assess accuracy or reasonableness. Based on what has been provided, it is suggested that the following must be considered in any future iterations of the FM. The costs detailed in Table 1 appear low for the full service when compared to the individual costs of the current provision. In 2021/22 NLC had a gross annual budget in excess of £272M and the FM has a total running cost for the NCS, and care boards come 2026-27 of between £241M and £527M. Using the LFR as a base is reasonable as a starting point, however care must be taken if individual elements are viewed in isolation as this could impact on the integrity of the figures and may ultimately result in assessments made across authorities which do not compare like with like. In 2021/22 the Scottish Government has been reviewing LFR03 and a new return has been designed for this coming year which may have an impact on the figures being used as a baseline. It is assumed that the 2019/20 LFR figures have been used to reflect the pre-COVID position, however some COVID expenditure is now recurring and will not be captured in 2019/20 data. Similarly, the baseline takes no account of the potential costs of long covid impacts. It is impossible to assess at this stage if the 3% growth figure built in would be sufficient to fund these impacts. Inflationary impacts are based on 2.3%. This is clearly not reflective of most recent and forecast projections. Staff costs linked to setting up of the NCS have been based on “management estimates of resource need for the various elements of the programme”. However, no detail has been given on what basis these were calculated. Therefore, no assessment of the methodology can be made. Paragraph 40: “The estimated set up and running costs have been established by comparison to the existing costs of national management of the National Health Service and other large scale transformation programmes in the public sector, such as the creation of Social Security Scotland.” Without further detail it is not possible to provide an opinion on whether this is “reasonable or accurate”. The figures given in table 2 do not increase in line with inflation and although these are stated to be costs of providing services that could be transferred to care boards, they do not appear to be used elsewhere in the document. The document does not state the split of costs between the national specialised care boards and local care boards. In addition, it does not specify the coverage area of local care boards which will impact the level of funding required.
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• If applicable, are you content that your organisation can meet any financial costs that it might incur as a result of the Bill? If not, how do you think these costs should be met? It is not possible at this stage, with the information currently contained within the FM, to assess whether North Lanarkshire can meet the costs. As previously highlighted, the significant financial and staffing impact on the Council remains a significant concern. • Does the FM accurately reflect the margins of uncertainty associated with the Bill’s estimated costs and with the timescales over which they would be expected to arise? Overall, the FM is lacking sufficient detail to be able to assess this. There were a number of areas raised as part of the original consultation which have not been addressed. For example: How will the NCS/CHSCB financial information be managed i.e. centrally or locally and via which management information systems? Will the Care Boards have a unique financial identity in respect of bank accounts and treasury functions? How will the HRA element of funding within Adult Social Care be treated? As this is ringfenced it is unclear what will happen to this funding if the management of resources transfers to the care boards. How will capital budgets be treated? Previous national re-structures have resulted in voluntary or compulsory redundancies for incumbent staff. If this scenario is repeated with the creation of the NCS/CHSCB it is unclear who will be responsible for meeting these redundancy costs as well as any ongoing pension costs. The council currently incurs expenditure in respect of a number of fixed and overhead costs. Examples include the cost of office accommodation, the costs of Council support services such as Finance, Payroll, Business Solutions and People and Organisational Development. If at future point in-scope budgets and staff are transferred to the NCS/CHSCB will the Council have to absorb these overhead costs across the remaining Council Services? The Council has procured a number of contracts with external partners and providers which are scheduled to run for several years into the future. An example of these contracts is the 10-year framework that is in place for Self-Directed Support, which extends beyond the 2026 proposed implementation date. The FM does not provide clarification on which organisation would be responsible for potential penalty or break clauses if these contracts are terminated early. If children and young person care is not to be included in this first tranche when does a young person/child become an adult? Therefore, when and how does this person transfer? There are no population figures given in this documentation therefore it is not clear how many people is the National Care Service meant to assist. This is one of the main cost drivers so is the FM assuming a steady state? Until the co-design work is underway, and more details are confirmed on what the future model is going to look like, both at a national and local level, the figures provided in the FM can’t be accurately reviewed.
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Questions on specific provisions In providing comments on specific sections of the Bill, please consider: • Whether you agree with provisions being proposed? • Whether there is anything important missing from these sections of the Bill? • Whether there is anything you would disagree with or there are amendments you would wish to propose to these sections of the Bill? • Whether an alternative approach would be preferable?