National Care Service Bill – Response to Stage 2 consultation
Renfrewshire Council · 18 September 2024
Back to Leadership Board — 18 September 2024 and its agenda
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_____________________________________________________________________________________ To: Leadership Board On: 18 September 2024 _____________________________________________________________________________________ Report by: Chief Executive _____________________________________________________________________________________ Heading: National Care Service Bill – Response to Stage 2 consultation _____________________________________________________________________________________ 1. Summary 1.1 This paper sets out the Council’s proposed response to a call for views launched by the Scottish Parliament’s Health and Social Care Committee as part of Stage 2 of the National Care Service Bill scrutiny process. The deadline for the submission of responses is 20 September 2024. 1.2 The Council’s proposed response has been drafted by officers, and has been informed by the consultation responses of professional organisations such as COSLA, Directors of Finance, SOLAR, Social Work Scotland etc. 1.3 A summary of the consultation process is provided within this report, with the response itself attached at Appendix 1. _________________________________________________________________________________ 2. Recommendations 2.1 It is recommended that elected members: • Approve the consultation response which will be submitted to the Health and Social Care Committee by the deadline of 20 September 2024 ______________________________________________________________________________________
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3. Background 3.1 In June 2022, the National Care Service (Scotland) Bill was introduced to Parliament. At that time, the Bill set out provisions to enable Ministers to transfer social care responsibility from local authorities to local care boards and to establish a National Care Service, amongst many other specific provisions. In September 2022, Council approved a response to the Bill as part of stage 1 of the parliamentary process at that time. 3.2 In the intervening period local authorities through COSLA, have sought to influence the further development of the Bill, and to advocate strongly against the transfer of accountability for these services from local authorities. In 2023 and following extensive discussions, a shared accountability model for the proposed National Care Service was agreed between COSLA, the NHS and Scottish Government, whereby local authorities would retain both the responsibility and the workforce related to the delivery of social care and social work services. It was agreed that a National Care Service Board would be created as the delivery vehicle for this shared accountability. 3.3 Following on from this agreement, Scottish Government proceeded within the parliamentary process relating to the National Care Service Bill, and published amendments at Stage 2 on 24th June 2024. The Heath and Social Care Committee has launched a call for views as part of the consultation process at this stage, with all responses due by 20 September 2024. 3.4 Officers have prepared a draft response which could be submitted by Renfrewshire Council in relation to the consultation which is attached as Appendix 1. This has been informed by responses prepared by COSLA and other professional organisations, and has been submitted as a written response rather than adhering to the specific questions in consultation document, which do not provide sufficient scope to respond with the detail required. 4. Summary of proposed response 4.1 Renfrewshire Council welcomes the opportunity to provide feedback on the National Care Service Bill at Stage 2 of the Parliamentary process. 4.2 The overall position of Renfrewshire Council on the National Care Service Bill and its associated documentation, remains that which was submitted as part of the national consultation exercise in November 2021 and again in September 2022. At that time, the Council confirmed that it did not support proposals to create a National Care Service (NCS) and to transfer accountability of adult social care and social work from the local authority, or for children and criminal justice social work to become a formal part of any National Care Service. 4.3 Renfrewshire Council welcomes the work that has been undertaken subsequently by Scottish Government, COSLA and the NHS to develop a shared accountability agreement for the development of a National Care Service which will ensure this workforce and all financial resources are retained by local authorities. It is agreed that the focus on improvement, on the social work
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and social care workforce, and on improved outcomes for the people that use these services, should be our shared focus going forward. 4.4 The Council notes with concern that some of the key pillars of the shared accountability agreement, have not been recognised within the amendments tabled at Stage 2 of the Bill development process, and further that in some cases these amendments allow for the potential inclusion of additional local authority services within the NCS at a future date through secondary legislation. 4.5 Our local response to the consultation is attached as Appendix 1 to this report. 5. Next steps 5.1 Council officers will continue to engage through professional organisations as the Bill progresses through the parliamentary process. Work is also continuing at a national level to develop workforce planning arrangements in relation to social care and social work, and around other improvement activities which will seek to improve the quality and consistency of care at local authority level such as in relation to the National Care Charter. _______________________________________________________________________________________ Implications of the Report 1. Financial – there remain potentially significant financial risks for the Council should the agreement not to transfer staffing and financial resources change in the future or be subject to significant amendment through secondary legislation. 2. HR & Organisational Development – as above, there remain a range of potential implications for all services and staff that deliver social work and social care services. The development of new workforce planning and improvement arrangements could also support professional development and learning opportunities for staff working in these services. 3. Community/Council Planning – health and social care services are core elements of local provision, and ongoing work will be required with all local partners to ensure that any transition to new governance arrangements for Integration Joint Boards is well communicated and understood. 4. Legal – COSLA have obtained legal advice in relation to the development of the Bill which has informed the officer response prepared to the consultation. As highlighted within the draft consultation response there remain a number of significant governance and legal implications of the NCS Bill, and the detail of such is yet to be developed. 5. Property/Assets - none 6. Information Technology - none 7. Equality and Human Rights – the development of the NCS has significant equality implications for a range of different stakeholders. 8. Health and Safety - none 9. Procurement – the development of the NCS may involve the development of further national commissioning arrangements and potential procurement implications going forward.
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10. Risk – the consultation response at Appendix 1 highlights a number of ongoing risks identified by officers in relation to the proposed implementation of the NCS, particularly in relation to governance, finance, and workforce. 11. Privacy Impact – none 12. Climate risk – none 13. Children’s rights - the rights of children and young people will require to continually be assessed as part of the development of the Bill at a national level. Any local impacts will be closely monitored as this process develops. 14. COSLA Policy Position – COSLA have co-ordinated a response to consultation on behalf of all member local authorities. This was used to inform the local officer response, along with information through professional organisations. Author: Laura McIntyre, Head of Policy and Partnerships
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DRAFT RESPONSE TO NCS BILL STAGE 2 CONSULTATION Renfrewshire posi�on Council welcomes the opportunity to provide feedback on the Na�onal Care Service Bill at Stage 2 of the Parliamentary process. The overall posi�on of Renfrewshire Council on the Na�onal Care Service Bill and its associated documenta�on, remains that which was submited as part of the na�onal consulta�on exercise in November 2021 and again in September 2022. At that �me, the Council confirmed that it did not support proposals to create a Na�onal Care Service (NCS) and to transfer accountability of adult social care and social work from the local authority, or for children and criminal jus�ce social work to become a formal part of any Na�onal Care Service. Renfrewshire Council welcomes the work that has been undertaken subsequently by Sco�sh Government, COSLA and the NHS to develop a shared accountability agreement for the development of a Na�onal Care Service which will ensure this workforce and all financial resources are retained by local authori�es. It is agreed that the focus on improvement, on the social work and social care workforce, and on improved outcomes for the people that use these services, should be our shared focus going forward. The Council notes with concern that some of the key pillars of the shared accountability agreement, have not been recognised within the amendments tabled at Stage 2 of the Bill development process, and further that in some cases these amendments allow for the poten�al inclusion of addi�onal local authority services within the NCS at a future date through secondary legisla�on. Our local response to the consulta�on is provided within the commentary below, as it has not been possible to align comments to the specific consulta�on ques�ons. General comments As highlighted above, whilst it is appreciated that work has been undertaken to highlight specific amendments that have been made between Stage 1 and Stage 2 of the Bill’s development, the document pack is not reader friendly. The Stage 2 amendments pack itself was also accompanied by a Ministerial leter that provided informa�on on planned further developments in rela�on to the NCS which were unfortunately not included within the Bill amendments, and which it is proposed will be implemented through secondary legisla�on. This includes powers to directly fund integra�on authori�es/new NHS local boards which is a renewed risk in terms of local budgets and the local workforce which had been addressed through the shared accountability agreement. The overall view is that the pack of amendments and accompanying documents create significant addi�onal confusion and uncertainty for all stakeholders. NCS – scope, purpose and governance The general purpose and focus of the Na�onal Care Service could be more �ghtly defined to beter reflect the shared accountability agreement. For example, the wording provided on scope and purpose indicates a focus on monitoring performance rather than intended in rela�on to improvement. The wording also indicates that the NCS will deliver services itself, rather than through the NCS local boards which is confusing for stakeholders including members of the public.
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The involvement of nominated elected member representa�ves on the na�onal NCS Board is welcomed, however the current defini�ons allow poten�al future widening of the board membership by Sco�sh Ministers, which may poten�ally reduce the role of democra�cally elected members within the NCS board at a future date, and this is not supported. It is suggested that the proposed governance for the NCS require further review, as at present the Bill amendments indicate that the NCS and its Board will be accountable to Sco�sh Ministers, which is not in line with the shared accountability agreement which requires NHS and local government involvement to fulfil this core joint role. Local authori�es are listed as an NCS ins�tu�on rather than as a full partner. As noted above it remains concerning that the scope of the NCS and local boards that will be created, could include all poten�al services listed within the Public Bodies 2014 Act, such as children and jus�ce social work, rather than focusing on adult health and social care provision as the key focus agreed as part of the shared accountability agreement. The Ministerial leter atached to the Stake 2 Bill consulta�on also creates addi�onal uncertainty by indica�ng that further services could be added through secondary legisla�on without significant parliamentary scru�ny. The development of a 5 year na�onal strategy to underpin the NCS is welcome, however in line with the shared accountability agreement, it is suggested this should be directed jointly by Sco�sh Government, local government and the NHS. Further detail would be welcome on how the implementa�on of any strategy would be funded. NCS local boards The Bill and its amendments indicate that the NCS at a na�onal level would aim to develop a support and improvement framework, but no detail is provided in terms of how this would be developed and agreed or work in prac�ce. There are provisions noted which could allow for the transfer of func�ons from local boards within “emergency scenarios” and it unclear how this could work in prac�ce, given many local authority func�ons are statutory and are defined in separate legisla�on. It is noted that within the Stage 2 Bill amendments, further clarity has not been provided on the membership of local boards which is desirable at this stage of the process. Children/Criminal Jus�ce Social Work The areas of concern highlighted in the Council’s previous responses to the Na�onal Care Service Bill remain. The inclusion of children’s services within the Na�onal Care Service goes beyond the scope of the Independent Review of Adult Social Care. As noted by COSLA, the report from Children in Scotland, commissioned by Social Work Scotland, Healthcare Improvement Scotland and the Care Inspectorate, highlighted that the answer to ‘the delivery of more effec�ve children’s services is not more structural change. Na�onal Social Work Agency / Chief Social Work Adviser The principle of the proposed Na�onal Social Work Agency in terms of suppor�ng the ongoing professional development of the social work workforce is welcomed, as is the formalisa�on of the Chief Social Work Adviser as a statutory role. It is suggested that the mechanism that has been proposed to develop the NSWA does not fully reflect the partnership approach which underpins the shared accountability agreement, with the Bill indica�ng that the current Office of the Chief Social
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Work Adviser would be shaped into a new body which would become an execu�ve agency of the Sco�sh Government. To work most effec�vely with the social work workforce, this new body needs to be developed on a partnership basis, with greater clarity provided on how the role of other organisa�ons would require to change, such as the Sco�sh Social Services Council. Na�onal Care Charter The principle of developing a Na�onal Care Charter is supported, and it is cri�cal that engagement is undertaken with people who need to access adult health and social care services as part of this process, as well as fully involving services and organisa�ons that deliver these supports across the country and in different se�ngs. Complaints The Stage 2 Bill informa�on pack, indicates that Sco�sh Ministers could have some responsibility for complaints received in rela�on to the delivery of services. More detail on this would be required to beter understand what is intended. Whilst learning from complaints may be something that could inform the development and improvement agenda na�onally, it is strongly advocated that complaints handling in rela�on to local services must be handled at a local level.