The Scottish Government has ditched plans to restructure adult social care in the country into a ‘national care service’ (NCS).

Social care minister Maree Todd said that she was scrapping the flagship Scottish National Party (SNP) policy because of a lack of support within the Scottish Parliament, in a ministerial statement issued this week.

She said that ministers remained committed to creating an NCS in Scotland, and would proceed with its National Care Service (Scotland) Bill, but shorn of any structural reform, meaning responsibility for adult social care will remain with councils.

Plans for ministers to take responsibility for sector

The SNP’s original plans, issued in 2022, were for ministers to take control of adult social care, with services commissioned nationally through regional care boards, which would be under ministerial direction.

At the time, the then cabinet secretary for health and social care, Humza Yousaf, said the NCS would “end the postcode lottery of care in Scotland”, to ensure “everyone has access to consistently high-quality care and support so they can live a full life”.

Another plank of the proposals was the creation of a national social work agency to oversee social work education, professional development, improvement, workforce planning and terms and conditions.

Widespread opposition leading to policy shift

However, the plan ran into widespread opposition, including from social work and local authority leaders, leading ministers to make significant revisions.

Notably, in 2023, the government said it would share accountability for the NCS with the NHS and councils. Local authorities would remain responsible for employing adult social work and social care staff and for their existing buildings and assets, under an agreement with local government body COSLA.

Instead of creating new care boards under ministerial direction, the government proposed reforming existing integration authorities – partnerships between councils and health boards that are responsible for adult social care and primary and community healthcare.

These would be accountable to a new national care service board, which would be responsible for overseeing the NCS, as delivered by integration authorities.

Revisions to national care service legislation

Then last summer, ministers announced proposed amendments to the bill to put its reformed approach into action, including creating the national board.

Under the plans, the board would have been subject to ministerial direction, while also being able to intervene in local services to drive improvement.

The proposals prompted COSLA to withdraw support for the bill, on the grounds that it risked a “restrictive centralised model which removes key local decision-making, prioritises increased national monitoring and reporting”.

In her statement this week, Todd said the Scottish Government was now scrapping the plan for the board and all other structural changes planned under the legislation.

Proposals ‘not supported by Scottish Parliament’

“We made considerable effort to find compromise and a way forward. But it is clear those proposals are not supported by this chamber,” she told the Scottish Parliament. “I have concluded that we must deliver our Scottish national care service without legislating for structural reform, securing a different means to deliver our goals.”

This includes creating a non-statutory NCS advisory board, including representation from people with lived experience, councils, unions and the NHS, to advise ministers on using their existing powers to drive improvements to adult social care.

Other elements of the National Care Service (Scotland) Bill – including a duty on care home providers to facilitate visits to and by residents, action to facilitate information sharing between services and new rights to breaks for informal carers – will remain, Todd added.

Positive response from local government leaders

In response to the changes, COSLA’s health and social care spokesperson, Paul Kelly, said he welcomed the fact that the Scottish Government was “listening to the many voices who raised concerns about aspects of the legislation and in doing so have set out what appears to be a more promising and positive direction”.

He also backed the continuation of reforms to carers’ breaks, care home residents’ rights to visits and information sharing, a view backed by sector leadership body Social Work Scotland.

However, the changes raise questions about what will happen to the planned creation of a National Social Work Agency.

Planned creation of social work agency

The reformed version of the bill put forward last summer would have placed the existing chief social work adviser role into statute and arranged other civil servants into an executive agency called the national social work agency. But this is within the part of the bill that is now being removed from the legislation.

Following this week’s announcement, the Scottish Government said there was a need to “future-proof reform to support the whole social work profession”.

It added: “The social work sector agrees and, along with the social work workforce, we all believe we must work differently. We must work in partnership to drive lasting improvements that support the vital role of social workers across Scotland.”

Discussions on future of social work

This statement was welcomed by Social Work Scotland, whose director, Ben Farrugia, said: “We were heartened to also hear specific references being made to a partnership approach to social work, and the commitment to improvement for generations to come.

“As a key partner in discussions around a future national social work structure, we believe that securing the right partnership approach – empowered by local and national politicians and accountable to social workers, will be critical to ensuring that legacy of support and improvement for the profession, and can contribute a significant co-ordinating role in addressing systemic issues like poverty and mental health across our communities.”

In its response to the changes, the Scottish Association of Social Work voiced support for the plan to create an executive agency for social work, working in partnership with the sector.

It said this was “the clearest route and best opportunity to create that greater consistency and continuous improvement in social work across Scotland”.

Sector leaders have urged the government to “change course on social care” after a week in which it cancelled the cap on care costs and a planned increase to workforce training funding.

In an open letter to health and social care secretary Wes Streeting, more than 30 leaders said the decisions had “raised alarm bells” for those working in, and receiving, social care.

And in a reference to the pay settlements granted to public sector staff outside of the sector, they said these were “a bitter pill for social care in a climate where other public services and their workforces are finally having their contribution recognised”.

The letter was signed by the heads of seven of the major umbrella bodies for care providers: learning disability body ARC England, the Association of Mental Health Providers, Care England, the Homecare Association, the National Care Association, the National Care Forum and the Voluntary Organisations Disability Group.

Other signatories included the heads of the Social Care Institute for Excellence, Learning Disability England, which represents people with learning disabilities and their families and several providers and local provider associations.

Ditched social care policies

Their intervention came days after the government first scrapped the adult social care charging reforms, due to come into force in October 2025, and then ditched the adult social care training and development fund proposed by its Conservative predecessor.

Both decisions were made to tackle a £21.9bn projected overspend on public spending, which chancellor Rachel Reeves said had been bequeathed to Labour by the Conservatives. This was despite £9.4bn of the funding gap being down to the incoming government’s decision to accept recommendations on public sector pay made by independent review bodies.

In their open letter to Streeting, the sector leaders acknowledged the “hugely challenging” economic situation. However, they stressed that social care was critical to delivering some of the new government’s key ambitions.

“Without high quality social care, it will be impossible to fix the broken NHS,” they said. “Without high quality social care, it will be impossible to sustain economic growth. Without high quality social care, it will be impossible to lift-up our communities and the people that live in them.”

‘Change course on social care’

The letter added: “We now need to see positive action on social care. There is time, political capital, and the expertise of a united social care sector to make this happen. We urge the government to change course and we stand ready to help you transform social care for the millions who work in it and most vitally, rely upon it.”

The sector leaders also referenced Labour’s two key policy pledges on social care: to introduce a fair pay agreement for the workforce and, over the next decade, to set up a national care service.

The fair pay agreement is designed to raise pay, terms and conditions for staff and will be legislated for in the forthcoming Employment Rights Bill, though the government is yet to say how the improvements will be funded.

It has also not fleshed out what it means by a national care service.

In their letter, the sector leaders said they needed “assurances about the timeframes and support needed to move to a national care service and the introduction of a fair pay agreement for care workers”.

Councils would continue to employ social workers and other social work staff under the Scottish Government’s plan to establish a National Care Service across the country.

The government’s original plan was to transfer councils’ social work functions – including staff – to the NCS, or regional care boards set up to deliver services on its behalf.

However, it said this week it had agreed with council and NHS leaders to leave local authorities responsible for employing staff and social work buildings and assets.

Under the new approach, councils, the NHS and the Scottish Government would share accountability for the NCS, which would initially cover adults’ services only, with the possibility in future that it would also incorporate children’s and criminal justice social work.

Opposition to National Care Service

The news follows widespread opposition to the plans – including from local government and social work leaders – and ministers’ decision to slow the passage of the legislation designed to bring it about, the National Care Service (Scotland) Bill.

It now won’t have its first debate until after the Scottish Parliament’s summer recess.

Announcing the shift this week, social care minister Maree Todd said: “The Scottish Government has been working closely with local government to find a consensus on the National Care Service (Scotland) Bill, which will allow us to deliver on the urgent improvements needed to strengthen the delivery of integrated health and social care for people.

“This partnership between the Scottish Government, local government and the NHS helps establish where responsibility for people’s care will sit under the National Care Service. The detail of how this will work at a local level will be developed in the coming months and we will continue to update parliament on this work, along with the results of our ongoing co-design events taking place across the country, after the summer recess.”

‘Reduced anxiety’ for social workers’

The Scottish Association of Social Work said that “many social workers will find this statement reduces their anxiety about their future employer”.

National director Alison Bavidge added: “SASW welcomes the clarity on this issue given its potential to adversely affect the existing recruitment and retention crisis in social work.

“Whilst the statement is the first step in enabling more detailed discussion around structures and governance, it does not give a clear route map for those improvements around access to support and the consistent yet tailored approaches that people in Scotland deserve from their public services.

“Without a significant change in the way social workers spend their days, having manageable workloads, reducing the unnecessary bureaucracy and being able to deliver preventative and early support through community engagement, the system will remain primarily focussed on individuals and tasks rather than social wellbeing.”

Agreement offers ‘comfort’ to social workers

The Convention of Scottish Local Authorities (COSLA) – hitherto a fierce critic of the reform – welcomed the move and said it hoped it would reassure social workers and other staff.

“Combining shared national accountability with local expertise ensures the right balance of further improvement across Scotland, whilst rightly reflecting the diverse needs of local communities,” said COSLA’s health and social care spokesperson, Paul Kelly.

“We know too that successful change is driven by the valuable staff who deliver services. We hope by setting out the continued role of local authorities in delivering social care and social work functions, and staff remaining employed within councils, we offer comfort and stability to the local government workforce.”

However, he said there “was still more to do” in relation to the reform.

‘Significant problems’ with proposed legislation 

UNISON Scotland issued a similar message in response to the change.

“The announcement that social care staff will continue to be employed by local authorities, and councils will still be responsible for assets like buildings and the delivery of services, is welcome,” said its head of local government, Johanna Baxter.

“While recognising this first step, there are still significant problems with the National Care Service Bill. The Scottish Government and COSLA must now get around the table with us to discuss the detail of how this shared accountability arrangement will work including any new, or revised, legislation required to ensure we can build a world class social care service.”

The bill’s proposals are designed to end the “postcode lottery” in care provision and are based on those of the Independent Review of Adult Social Care (IRASC), published in 2021, which recommended the Scottish Government create an NCS for adults’ services.

The Scottish Government must pause its ‘disruptive’ plans to remove social care from council control, in order to shore up local authority services that face real-terms cuts in 2023-24.

That was the message this week from the Convention of Scottish Local Authorities, in response to the 2023-24 Scottish budget, published last month, which COSLA claimed would put social care services under “tremendous pressure”.

The Scottish Government said the budget would provide over £550m more for councils than in 2022-23, a 4.5% increase in cash terms and 1.3% rise in real terms.

However, COSLA warned that, not only did councils need an additional £1bn in 2023-24, but, once policy commitments were taken into account, councils would only receive an extra £70m of the funding allocated. These commitments include £100m to fund a £10.90 minimum wage for adult care workers in services commissioned by councils and £140m to meet workforce costs arising from the 2022-23 pay deal.

Expert body the Institute for Fiscal Studies has also argued that the settlement amounts to a significant real-terms cut for local government, including by understating the impact of inflation on the cost of services.

COSLA said it was “inconceivable” that councils should be facing real-terms cuts to social care services, while the government was proceeding with “centralising structural reforms” to create a National Care Service (NCS).

The Scottish Government had previously estimated that establishing the NCS would cost £63m to £95m in 2023-24, but Scottish Parliament researchers have warned that there is no detail on how much was allocated for this purpose in the budget.

‘Reorganisation coupled with real-terms cuts’

COSLA health and social care spokesperson Paul Kelly said: “Improvements to care could progress faster and with more impact if services were properly resourced and did not face the distraction of structural reform. Instead, we are presented with reorganisation and real-terms cuts, which will have a significant impact on the delivery of care.

“Ministers must invest in change now and pause their plans for structural reorganisation.”

Social Work Scotland, which represents social work leaders, previously called for a pause to the legislation to create the NCS because of concerns about its financial impact at a time of high levels of social work vacancies and increasing waits for assessment and support.

Following COSLA’s comments, a Social Work Scotland spokesperson said this was still its position.

“We still believe that this is the right approach, and we are committed to working with our members and partners to get the best outcomes for people who need support, and social work and social care professionals,” the spokesperson said.

‘Serious pressures on workforce’

“Our ‘Setting the Bar’ reports indicate the serious pressures being felt by the workforce as a result of continuous financial savings and the shifting and increasingly complex work demands, as well as the impact of the pandemic over recent years.

“These cannot be underestimated, and we know that the timescales currently outlined will significantly impact the meaningful and critical participation of social work professionals in the design of a National Care Service.”

In response to the concerns, social care minister Kevin Stewart said: “The Scottish Government’s draft budget for 2023-24 increases funding for health and care services, including supporting the increase in pay for adult social care staff to at least match the real living wage.

‘Ending the postcode lottery’

“The National Care Service is the biggest public sector reform in Scotland since devolution. Our aim in delivering a National Care Service is to end the postcode lottery in care provision. We have a twin approach of delivering improvements now and working with people with lived experience to ensure the NCS to ensure the new system better meets the needs of the people of Scotland long into the future.

“We have also committed to increasing adult social care funding by at least 25%, £840m, by the end of the parliament, helping to lay the groundwork for the National Care Service.”

Agile working practices such as hotdesking are failing to meet social workers’ needs in Scotland and employers should review them, a study has concluded.

Approaches in which people are not allocated a fixed desk and work at different times and locations depending on need have become increasingly common, but practitioners are consistently negative about them, found a five-year study into newly qualified social workers published by the Scottish Social Services Council (SSSC). 

Early career practitioners surveyed for the study highlighted agile working’s adverse impact on their access to peer support – for example, on returning to the office after a home visit – and the stress and time wasted looking for a workspace each day.

While agile working was received positively when it involved adequate desk space, spaces for quite and concentrated work and good access to peer support, this was rare, found the research by social work academics at the University of Dundee and Glasgow Caledonian University.

Stress and lack of peer support

“The majority of participants over the last five years have consistently described ‘agile working’ in negative terms,” the report said. “Many referred to the added ‘stress’ of trying to locate and secure a desk or workspace each day. Many commented on the distance between themselves and team members, highlighting the absence of opportunities for informal ‘debriefs’ (eg after home visits and meetings) and to have quick chats or
discussions about cases.”

Half of practitioners surveyed in the first year of the study said that agile working was in place in their organisation, rising to almost two-thirds (65%) in year five.

Citing the wider body of research into the practice, it said local authorities had generally adopted agile working to make efficiency savings, not in response to social workers’ needs.

Urging employers to review their approaches, the report said: “Social workers need opportunities to communicate with team members; they need ready access to managers and technology, as well as quiet places for concentrated work. Our findings (consistent over the last five years) indicate that agile working models in Scotland are failing to meet the needs of social workers.”

Peer support valued more than managerial

The impact of peer support was highlighted by findings indicating that practitioners valued it more than managerial support. The study found that, on average, across the five annual surveys:

• 93% of participants agreed their colleagues gave them good advice compared with 78% who said the same about their manager.
• 85% said their colleagues were good at explaining complex information compared with 68% who had the same view of their manager.
• 84% said they could express their emotions to colleagues compared with 66% who felt that supervision was a safe space in which to do so.

As they grew more experienced, practitioners sought their colleagues’ advice less and less often, with those who reported doing so frequently falling from 75% in year one to 36% in year five.

Despite this, researchers said that peer support appeared to “buttress the capacity of formal supervision to meet the diverse needs of practitioners and should be recognised for the value it brings to the profession – particularly if we continue to adopt limiting forms of agile working practices in future”.

In relation to supervision, two-thirds of participants, on average, said they were happy with the quality of what they received, 61% said they received it monthly and 60% said sessions typically lasted 60-90 minutes. However, researchers said their ability to explore the content of supervision was limited, in common with many previous studies, and suggested there was a need for deeper research in this area.

Workload stress greatest in year 2

Across the five years, just over half of participants reported working unpaid hours, either to complete tasks or for learning, though this peaked in year two (61%) before falling to 42% in year five. Year two was also the time when workloads were felt to be least manageable, with under half (48%) finding their responsibilities to be manageable, compared with an average of 59% across the five years and a high of 68% in year 5.

Workload stress also peaked in year two, when 49% reported feeling anxious at times about their caseloads, though this also fell to 38% in year five.

Drawing on other research, the report suggested practitioners in year two were likely to be encountering new types of case, requiring additional skills and knowledge, which may require more time, either for tasks or learning.

The report added that “a significant proportion of newly qualified staff may begin to feel pressure and expectations by year 2 as they emerge from induction periods and initial core training”.

Researchers urged employers to be aware of these pressures and the risk of burnout, though they did not find significant evidence of negative outcomes for participants and stressed the that issues seemed to resolve as social workers grew in experience.

The study said that other research had shown that levels of anxiety were not just related to workload alone, but to this in combination with organisational context and a lack of support from peers or managers.

“To avoid unnecessary anxiety and stress, attention must be paid to organisational contexts and support given to social workers in their everyday work,” it said. “This includes availability of managers, proximity to colleagues, dedicated admin support and progressive organisational cultures.”

The report also urged a nationally agreed approach to workload allocation and management that addressed both case numbers and complexity. The recommendation follows a call for indicative caseload limits to be set for practitioners across Scotland, from a report commissioned by leadership body Social Work Scotland on practitioners’ workloads.

Social work agency concerns

Scottish Association of Social Work (SASW) director Alison Bavidge said the current situation around workloads was “untenable”.

The issue would to be considered by the National Social Work Agency that the Scottish Government intends to set up as part of its National Care Service, under which ministers would take direct responsibility for adult social care – and potentially children’s and criminal justice social work, subsequently – from councils.

The agency would be responsible for social work qualifications, workforce planning, improvement, training, professional development and pay and grading and, under current plans, would be a part of the Scottish Government, not an independent entity. As a result, it is not referenced in the National Care Service (Scotland) Bill, which is currently before Scottish Parliament and would enact the reforms, a move criticised by both SASW and Social Work Scotland.

In a submission to the Scottish Parliament’s health, social care and sport committee, which is considering the bill, SASW said that social workers broadly supported the establishment of the NSWA, but omitting it from the face of the bill was a missed opportunity.

The association said this meant that the profession was “not being directly consulted on the structure or function of the agency that will have such significant authority over it” and gave them no certainty an NSWA would be delivered, while making the agency part of government raised questions about its credibility.

Pause National Care Service legislation, urge leaders

Social Work Scotland made similar criticisms in its evidence to the committee, saying the agency’s omission from the bill did not provide any certainty it would be delivered, while making it part of the Scottish Government left it “open to rapid change (even deletion) without any reference to the profession or other stakeholders” and lacking in credibility with the profession.

More fundamentally, the leadership body called for the bill to be paused because of concerns about its financial impact at a time of high levels of social work vacancies and increasing waits for assessment and support, and the risk that it will add to the stress faced by the workforce.

Convenor Alison White said: “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.

“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 funded, so that we can make sure we secure the best outcomes for the people we support.”

Legislation to remove responsibility for social work from councils in Scotland to create a National Care Service (NCS) was published this week.

The National Care Service (Scotland) Bill would make social care the responsibility of the Scottish Government, and allow ministers to transfer local authority functions to the NCS or to new care boards, which the bill would create to commission care locally under government direction.

However, the NCS, which the Scottish Government intends to be in place by 2026, would only include adults’ services initially, with the bill requiring ministers to carry out further consultation before adding children’s and justice social work to it.

‘Ending the postcode lottery’

Unveiling the bill this week, Scottish cabinet secretary for health and social care Humza Yousaf said the NCS would “end the postcode lottery of care in Scotland”.

“Through the National Care Service we’re going to ensure everyone has access to consistently high-quality care and support so they can live a full life,” he added. “This is our ambitious goal and while it will not be easy to achieve it is vital that we do.”

The bill’s proposals are based on those of the Independent Review of Adult Social Care (IRASC), published last year, which recommended the Scottish Government create an NCS for adults’ services.

In its consultation last year on creating an NCS, the Scottish Government had proposed including all social care services in Scotland within the NCS, saying that to do otherwise would increase fragmentation of care and support and complexity for people who use services.

However, it now intends to just transfer councils’ adult social care functions to the NCS, or care boards, in the first instance.

More evidence needed on children’s services transfer

In a policy memorandum on the bill, the Scottish Government said that, while there was a “strong rationale” for including children’s services, as the IRASC did not consider this, the same evidence did not exist as did for the inclusion of adults’ services.

So it would carry out further consultation and evidence gathering on the issue before deciding whether to add children’s services to the NCS.

It said a key issue would be assessing the impact of inclusion for children’s services on the delivery of The Promise – the proposals arising from the 2017-20 Independent Care Review.

It made a similar argument in relation to justice social work, saying it was “important that the risks and opportunities, costs and benefits
are fully assessed before a decision is made to implement the transfer”.

Integration with health

The bill also allows the Scottish Government to transfer NHS functions from health boards to the NCS or care boards, and ministers intend that the care boards will also take responsibility for community health services.

This is similar to current integration authorities, to which councils and health boards must currently delegate adult social care and community health services.

However, the IRASC said these had not worked as well as intended in achieving health and social care integration because of inconsistencies between areas and a lack of national oversight, which it said an NCS would address.

Councils would still be able to directly provide adult social care services, commissioned by care boards, under the NCS plans, with decisions about whether to transfer these to the boards being up to local areas.

National Social Work Agency still planned

The bill does not need to create the NCS as it would be a part of the Scottish Government. It also does not mention the National Social Work Agency (NWSA) that ministers intend to establish as part of the NCS.

As set out in the consultation last year, this would oversee social work education, professional development, improvement, workforce planning and terms and conditions.

“The NSWA’s objectives will be to support and invest in the social work profession
by providing national leadership,” said the Scottish Government, adding that it would enable social workers to “implement rights-based practice”.

‘Significant change to social work’

Responding to the bill, Scottish Association of Social Workers (SASW) national director Alison Bavidge said: “This is a major piece of legislation that will bring significant change to social work and social care in Scotland. It is a high-level framework bill, with much of the detail expected to be fleshed out through secondary legislation.

“As the bill passes through parliament, SASW’s focus will be to work with MSPs, the Scottish Government and other partners to influence and shape this legislation to achieve the best outcome for social work.”

Ben Farrugia, director of leadership body Social Work Scotland, said the bill would “fundamentally” change social care and the role of local government.

‘Risks are significant’

“Change is needed, and at Social Work Scotland we have long been calling for a combination of reform and investment which can unlock the potential of social work and social care as forces for equity, social justice and empowerment,” he said. “The jury is still out on whether this bill delivers on that.

“Much of the critical detail remains to be written, and the risks inherent in such profound change are significant. The Scottish Government has listened to feedback which Social Work Scotland members have given to date, and we will engage constructively over current months to ensure that the Scottish Parliament has the data and insight it needs to make an informed decision about whether this is the best next step for Scotland.

Social work recruitment ‘an increasing challenge’

He also said that Social Work Scotland would remain focused on “shoring up social work and social care systems which are already in crisis”, with recruitment and retention of social workers an “increasing challenge”.

This message was echoed by local government body COSLA’s health and social care spokesperson, Paul Kelly, who said: “We are also clear that there are underlying challenges across the system requiring urgent and significant improvement, and which cannot wait for a National Care Service.”

Kelly said COSLA would take time to consider the legislation to understand its impact, adding: “We have always been clear that local government should be central to the provision and delivery of high-quality, locally accountable care services, that play a key role in promoting the wellbeing of our communities. We would reiterate our previous position that local democratic accountability is central to the way in which social care services are delivered.”