National Care Service Principles

We as a charity group provide activities and professional services to improve outcomes for our community and hopefully play a part in preventing the need for care at home until later in life. To enable people to remain at home for as long as possible, with good adequate person centred care provision is surely the main objective and is especially good for the person and the professional services i.e. NHS as it is more cost effective.

Local authorities currently have a public service equality duty placed upon them. It is important that responsibilities transferred to the new central system are subject to the same legal redress in respect of human rights. Local authorities currently consult with voluntary bodies which they part fund. The responses are therefore influenced and there needs to be much more direct contact with those with lived and living experiences.

Welcome the recognition of care services and the need to ensure access to care services is a human right. This needs to include the voice of those with lived experience to ensure services are relevant. This should include consideration of how care services are funded, and what is fair.

I agree with the principles outlined here, however, I think there needs to be specific reference made to the role of unpaid carers in a National Care Service. For example, a National Care Service should recognise unpaid carers as equal partners/experts, as well as acknowledge that they are a diverse group of people who require support themselves.

Both those commissioning service and the care workforce need training in what is real person centred care. Those receiving it know! Training needs to be thorough and receive proper qualification resulting in improved status and pay. Hence better care and happier reciepients.

Very laudable statements difficult to disagree with but in practice don't think the Scottish Government will be any better at delivering than HSCP's are. We need to build on what we have and not dismantle and rebuild.

How do you know you are entitled to these principles? Is there a hierarchy? The principles seem good, but want to know if they would be good in practice. Sound good and valid, but important to challenge them. Looks very optimistic, but do they really mean it? Sounds quite sceptical, but some systems promise things, but they can have cracks. They are good, but they have to have the means to be sustainable. What are the intentions behind this bill? If NCS is similar to principles of Good Transitions Bill, they are a good thing, but with Good Transition Bill, there was no resource to follow it through.

I support most of these principles but don't quite understand this one: “Provide financially sustainable care giving security and stability to people and their carers”; The situation currently facing people who need 24/7 support due to advanced dementia and other conditions and who have savings or have bought their own home is that they are effectively disowned by the system and left to pay double what the council pays for the same care home places. I would like to see the NCS take responsibility for everyone who needs care support and if it’s decided people with capital should pay, it should be recharged via the NCS in a very transparent way. Older people are being thrown to the wolves by the current system. I am disappointed that the bill makes no attempt to address this or at least state that this will be revisited. We need something fairer.

lack of communication is the biggest failing in health and social care provision. it tends to depend on the user trying to find out about what they don't know about! rarely is any communication in the current system accompanied by how to appeal or challenge decisions or treatment. it needs to be more proactive communication from the provider, particularly for those trying to access a system they know nothing about.

The workforce in social work is the main resource for service users. They are the backbone of the system, if they are not valued and terms, conditions, salaries and pensions are not upheld then this will be another vanity exercise by the Scottish Government and the whole thing will crumble and fail as the workforce will walk.

On a personal level I do hope scrutiny will be such that there is a role for ordinary people with interest in this service.

I would like to know how the above principles were arrived at and how the NCS plans to make these happen for real and not just have something on paper that they cannot stick to.

The principles are laudable but require proper organisation, planning, communication with people, understanding of rights and resourcing to deliver. There is a staffing shortage in the NHS and social care driving up costs and much care is provided by independent providers. The uncertainty associated with the proposed transfer of services, funding and powers to the NCS in a climate of public sector cuts will further impact on staffing and investment in the sector, choice and capacity of care services available to meet need. Financially sustainable care depends on clear messaging of services required to the sector, care payment levels to cover costs and clarity over who pays ( local authority or individual) and some certainty over the level of risk exposure for independent providers. As before, the aspiration is to be commended but the practicalities of how we move from the current system to deliver on these aspirations, whilst continuing to meet people’s needs, requires more detailed planning and analysis.

I am concerned about the reference to financial sustainability and that this could be used as a means to limit the provision of services which are otherwise required. Who determines the amount of social care finance (and it's allocation amongst different care groups) to base a decision on sustainability? More than most services, social care services are always referred to as having to be sustainable and affordable. We need to move towards a position where rather than have care boards be under general target duties they are under absolute duties to provide the required care. The proposed right to short breaks is therefore a welcome step in the right direction. If the intention is to conversely impose an obligation on the Scottish Government to provide appropriate funding to enable services to be delivered then that should be clarified. My response to the principles is therefore a don't know rather than a negative. The other proposed principles are of course to be welcomed.

The Scottish Government must ensure that that the NCS creates opportunities to respect, protect and fulfil the rights of Care Experienced people throughout their lifetime. The NCS must be a named Corporate Parent, and its Corporate Parenting duties should be applicable to all Care Experienced people regardless of age, to recognise that care experience stays with you after you turn 26. The Scottish Government must ensure that the workforce is trauma-informed in all areas of practice. There should be time and resource to connect with families, listen to and include them in decision-making, and tailor support to help families stay together. Evidence taken from Who Cares? Scotland Bairns Support Report