Our letter coincides with Audit Scotland’s latest report which warns that the proposed NCS will place “a huge strain on the health and social care budget”, with the current plans representing “a significant unknown financial commitment”.
We share the desire to improve the quality and consistency of social care and health services across Scotland but it is entirely unclear how the current Bill will achieve this or address the serious challenges within a sector that is in crisis.
The Bill lacks basic details around how the NCS will operate, how it will work alongside the NHS or even a clear definition of what functions the NCS will be responsible for. We have highlighted the many unanswered questions regarding professional accountability and governance, called for detailed plans on how social care reform will deliver fair work and raised concerns about the fact there is no mention of Scotland’s safe staffing legislation within the NCS Bill.
The Scottish Government is pushing through expensive and disruptive structural overhaul without a clear understanding of how to fix the current problems facing the sector or enough planning to ensure the effective functioning of an NCS. Instead, it must acknowledge that improving the quality and consistency of services cannot be achieved without increasing investment in services, tackling the workforce crisis and recognising the increasing need to deliver complex clinical care within community and care home settings.
Services must have the right numbers of staff, with the right skills, in the right place. This must be tackled now and that needs to start with improving pay, terms and conditions in the sector. But before implementing structural change, Ministers must take the time to engage with stakeholders - including staff working at all levels within the social care and community health sectors - and develop detailed plans for reform prior to taking forward legislation.
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