Weekly Poll – National Care Service: Range of Care Services
Each week Disability Equality Scotland send out a poll question to our members on a topical issue. For the week beginning 11 October 2021, we asked a question about the National Care Service consultation, relating to the range of care services.
Question 1. Do you think the National Care Service should be extended beyond Adult Social Care to include provision for Children Services, Community Justice, alcohol and drug services, social work and elements of mental health services?
- YES – 59% (33 respondents)
- NO – 41% (23 respondents)
We provide verbatim comments where appropriate to illustrate strength of feeling or personal experience.
Range of Care Services
A narrow majority of respondents (59%) agreed with the range of care services that are being proposed in the National Care Service consultation. This extends beyond Adult Social Care Services to include Children Services, Community Justice, alcohol and drug services, social work and elements of mental health services. Some respondents believed that joining up services would help to easily move between different types of advice, care and support.
“There is disconnection and a postcode lottery on all the services whether moving from one local authority area to another or moving from children’s services to adult services. Many people receiving adult social care have care needs in these other services too, an impairment, physical or mental, or addiction happens to us all, and it would save duplication of our information between services. It all needs to be joined up with the service user at the centre.”
“Does it not make sense to have everything under the same roof, instead of too many departments, each dealing with separate items. Having a lot of different departments, will ultimately lead to no one taking responsibility or accountability when things go wrong.”
“Extending the remit of the current care advocate will mean that extra funding and resources will be required. However, having everything under one department could in my opinion, make seeking care simpler for patients and their families.”
“I’d like care services to be more joined up as it’s difficult to know who to go to for anything at the moment. NHS drop their care on discharge from hospital and no other checks were made to help me cope post stroke when I came home feeling shell shocked. I am diagnosed autistic. Some guidance as to what might be available would have been good.”
Standard of Care
Some respondents reflected on the existing standard of care and believed that extending the National Care Service beyond Adult Social Care may help to create a consistent approach to care across Scotland.
“Having experience of care service both as a service user and as a decision and policy maker I know that the level of care varies so much across the country it could quite easily be classed as a postcode lottery. I truly believe that as long as the introduction of a National Care Service also levels up the quality of service across the country then we will have made considerable strides towards achieving an acceptable level of care for those most at risk in Scotland. The key to ensuring that the delivery of care services across the country is on a level playing field is enforcement that must be included as part of the introduction and delivery of a National Care Service.”
“Some of the services mentioned is where most of the help is needed.”
“Until we get consistency in care in all walks of life, we will not improve Scotland’s health.”
“There is a dreadful inconsistency across many local government services, almost discretionary, it seems. In order for the mentioned services to be really called services and to be fair, reasonable and most importantly to be fit for purpose across the board, they must all have the same level of criteria and consistency of service. People now expect to be able to at least get help with the basics but ‘basic’ can mean so much across the country. So, consistency and fit for purpose is an absolute that must be the same everywhere.”
Structure of a National Care Service
The range of services featured within the consultation extend beyond the original recommendations of the Independent Review of Adult Social Care. Respondents commented on the practicalities of incorporating a range of services within a National Care Service and suggested that during the initial phase, it must focus on adult social care services, before being extended to Children Services, Community Justice, alcohol and drug services, social work and mental health services.
“I don’t think anything should be added to the plans for a National Care service at this stage. We need to make sure that this service is doing what it promises to do for adult social care. It takes time to get things like this established and running if we add too much to this in the early stages of development it could mean that the whole thing collapses and is unable to cope with the demands placed on it. These other points come under the care social care umbrella and could be added to the service one at a time over a period of years (10 years) We want this to be the best service around and that will not happen overnight.”
“The National Care Service, if it is to actively strive to be responsive first and foremost to the needs of those requiring care, needs to develop a competent and agile structure. This type of development can only be done organically, slowly over time learning about the needs of the specific group it hopes to serve. To attempt to address every type of care setting and delivery without having a proven track record in delivering for even one group is a recipe for disaster which will impact negatively on an already compromised and marginalised sections of society.”
Some respondents believed that extending the range of services delivered by a National Care Service beyond adult social care would result in increased bureaucracy and a dilution of services. In turn, this may negatively impact on the standard of care that the National Care Service aims to address.
“The larger an organisation the less contact it has with those who need its services.”
“If you try and encompass everyone within the new framework of social care you will end up with a one service fits all but actually fits nobody service diluting the service care provision we already have.”
“It will result in greater dilution. More opportunity to talk loads about each sector and make no progress in any. I don’t like the idea of working in silos but different groups concentrating on their own issues yet sharing ideas, things that work and things that don’t but may not suit other groups could be more productive.”
“It would be too bureaucratic. They can’t run existing services efficiently as it is.”
“If past experience is anything to go by, to include all services under one umbrella will just make things even more unmanageable and we’ll hear the usual excuses of lack of resources, whether that be financial or staffing. I think there will be even less chance of anyone receiving a decent level of care.”
“I think it is far too large an idea, personally going by recent developments by central and devolved governments it would lead to major problems for people.”
A portion of respondents raised concerns about the impact a National Care Service may have on care services that are currently delivered by local authorities. It was suggested that key services must be developed through meaningful engagement with local service providers.
“A joined-up approach is required, but this needs to be shaped by local expertise.”
“We need to ensure that this does not result in a reduction of key decisions being made at a local level.”
One respondent questioned the accessibility of the National Care Service consultation due to the length of the documents and the number of questions that are featured. To ensure the views of various groups are taken into consideration, it is vital to ensure that the consultation is available in a variety of accessible formats.
“All care services should be included. However, the consultation should be in manageable pieces. 130-page document and 100 questions are ridiculous. Even the professionals are saying it is far too much all together, never mind the volunteers. A document like that just puts people off responding.”
There was a mixed response from disabled people regarding the range of services that are being proposed in the National Care Service consultation. Some respondents recognised the need to join-up services to attain a consistent standard of care across Scotland. It was suggested that in the early stages, the service should focus on linking-up adult social care, before extending care to include Children Services, Community Justice, alcohol and drug services, social work and mental health services. In contrast, a portion of respondents believed extending the range of services would lead to greater bureaucracy and red tape. It is vital that further consultation takes place with a range of stakeholders, including local authorities who are currently responsible for the provision of care services in communities across Scotland.