Weekly Poll – National Care Service

Each week Disability Equality Scotland send out a poll question to our members on a topical issue.  For the week beginning 5 April 2021, we asked a question about a National Care Service for Scotland.


Do you think a National Care Service (NCS) will help to improve social care in Scotland?

  • YES – 79% (72 respondents)
  • NO – 21% (19 respondents)


We provide verbatim comments where appropriate to illustrate strength of feeling or personal experience.

National Standards

The vast majority of respondents (79%) believed a National Care Service (NCS) will help to improve social care services in Scotland.  Respondents reflected on social care delivery in its current form with various inconsistencies and highlighted the potential benefits of a unified approach achieved through a set of national standards.

“There needs to be a national standard – consistent, accountable, about people not profit, highly skilled, well paid, good terms and conditions. There are undoubtedly good practices but if the past year has proven anything it is that the caring profession is undervalued and underpaid.”

“As care can differ from each council it would be beneficial to everyone to get the same care all over the country. Hopefully, this will mean everyone will get the best care that they deserve.”

“I personally think this would be beneficial as it would mean a more regulated service provision with same standards of care from the borders to the Highlands and Islands, it would also mean that staffing terms and conditions of employment, as well as pay should be uniform!”

“The care sector needs to be overseen to help ensure a consistent level and quality of care.”

“It is likely to sort out postcode inconsistencies, however that in itself is not enough to address improvement. Clear standards based on both best practice and lived experience involvement need to be reviewed/set and measurable. Communication for example is a gap at the moment but essential to address. I would want to see further controls to individuals for their own packages and shake up of suppliers to meet need not deliver standard options.”

“I think a joint working National Care Service (NCS) would be great, but a nationalised system would also stop the current postcode lottery regards to level and consistency of care provided. Nationalising the care system provides a more robust and cost-effective use of funds both private & public.”


Respondents recognised the importance of enhanced pay and conditions for workers in the care sector, which will help with retaining and recruiting care staff.

“One essential benefit would be the standardising of pay levels for carers which would help improve the recruitment of those so desperately needed staff.”

“If pay conditions were to increase and overall conditions improved for employees, we feel that would encourage more people to work in this sector. Although it is not clear from the info we have been given, whether this means there would be a pay increase for people who don’t work in NHS, or if and when they are likely to have an increased pay, and also if it would be backdated or not.”

“I think it will make a real difference both to those who receive care and also those who care for them. A National Wage for carers would ensure that the value of the wages of our social care workforce better reflects the value of the work that they do and encourage more people to think of care giving as a career, especially if it is run alongside the NHS. It would also be very welcome if they abolished charges non-residential care – easing the financial pressures on people accessing care and helping them to realise the right to independent living.”


Some respondents believed that a National Care Service will help to increase the level of accountability in the sector. The report recommends that accountability for social care support should move from local government to Scottish Ministers, and a Minister should be appointed with specific responsibility for Social Care.

“A National Care Service would hopefully hold local decision makers accountable.”

“At the moment there is no accountability and social workers and budget managers frequently do not show best practice or treat service users as humans with rights, wishes and lives they want to lead. I’m really hopeful a National care service would lead to more fairness and equality and allow service users to have lives they can lead that they can choose rather than the limited lives a local council chooses for them.”


Respondents believed that a National Care service must receive appropriate levels of funding to match the ambitions that are featured in the ‘Independent Review of Adult Social Care in Scotland’.

“The only way Social Care will improve is if it is given similar status to Health Care. Social Care needs to be appropriately funded so that services are not only available to those at the high end of need. A proper injection of funds would in the long term save money because fair and equitable social care would improve health, prolong independence and reduce the burden on the NHS.”

“There needs to be funding to match the ambition. Also it would be important to involve and co-create with users of the service and people who work in it. It’s so important that there is equity with NHS and shared training for workers too.”

“I said yes in the hope it will be properly funded with achievable timescales.”

Involving Disabled People

To help shape a National Care Service, it is vital that continued engagement takes place with various key stakeholder groups and organisations, which includes meaningful involvement with disabled people.

“I’m really hopeful a National care service would lead to more fairness and equality and allow service users to have lives they can lead that they can choose rather than the limited lives a local council chooses for them. I think in the creation of such a service it’s vital that disabled people help create the map of what it will look like.”

“It needs to be rights based, person centred, flexible, adaptable & accountable at locality and national level. Would love to see investment in lived experience led review and evaluation, mystery shopping and informal assessment for example.”

Young People

There are an estimated 29,000 young carers in Scotland – 4% of the under 16 population. There are significant opportunities for a National Care Service to improve the rights for young carers across the country.

“I think that this could be a very positive step in the right direction and would hopefully the set up will set high standards for care that have to be met. I would hope that we would also see something about standards of care for young Disabled adults who often find themselves in a setting that is unsuitable for them. Someone in their 30s in a home where the next youngest resident is around 77 for example. This results in the younger person not having anyone to communicate with and can be very demoralizing for the younger person.”


Some respondents raised concerns about the introduction of a National Care Service (NCS), in terms of managing the number of organisations involved, the level of flexibility to meet individuals needs and retaining freedom of choice.

“While the theory sounds good, there are too many organisations involved. The mix of the 3 sectors, is a recipe for disaster. People will be shunted from pillar to post, with each organisation saying they can’t help, but this other one will, and then before you know it, you’re still on the merry go round.”

“Whilst I believe that a more qualified, well trained workforce would be of benefit to social care in Scotland, I believe that large scale institutions such as a national care service would lack the ability to be truly flexible when it comes to individual’s needs. I feel that instead of promoting choice, this would remove it.”

“People who need care should still retain that it is their choice who provides for their care and that other care agencies should be able to exist to ensure a larger pool from which to choose a carer.”


Disabled people believe a National Care Service (NCS) will improve delivery of social care in Scotland. Respondents are encouraged by the recommendations featured in the Independent Review of Adult Care in Scotland to create a set of national standards, enhanced pay and conditions for workers and increased levels of accountability across the sector. To achieve the ambitions, it is essential to ensure appropriate funding is in place and the service is developed with meaningful engagement with a wide variety of stakeholders, including disabled people across all parts of Scotland.