A National Care Service for Scotland: consultation

About us

The Scottish Council for Voluntary Organisations (SCVO) is the national body representing the third sector.We’re passionate about what the voluntary sector can achieve. Along with our community of 2,000+ members, we believe that charities, social enterprises and voluntary groups make Scotland a better place.

There are over 40,000 voluntary sector organisations in Scotland involving around 108,000 paid staff and approximately 1.3 million volunteers, managing an annual income of around £6 billion.

As the national body for the voluntary sector in Scotland, SCVO is an expert on issues relating to the voluntary sector, but not on issues relating to social care.  On much of the detail of the proposals for a National Care Service, and its impact on people who use it, we refer you to the voluntary organisations and their intermediaries active in this area who have responded to this consultation. 

Our response comments on issues of partnership, procurement and Fair Work, which we monitor across Scottish public services, and give our thoughts on how our understanding of the sector’s experiences of these issues may apply to the development of a National Care Service.  We are pleased to see these issues being acknowledged within the consultation, and aspirations to tackle them outlined.  While more detail is needed on how many of these aspirations will be taken forward, we will watch the development of the National Care Service with interest for lessons which could be learned for the wider involvement of the voluntary sector in other public service transformation.

Summary

Voluntary organisations play a significant role in social care, both as currently defined and as envisaged in this consultation, and must therefore be considered as a key stakeholders in this programme of work.

Voluntary organisations have not found it easy to participate in this consultation – Scottish Government must think more creatively about how to ensure the sector’s voice is heard in this work, particularly those voluntary organisations not currently thought of as social care providers.

The engagement of the voluntary sector in local and national planning must be integral, not an afterthought, and the support required to enable the sector to participate as an equal partner must be built into structures and processes from the outset.

While noting that some parts of the sector do not feel they go far enough, we welcome the focus in the consultation on tackling longstanding issues around commissioning and procurement, particularly in relation to sustainability; it is vital that voluntary organisations are involved in the development of plans to turn these aspirations into reality.

The explicit connection between commissioning and Fair Work is also welcome, and again it is crucial that voluntary organisations are involved in the development of this work, to ensure that it reflects the realities facing voluntary organisations.

The voluntary sector and a National Care Service

• Engagement in the development of the National Care Service

The development of a National Care Service is one of the biggest changes to Scottish public services in decades.  Voluntary organisations play a significant role in both providing and supporting public services, and must therefore be considered as a key stakeholders in public service reform.

This includes large social care providers, who have been recognised as important partners in this process, which is very much welcome.  However, it also includes organisations who, while not providing directly commissioned social care services, are an important part of the ecosystems surrounding social care, and in particular play a key role in the preventative and early intervention agendas that this consultation seeks to enhance and bring within the more formal structures of social care; their voices must also be heard in this process.

Unfortunately, we have heard from a number of local and national intermediary bodies that these organisations, often smaller and more local, have not felt that this consultation exercise is accessible to them.  They have been daunted by the length and complexity of the document, and found it difficult to find an accessible entry point to the discussions.  Intermediary bodies, keen to support these organisations to engage, have also found that the length and complexity of the document have made it difficult to break down/make accessible for their constituent groups, particularly within the timescales allowed.  While the extension of the consultation process is welcome, with such a large number of interconnected issues to consider, and with intermediaries responding to many other national consultations and frontline organisations still stretched extremely thin post-Covid, the extra two weeks did not make a significant difference to organisations’ ability to engage. 

We would urge Scottish Government to consider how voluntary organisations can be supported to engage throughout this process.  The consultation paper usefully refers to alternative mechanisms for talking to and hearing from people, and we would encourage the Scottish Government to ensure that this includes people with lived experience of providing social care and related services, as well as lived experience of receiving it.  It should not be assumed that just because someone is involved in social care in an organisational capacity, they will have the resources to engage with formal and complex consultation processes.

Further, we would ask that where the Scottish Government intends to prepare an impact assessment of the proposals for businesses, a similar impact assessment for the voluntary sector should also be considered.  The sector has responsibility for a significant proportion of both the money spent on social care and the social care workforce, for example figures from the SSSC show that the sector employs 27% of the workforce, as compared to 39% in the private sector.  It is also important that the impact of the proposals on the wider voluntary sector are considered, not only the impact on current social care providers; for example, the assessment should ensure that proposals do not place increased/unfunded pressures on organisations providing more informal types of support.

• Involvement in local and national planning

The consultation makes reference to the involvement of the voluntary sector in many of the proposed new structures and processes: “The National Care Service and CHSCBs will work in concert with the NHS, local authorities, and the third and independent sectors to plan, commission and deliver the support and services that the people of Scotland require.” As would be expected at this stage in the process, these plans are not yet detailed.

We would urge the Scottish Government to ensure that, in development of these structures and processes, the engagement of the voluntary sector is not seen as an afterthought, or something that will just happen without planning or support.

Working in partnership is key to achieving services that are truly based on needs. It also helps in ensuring greater transparency and stronger accountability at all stages in the delivery process. The voluntary sector is keen to share its experience and expertise and work together better with colleagues across all sectors.  In developing governance structures and planning processes, attention must be paid to the role that the voluntary sector can play, and how it can best be supported to do so.  We would ask that the Scottish Government strives to build in parity of esteem among partners; this will take time and resources, and this should be taken into account from the very beginning. 

• Commissioning and procurement

SCVO has highlighted issues with the commissioning and procurement of services from the voluntary sector for many years.  We carried out two surveys, in 2013 and then 2019, to capture members’ experiences of procurement processes, and while the latter showed a small improvement in members experiencing good practice (favourable contract arrangements, such as inclusion of minimum wage or inflationary uplift, multi-year funding and full cost recovery), in the main voluntary sector organisations across Scotland continue to feel constrained, pressured and undervalued by current procurement processes. This has resulted in, amongst other consequences, severe financial pressure on organisations, negative outcomes for staff, and contracts being handed back.

As such, we are pleased to see acknowledgement within the consultation of the issues relating to commissioning and procurement, and the vital importance of addressing these: “The purpose of this is to ensure commissioning and procurement delivers a person-centred, human rights based approach that supports the outcomes and needs of the individual, meets minimum quality standards established for social care services, ensures fair work, promotes sustainability and ensures consistent implementation and equitable quality of service throughout Scotland.”

We are supportive of these aspirations, but note that there will be considerable work required to turn these aspirations into reality.  We would urge the Scottish Government to engage with the voluntary sector as plans are further developed, both those who are currently commissioned to provide social care services and those who are not but are in scope of these proposals.

The Coalition of Care and Support Providers in Scotland (CCPS) have noted in their response to this consultation that the aspirations set out do not go far enough to bring about the radical change that is needed within social care, and their expertise in this area should be considered a key resource as plans progress.  To complement this, we offer observations on the commissioning and procurement of voluntary sector services across the board, which may be of use in considering the experiences and needs of smaller voluntary organisations.

The issue of sustainability is of particular concern to voluntary organisations.  The persistence of single-year contracts across the sector makes it extremely difficult for organisations to forward plan and often results in the need to initiate redundancy processes on a not-infrequent basis, which are costly in terms of finance, staff recruitment and morale. Although one-year contracts are not as common within social care as some other contexts, our sector-wide learning would stress the importance of addressing this issue, which still exists in some areas, particularly in relation to smaller voluntary sector providers. Other contract issues are around a lack of full cost recovery, insufficient support to cover increases to the living wage (which was addressed in relation to social care this year) and a trend of the voluntary sector being asked to take on more work with reduced financial support.

• Fair Work

We are pleased to see promotion of Fair Work within the consultation, and in particular an explicit link being made between Fair Work and commissioning/procurement practices.  Without financial provision within contracts for the aspects of Fair Work relating to pay, voluntary organisations would have no means of meeting this, and the proliferation of short term contracts within the sector can make security of employment contracts an issue.  SCVO agrees with the call from the Fair Work Convention’s 2019 review of Social Care that key stakeholders should develop and agree appropriate minimum contract standards for the provision of publicly funded social care services, consistent with the Fair Work Framework and the Scottish Government’s Fair Work First initiative. This should not only cover pay and income stability, but also include measures for appropriate supervision, training and development. For the voluntary sector in particular this should mean staff are given the same training opportunities as colleagues in the public sector, as well as similar job security and conditions.

We would urge Scottish Government to work closely with voluntary organisations in developing aspirations and requirements around Fair Work.  This will help to ensure that the principles and processes developed take account of the particular reality voluntary organisations face.  For example, from SCVO’s experience of supporting voluntary organisations to provide Community Jobs Scotland we know that some voluntary organisations faced difficulties when CJS employees received the Living Wage, but other employees under different commissioned arrangements did not.  Issues such as this could impact on the idea of the “Fair Work Accreditation Scheme”, due to difficulties in embedding Fair Work in organisations that have different contractual arrangements with different funders.

We are currently working with voluntary organisations across the sector on a response to the broader Scottish Government consultation on Fair Work, which colleagues developing these proposals will no doubt be able to draw on.

Contact

Kirsten Hogg                                                                      

Head of Policy, Research and Campaigns

Scottish Council for Voluntary Organisations,

Mansfield Traquair Centre,

15 Mansfield Place, Edinburgh EH3 6BB

Kirsten.hogg@scvo.scot

Tel: 0131 474 6158