We carry a future: the potential of immigration for social care in Scotland.

On Tuesday past I met some of the UK Government ministers along with three Scottish Government ministers to explore the issues of immigration as they relate to the recruitment challenges facing the social care sector in Scotland. It was a useful sharing of perspectives though I fear it will not lead to the urgent outcomes desired by many of us in the social care sector in Scotland.

Whenever I mention the topic of immigration, I am acutely aware of the polarities and positions that folk seem to adopt with almost knee jerk automatic reaction. In this short blog I want to underline why I think we need to de-politicise the issue of immigration even if that be a hope beyond heeding.

Scotland has always been a country which needs and requires an international workforce, and this has often been the case in social care. There is a demographic truth that is undeniable which states on the one hand that we have an ageing workforce population and on the other that we have an ageing overall population. We know that that by 2039 there will be an 85% increase in those aged 75+.  Latest estimates show that:

‘by mid-2043, it is projected that 22.9% of the population will be of pensionable age, compared to 19.0% in mid-2018. As the proportion of Scotland’s pensionable age population grows, the proportions of both Scotland’s working age and child population are projected to fall.’

This is at the same time accompanied by a really positive reality which is that there are more of us living for longer and into what demographers call the ‘oldest old’ age categories. National Records Scotland projects that the number of people aged 90 and over in Scotland will double between 2019 and 2043 from 41,927 to 83,335.

As I said this is positive news especially if we can continue to work to address health inequalities so that more and more people are living healthier into older age. But at the same time all this good news has an impact on our working age population. It is this that makes a flexible and responsive immigration system even more urgent and necessary for Scotland as a whole but for social care in particular.

Put simply there are fewer people of working age in Scotland, and this is only going to increase especially with a relatively closed immigration system. Now whilst that has a direct impact on our fiscal ability as an economy and society it also has an impact on our ability to fill jobs from an indigenous population base. It gets even more challenging when we recognise that an ageing workforce is consistently less productive than a younger workforce. A recent report has stated that:

‘…although “long-term sick” as a reason for inactivity accounts for 6.6% of the inactive population of 16-24 year olds, this rises to 38.4% of inactive 50-64 year olds.’

Without rehearsing the arguments over Brexit and the reality that Scotland voted substantially to remain in the European Union, the impact of Brexit and in specific the introduction of new immigration procedures has had a profoundly damaging effect on social care in Scotland. There are several reasons for this.

One of the main reasons is that in the conversations I have had with employers and social care providers, especially in rural and remote areas, we know that many folks from Europe went back home when the pandemic hit to be with their families. This was wholly understandable as the virus swept across Europe. Many of those individuals are unable to return both because of the cost of and obstacles within the new immigration system. In some parts of the country up to half of those who had worked in the care home sector and who were from Europe have left.

Secondly the whole narrative around immigration not least around Brexit has been at times toxic and unwelcoming of the immigrant. Despite the efforts of some, not least the Stay in Scotland campaign, many folks have considered that they were not welcome and who would want to stay in a place where you are not valued?

Thirdly and perhaps most immediately we know that many of the amazing women and men who were at the frontline of our pandemic fight in social care have been exhausted by the effort and looking around at the relative lack of societal valuing of their work (and those of their colleagues in social care) have decided to move into other sectors such as hospitality and retail. Indeed, the inability of those two sectors to attract an international workforce has meant that there are many more opportunities in those areas of work for social care staff. As social care providers have always known the skills someone develops in social care – skills of integrity, empathy, communication, are very attractive indeed to other sectors who often pay more and reward better.

Lastly the introduction of the points-based system and visa requirements, together with the failure to recognise the distinctive needs of social care with a salary threshold which does not equate to the reality of reward in the sector, has meant that traditional routes for attracting international staff have largely been cut off to Scottish social care. This is in no small part because unlike in the rest of the United Kingdom most social care provision in Scotland is delivered by small and medium sized enterprises who do not have the scale, capacity or experience to manage the labyrinthine ways of the immigration process.

So, the above is the mechanics and the reality of a fractured immigration system which is resulting in real damage to our ability to care as a nation. Yes, we all recognise the importance of recruiting from within our own communities and we are seeking to do that and much more. Yes, we all recognise the criticality of improving pay and conditions, and we are on that journey but let us not forget that the vast majority of social care in Scotland (and in the UK) is paid for by the State so until the Treasury really opens the purse strings and recognises the social and economic contribution and criticality of social care we will always as nations be dancing on the edge of potential.

But against all this background it is not just numbers on a demographic spreadsheet that we have lost and are losing. We have lost people, real folks who have brought over the years, their skills and talents, their innovation and creativity, their humanity and adventure to our villages, streets and cities. They have been our neighbours and friends, they have sat alongside us, worked amongst us and have been one with us in all places and spaces.

A migrant and international workforce elevates our community to a new level. We are a better place and people because we have a door open to the world, a light of welcome to encourage strangers to find a place at our hearth.

People like me will doubtless keep working at opening that door to the world, because we know that for us to care for those who need it that we cannot do it alone with the demographic realities we are facing. I will keep arguing for the urgent necessity not of butchers and truck drivers getting visas, but for folks to get visas to come and work in nursing and social care, for folks to be prioritised and for social care to be added to the Shortage Occupation List. In all the focus on toys not being on the shelves at Christmas where has been the equal focus on people not being cared for? We need urgently a regionalised, flexible, responsive immigration system which meets the needs of all sectors and all parts of the country.

The sense of a broad, inclusive and confident community is at the heart of what I think permeates the rhythm of our way of being as a people in Scotland. Not emotional idealism wrapped around a flag but a hard reality rooted in open acceptance. The welcoming of divergence and difference are the marks of maturity – the comfortableness with otherness is the soul of community. The immigrant is not to be feared but to be nurtured.

This past week was the 100th anniversary of the birth of one of Scotland’s greatest poets, George Mackay Brown. I had the honour to meet GMB when I lived and worked in Orkney some 30 years ago and this last week I’ve been reflecting on and revisiting his poetry – hearing in the words and rhythm his distinctive voice of soul-filled space and Orcadian wisdom; a place which welcomed me as a stranger and has done for so many over the generations.

His insights on community infuse his poetry and describe well the hospitality and rootedness of a place not on the edge of civilisation but at the heart of nature. It was a place that taught me that what appears to be on an isolated edge can possess a creativity which centres itself in the heart of life. It taught me that community isn’t an idyllic calmness all the time, but a reality that has to be worked at alongside others prepared to roll their sleeves up to do the work. That’s why we are less without all those who want to come and work alongside us.

I leave you with one of my favourite GMB poems – a favourite because I lived overlooking Hoy for such a long time – Orkney with its iridescence and astonishing light draws you beyond a horizon of sight – it gives you a way of seeing the world unlike any other place I know. We need urgently in our addressing the workforce crisis in social care to have a way of seeing further than we have – to carry our future into our present.

Further than Hoy

Further than Hoy
the mermaids whisper
through ivory shells
a-babble with vowels

Further than history
the legends thicken
the buried broken
vases and columns

Further than fame
are fleas and visions,
the hermit’s cave
under the mountain

Further than song
the hushed awakening
of country children
the harp unstroked

Further than death
your feet will come
to the forest, black forest
where Love walks, alone.

Quoted at https://allpoetry.com/Song:–Further-than-Hoy

Donald Macaskill





Care Home IPC Manual Webinar – 28 October

We are hosting a webinar with our Transforming Workforce Lead, Dr Jane Douglas and Jackie Dennis, Senior Improvement Adviser (IPC Focus) from the Care Inspectorate to discuss the Care Home IPC Manual. This webinar is scheduled for  Thursday 28th October, 2:00 pm.

This webinar will help members better understand the process of the IPC Manual & Cleaning Schedule. This session will be in a meeting format to allow members to interact with our speakers and to ask any questions. We are keen to find out how members are getting on with the manual and what they might find difficult.

If you have any questions for this webinar session please send to [email protected].

Details to join this session will be available on the Members Area shortly.

Older age and the human right to food: an opportunity for Scotland.

Today is World Food Day which is an international day celebrated every year worldwide on 16 October to commemorate the date of the founding of the United Nations Food and Agriculture Organization in 1945. The day is celebrated widely by many other organisations concerned with hunger and food security, including the World Food Programme who received the Nobel Prize in Peace for 2020 for their efforts to ‘combat hunger, contribute to peace in conflict areas, and for playing a leading role in stopping the use of hunger in the form of a weapon for war and conflict.’

But what does World Food Day mean for Scotland? For me part of the answer to that wide question is the fact that we have also two days left of  UK Malnutrition Awareness Week.  Scotland has many great campaigning organisations dedicated to progressing issues of equality and justice in relation to food. None more so than Eat Well Age Well who this past week have been leading a social and wider media campaign to raise the profile of issues of malnutrition and food poverty as they affect older people in our society.

On Monday I read of the excellent new project being run by Scottish Borders Council, NHS Borders and Food Train’s Eat Well Age Well project, alongside care organisations and and housing bodies. It is designed to increase conversations about nutrition and weight loss in order to identify need amongst the area’s older population with the aim of securing earlier intervention for those aged 65 and over who live in their own homes and are at risk of becoming malnourished.

Eat Well Age Well argue that whilst 1 in 10 older people in Scotland today are at risk of, or living with malnutrition, they believe that this may be an underestimate, with between 20% and 30% of older people living in Scotland suffering or at risk of malnourishment. Those of us who work in social care will also be very aware – especially in the community – of the impact that the Covid-19 pandemic has had on increasing food-illness and malnutrition amongst the isolated and lonely old. I continually am being told stories from the frontline of older folks who are making hard decisions to limit their diet and food consumption in order to heat and fuel their homes.

Quoted in The National, Laura Cairns, Food Train’s Eat Well Age Well project manager, said:

“We have long said that malnutrition among older people is under-recognised and under-reported… Increased screening action and early identification of malnutrition in the Scottish Borders will help address that and create an example that we hope can be rolled out across Scotland.”

Great news for the Borders but sadly illustrative of the shocking increase in malnutrition amongst our older age population. The challenge is expressed plainly by UK Malnutrition Awareness Week who stated:

‘As the winter approaches, we must take action to raise awareness of preventable malnutrition. We also need to alert communities that many older people may find themselves more vulnerable than ever before.

Many older people have become less physically mobile, have experienced loss, bereavement sadness and loneliness. Many lack confidence, are reluctant to go out and have worries about their mental health and general well-being.

Health and social care services, voluntary sector and community food providers are stretched and struggling to keep up. There are already concerns over the difficulties that older people may experience in buying, preparing, cooking, and eating food. Many may not be getting the help to eat and drink when they need it.’

The World Food Day theme for this year, 2021, is “Safe food now for a healthy tomorrow”. Never were words more apposite as we in Scotland prepare for the arrival of thousands at the UN Climate Change Conference COP26 in Glasgow. The relationship between environmental sustainability and responsibility alongside ethical and safe food production should be intimate and inextricable.  The way we grow and produce our food, the food which we choose and the way we consume it affect our health and that of our planet.

For some time now a host of organisations under the excellent, able and creative leadership of Nourish Scotland have been in coalition, campaigning to improve our nation’s response to food.  Nourish Scotland have made five asks, including the creation of a Good Food Nation Bill, the incorporation of the human right to food directly into Scottish law, the establishment of an Independent Food Commission and the development of cross-cutting National and local Food Plans critical to embedding the right to food in a holistic, whole-system manner.

Just over a week ago the Scottish Government published its Draft Good Food Nation Bill. To say that I and others were disappointed is to put it mildly. This is a real missed opportunity, not just because the eyes of the environmental world are on our actions in the weeks ahead, but because there is the potential for a more robust and ambitious piece of legislation which could make real and meaningful difference to the citizens of Scotland not least those who are older and those today suffering from food poverty and malnutrition. What we have, I fear in this draft Bill, is a moving of the plates around the table, rather than bringing us a rights-based innovative new meal! I hope all concerned about issues of poverty and food, malnutrition and diet, social care and health, will take the opportunity to respond to the Bill and communicate their concerns and aspirations.

Food and the right to food is an inalienable human rights issue and so should be central to the development of a new Scottish Human Rights Act. It should not be peripheral to a new Good Food Nation Act in any form and there should be clear and explicit obligations upon both national and local governments, and upon organisations delivering public services, to ensure that the right to food is upheld. This means not simply giving a nod – a ‘regard’ to the right to food but to ensure that public bodies are required to ‘act in accordance’ to the human right to food.

In my own sector that not only means duties upon those who commission care and support for those in the community, but it also means an adequate allocation of resource and finance to enable real nutritional and health-beneficial sustainable and environmental food is allocated to those cared for and supported in care home and hospital alike. For too long many of us have felt that what we spend on the food and nutrition of those who are supported by the State is woefully inadequate especially for an older population. A human right to food would also serve to prevent folks failing to be properly nourished in their own homes, having to make cruel decisions between being warm and being hungry, and to ensure that as we age food is there in sufficient plentifulness to enable us to thrive and flourish until the end of our days rather than to wither in the body through hunger and thirst. The essence of a hospitable nation is the extent to which it afford fulness to those who sit around its table, whether neighbour or stranger, none should go hungry.

We have it within our ability and grasp to change the way we relate to food, for all ages not just the old, to call out the silence of hunger from the shadows into a light of shared commitment to both the planet and humanity which will banish hunger from fearful lives and communities. I leave you with the words of the English 20th Century poet Robert Laurence Binyon:


I come among the peoples like a shadow.

I sit down by each man’s side.

None sees me, but they look on one another,

And know that I am there.

My silence is like the silence of the tide

That buries the playground of children;

Like the deepening of frost in the slow night,

When birds are dead in the morning.

Armies trample, invade, destroy,

With guns roaring from earth and air.

I am more terrible than armies,

I am more feared than the cannon.

Kings and chancellors give commands;

I give no command to any;

But I am listened to more than kings

And more than passionate orators.

I unswear words, and undo deeds.

Naked things know me.

I am first and last to be felt of the living.

I am Hunger


Donald Macaskill



‘Building Compassionate Connections’ – Bereavement Charter Webinar (3 Nov)

Building Compassionate Connections | A Webinar on Bereavement 

Wednesday 3rd November, 13:30 to 15:15 (via Zoom)

The Group which developed the Charter is holding the second in a series of webinars exploring different elements of death and bereavement as part of To Absent Friends Week.

Full programme can be viewed below.

Register your place here.


Climate Change and Social Care Collective – Hot Report 2

On September 15th 2021, The Health and Social Care Academy (a programme of the ALLIANCE) and Scottish Care held the second event of ‘The Climate and Social Care Collective’ roundtable series. More information about the development and purpose of the roundtables can be found in the first report 

The second roundtable was focused on innovation and solution, with emphasis on taking a cross-sectoral approach. The event also explored people-centred solutions and a role of the community in supporting sustainable change. 

Our first speaker was Kenneth Watt, Policy and Public Affairs Manager for the Red Cross, leading work across the devolved nations covering health and independent living, refugee and asylum and emergency response. Kenneth spoke about the ‘Feeling the Heat’ briefing which discussed the impact of heat waves and climate change in the UK. The report evidences the increasing risk of heatwaves, explores public perceptions, and sets out solutions. The impact of heatwaves will be especially significant in terms of excess deaths, on older and more vulnerable people. Further, the overall impact on health services will exacerbate underlying health inequities. There is a significant role for community organisers and volunteers to take action as this sector feed into early warnings and getting information out to communities. Government recognition of the human impact of heatwaves, with coordination across sectors and levels. People must have access to targeted information that appropriately meets their needs.  

The second speaker was Christine Owen, Senior Manager with the People Powered Results (PPR) team, a Nesta Specialist Enterprise. The PPR team works with organisations and public systems to release the power of people closest to issues to adapt and take action in an increasingly complex world. Christine discussed place-based approaches to change, how to create the conditions for such change and how we might start to think about challenges differently through adapting, maintaining, and sustaining ourselves. This was demonstrated through a practical action programme ongoing with the Wales Council for Voluntary Action (WCVA) to deliver transformation focused on Covid recovery with community-led action to build a fairer, greener and healthier future as part of this recovery. Christine echoed Similar to our first speaker and emphasised the importance of collaboration as an instrument to effect change.  

The third speaker in the roundtable event was Bev Knight, Head of National Operations, with Redeem Exchange – a circular economy initiative introduced to divert plastic waste from landfill by reusing plastic hand sanitiser and soap bottles through a collect, wash, refill and return service. Bev highlighted the impact that people can have on the climate with simple methods. Potential solutions to a more sustainable future align with green jobs and a circular economy approach and discussed how the changes from this initiative support other vulnerable groups as well as the care sector. 

After the Q and A session, participants were split into smaller breakout groups to cover questions around key questions:  

1) if there was a £25 million social care climate innovation fund, what types of sustainable solutions would you like to see it used for?  

2) Which key stakeholders need to work together to take climate action? This may involve local authorities, those delivering and receiving care, health and social care partnerships, care providers, the business sector, transport and procurement. 

 3) Do you have any good practice examples (including from other sectors) that you would like to share which you think would be applicable to the social care sector? 

The breakout sessions fostered thoughtful conversation on the challenges and shortcomings with placing social care as a top priority alongside and within climate issues. Some of the recurring points that came up were on the biggest carbon emitters in the sector. While there is little data to evaluate the social care sector’s carbon footprint in Scotland, we know that the big areas of concern are around transport and energy – specifically heating.  

One of the areas that participants pointed out would be most useful would be to centralise information; this would allow people to access or contribute to showcasing measures that can be taken and the effectiveness of this would be useful for providers to understand where they can make a difference. Speakers mentioned there is a collective effort needed to implement change and pooling resources in this space would be helpful. 

There was recognition that the social care sector does not sit in isolation. Participants suggested joining up approaches to better understanding the role of regulators and inspectors, commissioning of services, of hospitals and health boards, and potential costs (both from action to inaction). It is important to join up data to understand how different industries connect and play a role in the delivery of care and support (more specifically laundry, food, agriculture, retail, PPE). There is a carbon cost to the delivery of care and these processes and costs must be balanced with a rights-based agenda. Many of the concerns circle back to the long-standing issue of insufficient funding available in the sector and the undervaluing of social care. Changing mindsets to focus on sustainability in the commissioning and procurement processes would be beneficial to implementing long-term change. 

We are looking forward to our final roundtable event taking place on Wednesday 20th October from 10:00- 12:00 which will look at key principles and calls to action developed as part of the series. We look forward to welcoming our panelists for the session and invite anyone interested in the subject to attend! Sign up here.

Climate Change and Social Care Collective – guest blog from Anne Marie Bergseng

This summer saw wild, hot and wet weather causing disruption and taking lives in communities across the globe. The heat wave in Canada and the USA, and the devastating floods in Germany and Belgium are some of the international examples. Closer to home flash flooding following unusual summer heat has hit communities in Scotland and across the UK. What does this changing climate mean for the social care sector?

Earlier this summer the UK Climate Change Committee released its Independent Assessment of UK Climate Risk saying the UK is ‘struggling to keep pace with climate change impacts’. The summary for health and social care points to flooding, overheating, and water scarcity as the main concerns. There could also be increasing risks from high winds or storms, and changes in air quality.

These risks will impact the social care sector both as disruption to the services from transport and access issues, and through the service users’ changing medical needs. It is also important to remember that the impacts of climate change are not evenly felt. Those already disadvantaged or in poor health are disproportionately impacted.

This is recognised in Climate Ready Scotland: Second Scottish Climate Change Adaptation Programme, which has an aim of ‘Scotland’s health and social care is ready and responding to changing demands as a result of the changing climate’. It also acknowledges that ‘impacts on these services will likely disproportionately affect those who are already more vulnerable’. The programme lists a number of actions underway to improve the sector’s resilience.[1]

At the same time every organisation and every one of us individually have a role in reducing the greenhouse gas emissions causing climate change.  Travel, waste and energy use are some of the practices where organisational and individual everyday practices can be part of taking us in the right direction, with a wealth of resources available to inspire and enable change to reduce the unhealthy and dangerous impacts of a warming world.


Anne Marte Bergseng


[1] Last year ClimateXChange published a report looking at how social care at home services had faired through three extreme weather events. The research found that extreme weather events result in a substantially increased workload for care workers and managers in the care at home sector.

About the author:

Anne Marte is the Knowledge Exchange Manager at ClimateXChange – Scotland’s centre of expertise connecting climate change research and policy. She manages research projects on behaviour change and adapting to the impacts of climate change and is a knowledge exchange expert with 20+ years’ experience from media, corporate and science communications, and facilitation. In addition to specific research projects she works across ClimateXChange’s portfolio to connect research and Scottish Government policy-making.

Twitter handle: @annemarteb

This blog was specially commissioned as part of the Health and Social Care Academy (a programme of the ALLIANCE) and Scottish Care’s ‘Climate Change and the Social Care Collective’ roundtable series. The roundtables are helping to foster dialogue and explore the crucial role that social care must play in the context of climate change – in addressing, adapting to and taking action to mitigate the impacts. The last roundtable session will be held on October 20th 2021, from 10:00 – 12:00. More information can be found here: https://www.eventbrite.co.uk/e/climate-change-and-the-social-care-collective-roundtable-series-tickets-162420268395

Scottish buildings light up for homecare workers

On the evening of Wednesday 22 September 2021, significant buildings across Scotland will be lit up in yellow to acknowledge care at home staff. This initiative is in line with the ‘Celebrating Homecare’ event taking place on the same day.

‘Celebrating Homecare’ is an online event developed by the Homecare Association in conjunction with the Care Workers’ Charity. It’s all about celebrating the amazing difference homecare makes in people’s lives every day. It is also being supported by care associations across the UK and Ireland including Scottish Care, Care Forum Wales, Independent Health & Care Providers (Northern Ireland) and Home and Community Care Ireland.

The Partners for Integration team, along with Scottish Care, supported by the Scottish Government, the Scottish Parliament and the Care Inspectorate will be marking ‘Celebrating Homecare’ by lighting up buildings in Scotland to give thanks to the homecare workforce. This initiative is also supported by the Health and Social Care Partnership for Edinburgh, West Lothian, Argyll and Bute, Aberdeen, South Lanarkshire, Perth and Kinross, and West Dunbartonshire.

The buildings will include:

  • St Andrews House, Edinburgh
  • Victoria Quay, Edinburgh
  • Civic Centre, West Lothian
  • Castle House, Dunoon
  • McCaigs Tower, Oban
  • Marischal College, Aberdeen
  • Hamilton Townhouse, Hamilton
  • Perth Bridge, Perth
  • St Paul’s Square, Perth
  • Council Offices in Dumbarton

The buildings will be lit up in the colour yellow, which was chosen to symbolise the flame of a candle. This relates to another initiative by Scottish Care – ‘Candle for Care’, whereby candles are lit every Tuesday at 7:00 pm to express gratitude to all those who provide care and support during the COVID-19 crisis and in memory of all those who have died from COVID-19.

To be able to stay in the place you call home and to remain around family, friends and community is a desire many of us have, maybe most especially when we are ill or requiring support and care. It is this independent living which thousands of homecare staff enable people to achieve every day across the UK.

Throughout the pandemic, care at home staff has continued to support some of our most vulnerable people in their own homes, ensuring their health and safety whilst combatting the challenges of COVID-19. They provide support not only to individuals but their families too. Recent months have also seen unprecedented demand in home-based care organisations, despite this, the homecare workforce has rallied together and gone above and beyond their roles to deliver quality care.

The homecare sector shows us caring, resilience and compassion at its best. Yet this workforce is often undervalued and not recognised. This workforce deserves recognition for their dedication and professionalism every day of the week, regardless of weather, risk or fear.

A relative of a service user said:

“During the Pandemic, it has been a lifeline for my mother to have carers support her at home. We live around 90 minutes away and supporting mum daily would be challenging, particularly as my husband is going through cancer treatment. On the occasions when we have met with carers, usually when delivering meals for mum, we’ve both been extremely impressed by their care and professionalism.

My mother very much enjoys the company of the carers and the support they provide. It gives her a focus and also a ‘raison d’etre.’ It’s encouraging to hear that they are supporting mum leaving her flat for short walks. Our thanks to all the carers.”

Jim Carle, Joint National Lead for Partners for Integration, Scottish Care, commented:

“This ‘light up’ is an acknowledgement of the care at home workforces’ uphill battle to continue to provide an incredible service in a year like no other, as they have faced and met the challenges of Covid-19.  In an extended period of unprecedented demand, they have gone above and beyond. To acknowledge the magnificent contribution they make to the vulnerable individuals they care for on a daily basis, which is truly worthy of celebration. Our heartfelt thanks for their dedication and care.” 

Preferred Supplier Webinar – Citation: Tendering (30 September)

Free tendering for Scottish Care Member

Practical tips and guidance on improving success…

No matter the size of your business and your ambition, tendering offers exciting opportunities and is an important part of a care business’s ultimate success. But in a world of competition, are you doing everything you can to stand out from the crowd?

Join Gold Tier Preferred Supplier, Citation, for a free, 60-minute webinar on 30 September (2 – 3 PM)  which will cover the key HR, Employment Law and Health & Safety aspects needed to drive efficiency as well as practical tips and guidance on how to tender correctly.

Key talking points in the webinar will include:

  • An overview of the tendering process and when and where to find suitable tenders for your business
  • Tips on how to win more tenders such as the preferred certifications and accreditations
  • Ensuring your rating is as strong as possible for the best opportunities
  • Common mistakes and how to avoid them
  • HR and Health & Safety policies and procedures needed for tendering as well as planning and preparation to keep your business running smoothly while you focus on winning more business.

Date: 30 September

Webinar time: 2 – 3 PM

How to join: Joining link will be available on the Members Area of this website. If you come across any issues accessing this area, please contact [email protected].

They’ll also be answering your business-specific queries, so feel free to come along armed with any questions you may have.

Knowledge leading to action: the urgency of dementia. A blog for World Alzheimer’s Day

September for some time now has been World Alzheimer’s Month and, on this Tuesday, 21st it will be World Alzheimer’s Day. This year, across the world individuals and organisations will be asked to reflect on the theme ‘Know dementia, know Alzheimer’s.’

It is an opportunity to consider the power and nature of knowledge. As part of this organisations and individuals are being encouraged to find out more, to get to ‘know’ more about the signs and symptoms of dementia so people can get the right diagnosis and support as quickly as possible.

Knowledge and dementia are an interesting association. Knowledge is both personal and emotional, intellectual and factual. It is also something which can inspire, create passion, and foster change.

As I sat down to write this blog, I could not help but think as I have for some years now at this time about my own mother who died from dementia some years ago. Before she was diagnosed, I thought I knew about dementia. In some senses I did, and I suspect I thought I probably knew more than others. As a young student on placement, I met many older patients in what was then termed a ‘psycho-geriatric’ ward including a man who had undertaken a career of neurological research but had himself developed dementia. So, I knew a lot about the technical aspects of the disease as I worked in different places and occupied different roles. But in reality my knowledge was a partial shadow of the truth.

Then my mum was diagnosed, and the lessons of love offered a different, hard, and painful knowledge. It was the knowledge of tear and fear shared by my family as we witnessed mum and granny decline inexorably in front of us. Having worked until her early 80s her decline seemed so rapid and yet so inexorably slow. This was a woman whose solution to all of life’s traumas and ills was the making of a cup of tea, a ‘strupak’. Then came that moment when she had forgotten the steps of her healing ritual and stood frightened in an empty moment without remembrance. She had forgotten how to make a cup of tea. The stripping of inner knowledge is one of the obscenities of this disease. Knowing changed, love remained, but relationships pained and fractured. There was a new world of knowledge, one which was not about the past or action, but one which was about discovering with faltering step and searching fingertips the landscape of a new world.

Knowledge and dementia are indeed strange sisters.

But there is another dimension to knowledge. There is not just the knowledge of fact and intellect, and even that of emotion and heart. There is also a knowledge that changes you and puts you on a new and different path, a knowledge where you cannot no longer be the person you were before it’s awareness, can no longer accept old familiar ways.

Knowing what I do about this disease both in my head and heart I cannot accept the casual discussions and debates, the easy political presumptions, media stereotyping and societal ageism that I have heard and witnessed for so long and which have been so manifest in the last few weeks.

The future of social care is centre stage in both Scotland and the other nations of these islands. The lazy debate which has been held has wholly failed to appreciate the nature of social care and the reality that it is more than a series of services and supports but a whole eco-system that enables people to fully live their lives as citizens regardless of condition, age or infirmity.

But perhaps where that public and political debate has fallen most short has been in its exploration of dementia.

The knowledge that needs to be shouted from every street this World Alzheimer’s Day is that dementia is a health condition first and foremost. So why? why? why? are we allowing its treatment to be seen solely through the prism of a social care solution? Paradoxically maybe those of us who have over the years resisted the pathologising of dementia and what happened when I was young which meant people were to be hospitalised, perhaps our emphasis on the need to see dementia as more than just a neurological disease, perhaps we bear some culpability. But the pendulum has swung far too far to the extent that dementia is in the eyes of many seen as a disease which can ‘solely’ be supported by social care interventions and supports. This is naive ignorance. It is a denial of the clinical reality that dementia is a disease first and foremost and one that requires significant clinical and health service intervention alongside social care support and re-enablement.

Where this simplistic dualism is seen most acutely is in how society resources and finances dementia care – or to be more accurate does not finance it.

It is wholly iniquitous that if diagnosed with dementia one has to sell one’s home to receive residential nursing home support. Now credit where it is due, the Scottish Government have committed to extending free personal and nursing care to better reflect the true cost of care and have recognised the gap between the true cost and the reality of underfunded rates in our care homes – though we await the realisation of the commitment. But that does not go far enough. How is it in any sense fair that someone who is in the advanced stages of dementia is not given the option of 24/7 nursing and social care in their own home? Why if someone chooses to or needs to live in congregated living like a care home is it assumed that their accommodation costs would be the same as at home? Come on this is the crude arithmetic of discrimination.

Henry Simmons the CEO of Alzheimer Scotland in a newspaper article this past week rightly argued the policy on enhancing free personal and nursing care still left people with advanced dementia facing huge costs because of the high level of health interventions and care that they need.  I was fully supportive of Alzheimer Scotland ‘Fair Dementia Care’ campaign when it was launched and remain so. As Simmons said to The Herald.

“In Scotland, we’re looking at five years to see the development of the new National Care Service, and three years for the rest of the UK before the full amount of new funding will find its way to social care.

“Notwithstanding the fact that people with dementia do not have time to wait for these improvements, there is also one fundamental and massive inequality that neither of these proposals go far enough to resolving – or even mentioning – and that is the fact that people with advanced dementia… are still going to have to pay substantial amounts for their care costs.

“Take a person living with advanced dementia. Their illness – a direct result of an untreatable brain disease – has progressed to the point where they may require assistance to walk, bathe, toilet and communicate.

“For this person, these are unequivocally health care needs.

“Why do we still feel that it is acceptable that we ask this person to pay for their care?

“We are talking about people who have worked their whole life, contributed through tax and National Insurance to help build the quality of life than many of us seek to enjoy.

“Why is dementia so different to other terminal conditions? It’s unequal, it’s unfair, and it needs to stop.”


People who have lived with dementia and those they love have known for years about the grotesque inequality of the funding of care and support, of clinical intervention and health support for the condition. It is a knowledge that should shame those who make political decisions and exercise fiscal oversight.

Knowledge must always lead to action, or it withers the heart. Knowledge of the inequity of support and care for those living with dementia should challenge us all to create a system which treats all with equality regardless of condition, age or illness. I yearn for the maturity and the dignity of such a day to come. I suspect – sorry mum – that such a day will not be brought about by cups of tea alone but my calling out the inequality at the heart of dementia care for what it truly is – an abuse of the human rights and dignity of tens of thousands of our fellow Scots.

Donald Macaskill