Social care in Scotland stands at a critical juncture. Rising demand, workforce shortages, and financial pressures have created a system under strain.
For years, reform efforts have focused on structural fixes, the introduction of integrated boards, new governance models, and performance targets. We even came up with the ill-fated National Care Service. Yet, the lived experience of many remains fragmented. Why? Because we have been trying to manage complexity with tools designed for simplicity.
Occasionally there are times when certain parts of your life and worlds come into creative engagement. I recently had such a moment when I listened to a superb speech being delivered by Professor Toby Lowe and recognised the synchronicity of his words with my role as Chair of NDTI who are continually trying to promote and develop creative ways of addressing broken systems in their work, not least the failures to deliver citizen-led and controlled social care and support.
Professor Toby Lowe’s work on Human Learning Systems (HLS) offers a radical alternative to a lot of traditional and normative social care reform approaches. It begins with a simple but profound truth: outcomes can not delivered – they emerge from complex systems of relationships. This insight challenges the dominant logic of control and invites us to design systems that learn, adapt, and serve human flourishing.
Traditional public service management, shaped by New Public Management philosophy and practice (beloved of civil servants and Prince 2 learning systems) assumes that outcomes can be specified, measured, and purchased through contracts. In reality, social care outcomes which are after all wellbeing, independence, or dignity, are created by hundreds of interacting factors: family support, housing, community networks, health services, and personal resilience. Holding providers accountable for outcomes they cannot control leads to gaming, stress, and worse results.
It turns professionals into bureaucrats and people into cases. Scotland’s experience with integration shows this clearly: structural change without cultural change achieves little.
Lowe’s Human Learning System approach rests on three principles:
- it is Human – see people as unique, not data points. Design bespoke responses that start with individual strengths and aspirations.
- it is Learning – make learning the engine of improvement. Use cycles of inquiry and adaptation, not rigid plans and targets.
- it is about Systems – nurture healthy systems: trust, collaboration, diversity, and shared stewardship across organisational boundaries.
Instead of asking, “How do we deliver outcomes?” HLS asks, “How do we create the conditions for good lives to emerge?”
In his talk Toby Lowe cited the innovative work being undertaken in Leeds. There Leeds City Council have embraced a strengths-based approach that aligns beautifully with HLS thinking. This has led to a liberation of social work and social care. They have moved from care management to relationship-based practice. Social workers became “travel companions, not travel agents.” It has as a result reduced bureaucracy, by cutting assessments from 52 pages to two conversational pages. It has led to real community investment through small grants for local initiatives that build resilience and belonging. And critically it has been rooted in system stewardship with senior leaders giving a clear mandate: “Do no harm. Don’t break the rules. Don’t break the budget. Otherwise, go for it.” This created psychological safety for innovation.
The result was social workers reporting feeling empowered, and citizens experiencing care as something co-created, not imposed. For those who were around at the start of Self-directed Support in Scotland, this is what we dreamt of and we can only yearn for such achievements.
I mentioned my work with NDTI and it is through their work that some of these principles are becoming more rooted in parts of Scotland. The National Development Team for Inclusion (NDTi) has helped spread these ideas through its Community Led Support (CLS) programme. CLS creates local hubs where people can have “good conversations” about what matters to them, reducing bureaucracy and connecting them to community resources.
In Scotland, CLS has been implemented in East Renfrewshire, South Ayrshire, Scottish Borders, Fife, and South Lanarkshire, with measurable impacts. Waiting lists have been reduced (e.g., Scottish Borders saw a 37% drop). There was evidence of improved staff morale and reduced bureaucracy; of better outcomes for people as a result of quicker access and more community-based solutions. And CLS also demonstrates cost-effectiveness by preventing crises and reducing reliance on statutory services bringing clear economic benefits.
These changes echo HLS principles of trust, learning, and human-centred design.
I think Lowe’s approach has clear potential for Scotland as we struggle with complexity by too often delivering simplistic responses. Applying these lessons means:
- Commission for learning, not control – fund organisations to adapt with people, not hit arbitrary targets.
- Invest in relationships and communities – strengthen local capacity and trust, because outcomes emerge from networks, not contracts.
- Create connected learning systems – link insights from frontline practice to policy, so reform grows from lived experience rather than top-down design. And stop obsessing with the mistruth that the only people with ‘lived experience’ are those who are currently using care and support. Cast the net wider to the users of tomorrow, to the workers of today and the employers of the moment. They all have invaluable lived experience to teach a failing system.
This is not about importing a model wholesale. It’s about embracing principles that honour complexity and human dignity. Leeds and CLS show that when you trust professionals, invest in communities, and make learning the core of improvement, transformation happens.
Imagine a future where a district nurse, a social care worker, and a community volunteer co-design support around a person’s life. Where local teams share learning openly, shaping policy through lived experience. Where success is measured not by throughput or cost per case, but by stories of flourishing.
This is not utopian. It is already happening – in Leeds, in many other places in England as well as in Scotland. The question is whether we have the courage to scale it.
As Toby Lowe reminds us: stop pretending the world is simple. Embrace complexity. Learn together. Build systems that serve human freedom and flourishing not that feed the gods of performance and the cult of system outcomes.
Donald Macaskill
Photo by Armand Khoury on Unsplash
