Thanks to changes in society itself, advances in science and technology, alongside the high quality of healthcare provided by the NHS, as a population we are enjoying longer lives. This does mean, however, that people are living longer with more complex needs.

In Scotland we are proud of our social work and social care system’s focus on human rights as it supports thousands of people with short term difficulties in their lives, disabled people and people with long term conditions to live full lives in their communities and carers to have a life alongside caring.

However, it’s becoming clear that our traditional approaches and services weren’t designed for how quickly demand for care and support is growing.

‘Scaling up’ the current system to meet growing demand isn’t sustainable, and doesn’t address the types of changes that need to be made to make the system stronger.

We need to think differently about what social care is, the value we place on it as a society, and how people can access the support that is right for them. That also means thinking about where change is required, what change is already being shaped, and how best to bring it forward.

In thinking widely about how to address the issues faced by the system, a pressing question arose: is there a role for national government and partners in supporting local reform of adult social care? What should that be?

From conversations we’ve had so far, there is no clear cut answer. Speaking with people and organisations and reviewing research has thrown up different views on:

• what the biggest challenges are in social care in Scotland
• what should be done about them
• what a national programme should focus on / what it should do

In asking these questions, responses have been coloured with everything from energy, experience and enthusiasm to frustration and exhaustion.

In addition to that spread of emotion, this told everyone involved something that they already knew: There is no single answer; if it were easy, it would have been done by now.

Rather than debate the diverse spread of issues down to the last speck, it was agreed that time would be better spent crafting a shared agenda – an agenda that would identify change and improvement in the system, and one that would allow everyone involved to see the value and importance of their part in the bigger picture.

Change will be – and is being – led locally, by workers, organisations, people, partnerships and communities.

With this in mind, we needed to start the conversation. Speaking to stakeholders, they have begun to identify a number of priorities where a collective national  programme might bolster what was happening at a local level:

• Raising the profile of social care in Scotland, as well as awareness of its value for individuals and society.
• Working to fully embed self-directed support and clear up its many misconceptions.
• Expressing our vision and ambition for adult social care. The national programme offers an opportunity to develop and promote this.
• Looking at the rich provider landscape and how services and support are planned, designed, developed and delivered – all of which will be key to reform.
• Allowing a platform for an honest discussion about the cost of social care, and how care is paid for.
• Barriers to progress come up frequently, and so a national programme would be one route to identify these and then make or support changes necessary to overcome them.
• Leadership of social care reform must be far-ranging, and so a key focus of the national programme would be on creating the right environment for collective decision-making.

We recognise that a lot of people and organisations are already doing, or have already done, extensive great work, and there’s something to be said about making space for creativity and innovation in addressing the issues faced by our social care system.

Moreover, we know that reforming social care is something that can only be achieved through collaboration.

Crucially, it needs to have people with lived experience of using the social care system at its core, fully engaged in the discussions around reform.

@SG_SDSPolicy

Andrew Scott

Adult Social Care Reform, Scottish Government

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