Agenda item

Pippa gave a presentation, with Fiona, to discuss how the CPP want to response to this consultation, and how we can progress that. The consultation was launched in August 2021 as part of the Scottish Government manifesto commitments following the Feeley report (Review of adult social care February 2021) and expands on that to include children services, community justice, alcohol and drug misuse, prisons, mental health and social work. It is the largest proposed change to local government since reorganisation. It is a lengthy consultation covering a number of themes and proposals. Responses are due by 2 November 2021, and feedback will be analysed to develop a Bill which is expected to be put to the Scottish parliament by summer 2022. This will involve extensive legislation for scrutiny by parliament with the intention to have a full social care service in place by 2026.

Pippa noted that they will be key issues to consider with the remote rural challenges in our area. She added that there is a lack of clarity on the detail within the consultation for key elements of the proposals, and we also need to consider the implications for the CPP. Takki noted that TSI network across Scotland is also going to do an overview response to the consultation.

The key areas of the consultation are:

-       Improvement - Establishment of single nation body for health and social care with accountability to Ministers at national level (not local government),

-       Access to care and support - removal of eligibility criteria’s and a focus on need, a consistent approach, prevention and early intervention and development of a national proactive model,

-       Rights to breaks from caring,

-       Using data to support care - implementation of accessible national social care and health records, 

-       Complaints and putting things right and

-       Residential care charges - increase sums paid for free personal and nursing care for care home residents.

Fiona then introduced herself as the interim chief officer for HSCP and said that it is important to draw out eligibility criteria in addition to an early intervention approach. There is an ambition to use this new approach to get things right and that social care done well enables people to achieve.

Takki said this is a massive change to the local service delivery model and risks losing the gain of local relationship building. Many welcomed the national standards but there is nervousness of democratic influence and control i.e. how would Argyll and Bute put  a rural frame on this proposal, and the need for another level of detail in how that applies in rural areas. TSI are supporting of the general principles but do have concern of loss of democratic control and that there has perhaps been a dilution from the original Feeley report. Pippa noted that individuals and organisations can also separately respond to the consultation, out with a joint response from the CPP.

The National Care Service (NCS) seeks to establish a service that removes responsibilities for social work and social care from local authorities. NCS will lead on all aspects of community health and social care improvement, with responsibility for national workforce planning. Takki would like to see more detail on how that applies to children services, for example, The Promise moves towards a child by child specific approach but how does that work when transferred to a national body?

Pippa advised that the consultation throws up a lot of practical question as to how it will work on the ground, and as it difficult to assess that without further detail a point of principle can be drawn out regarding that. Fiona added that in terms of context, the current remits of HSCPs vary hugely by area in terms of delegated service. Whilst not wanting to lose the gains of previous reviews, she felt that anything that can be done to improve services is a good thing. Albert asked about the existing IJB set up and work with social care, he worries about how we ensure the engagement is not centralised.  Pippa added there may be areas where the “economy of scale” needs adapted to fit rural areas.

IJBs are to be reformed to Community Health and Social Care boards (CHSCBs). Functions will become consistent across the country. CHSCBs are to be accountable to ministers and will have locally elected members and members representing the local population (including those with care experience and carers). CHSCBs will also become a member of community planning partnerships. Pippa is interested on partner views on that. Rona asked what the local geography is likely to be for the CHSCBs and Fiona confirmed the proposal states it is to mirror the IJB boundaries.

Alison noted there is a cross cutting theme for bodies to have equality outcome frameworks and report on those. It is a challenge for IJBs to do that as the parent organisations of Argyll and Bute Council and NHS Highland Board have different reporting periods. However, some of those anomalies may be ironed out and benefit the high level intentions to levelling up and equalities. Takki noted that the CHSCBs are to have responsibility for planning and procurement in the context of a national care service. The TSI are reflecting on that and there is fear of how a nationally set commissioning approach will that relate to small scale organisations, and associated third sector capacity building, being able to bid for contracts. All agreed that the independent scrutiny of the NCS standards and processes for ethical commissioning of social care services and support is good practice.

Fiona noted that in terms of the effect of this on the existing workforce, the consultation currently raised more questions than answers. The consultation proposes a national job evaluation framework and implementation of a national pay structure similar to the NHS. She hoped that these matters will be resolved as the process moves forward. Pippa also noted that if there are to be changes to staff employment, the timescales are ambitious.

Rona asked how the consultation looks to make linkages with national policy elements (Community Wealth Building and its link to procurement, climate change, digital etc.). If it does not address these then Rona suggests that is something the CPP would want to pick up on in their response, and any national work linked to care and reform should ensure to make sure linkages to key national policy areas and be embedding these from the outset.

There were questions around how easy it will be to complete the legislation given the number of questions that need to be resolved. Getting this wrong for communities has big implications. Fiona noted the document is written in a very literally way, and cannot answer these lateral aspects, but it is important to feed these points back to the consultation so they can be considered and she is keen to get as many of those issue on the table for discussion at this stage.

Pippa noted a keenness in the CPP to provide a response to reflect the remote rural voice, adding that the more local responses we can get to the consultation, the better. Pippa suggested a practical approach is to form a subgroup to capture the points to be raised on the consultation response from partners to create a response on behalf of the CPP.

ACTION - Expressions of interest to join a sub group to respond to the consultation are to be sent to cppadmin@argyll-bute.gov.uk by 1 October. Responses, from those not specifically involved in the sub group are to be received by 28 October in order to meet the response deadline of 2 November.