Minutes:
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.
Supporting documents: