Social care in Scotland needs to be better planned and organised

Scotland’s councils and NHS (National Health Service) boards must improve the planning and organisation of social care. Councils spend £3 billion a year on these services, which are vital for many people.

An Audit Scotland report published today, Commissioning social care, looks at how well the public sector plans for, organises and delivers social care. Social care services range from supporting people with basic personal care such as washing and dressing to helping them with every aspect of their daily lives. People depending on these services include older people, vulnerable children, people with disabilities, and people with mental health problems, addictions or HIV/AIDS.

The report says planning social care is complex and is becoming harder as demands are rising and budget constraints are tightening. A major change is the introduction of self-directed support which aims to give people a bigger say in the services they receive. This will require a new approach from councils and health boards which must do more to involve both the people receiving services and the service provider organisations. If services are to improve there needs to be better information on the needs of the population, on the costs, quality and impact of services.

Accounts Commission chair John Baillie said:

“Social care in Scotland faces a number of challenges. As budgets come under growing pressure, there are signs that councils are concentrating resources on people who need intensive support. There is a risk that people who need a small amount of support may not get the help they need to live independently. Their early problems may worsen more quickly without this help and this may lead to greater cost over the longer term.”

In December, the Scottish Government announced plans to integrate health and social care for adults. It is also expected to launch the Self-directed Support (Scotland) Bill, which aims to give people more choice and control over the support they receive.

Auditor General for Scotland Robert Black said:

“The plans for bringing health and social care closer together mean that major changes lie ahead for these services. The self-directed support legislation should give people greater choice and control over their care packages. However, if these changes are to work well, it is essential that councils and health boards improve the planning and commissioning of care services.”

The report also says voluntary and private organisations provide a substantial amount of social care to people in Scotland, and councils and their partners should be working more closely with them. Councils should have contingency plans in case providers close and need good information on the financial health of the providers they are using. The report says this can be complex and will involve developing and coordinating capacity and expertise at both local and national levels.