Urgent action needed to address critical issues in delivery of social care services

27 January 2022
Report cover

Action is needed now to change how Scotland’s social care services are delivered so that it meets the needs, and improves the experience of, people relying on care and support.    

A joint briefing by the Accounts Commission and the Auditor General for Scotland says fundamental issues and threats to the future sustainability of Scotland’s social care system need to be addressed. The pandemic has exacerbated long-standing challenges, highlighting the precarious situation of many vulnerable people who rely on social care or support.  

Over £5 billion a year is spent on delivering social care services, yet some services are at near crisis point. There needs to be a shift in how this money is used, with a far greater emphasis needed on preventative care that meets the needs of individual people. Service users do not always have a choice or say about what support works best for them. Nor are carers getting all the support and advice they need, despite existing legislation.  

Now the Scottish Government, together with its partners, must listen and bring together the views and experiences of service users and carers. This will support the delivery of their long-held ambitions for social care. 

The 200,000-strong workforce is under immense pressure and feels undervalued. There is a high vacancy rate and a continuing problem of recruiting and retaining this workforce into roles which often have low pay and poor conditions of employment. At the same time demand for social care services continues to increase. 

Commissioning social care services tends to focus on cost, rather than quality or outcomes. Worrying limitations in social care data has created major gaps in the information needed to inform improvements.  

William Moyes, Chair of the Accounts Commission, said:

There are significant problems with the delivery of social care services. These services are vital, yet we have a workforce that’s not adequately valued or regarded. Staffing shortages are a major issue across the sector and not all people’s needs are being met. Too often a focus on costs comes at the expense of delivering high quality services that aren't at the heart of the needs of individuals. The additional funding to achieve this will be significant. Not taking action now presents a serious risk to the delivery of care services for the people who depend on them.

Stephen Boyle, Auditor General for Scotland, said:

We cannot wait another five years until the planned National Care Service is in place. Action must happen now, and at speed, by the Scottish Government. There must be clear timescales for delivery, demonstrating that lessons have been learnt from previous reforms of health and social care services. This will create a strong foundation for the government’s vision to create a National Care Service.