FUNDING and difficulties in recruiting staff will throw up barriers to reforming Scotland's social care system, the public spending watchdog has warned.
Audit Scotland said changes to how social care is provided in Scotland are needed – but the solutions "are far from simple".
First Minister Nicola Sturgeon has committed to implementing the recommendations of a review carried out by former civil servant Derek Feeley.
This includes creating a National Care Service on par with the NHS.
But Antony Clark, interim controller of audit and interim director of performance audit and best value at Audit Scotland, said it is "not clear what that would look like".
In a new blog post, he said the solutions to the challenges facing social care "go far beyond new structures".
He wrote: "As more people are living with complex health and care needs and the population gets older, not everyone is receiving the support they need.
"Demand for care at home and giving people more choice and control over their own lives is also rising.
"But the new models of care required to tackle these trends - involving the public, private and third sectors - will cost more money and it's not clear how they will be funded.
"There are other barriers too. The integration of health and social care – initiated in 2016 by the Scottish Government – has moved too slowly."
He added: "Councils and service providers also face difficulties in recruiting staff due to low pay, antisocial hours, and difficult working conditions.
"The Scottish Government and [council umbrella body] Cosla are committed to ensuring adult social care workers receive at least the Real Living Wage of £9.50 an hour - an important step forward.
"But the latest figures show gaps in skills across the care sector and over a third of services with vacancies.
"And of course, most care and support is provided by unpaid carers. There are an estimated 700,000 unpaid carers in Scotland compared to around 125,000 workers in care at home, housing support and care homes."
Mr Clark said more investment is needed "on top of almost £4 billion already spent each year on paid adult social care".
He said: "Spending is forecast to increase by 3.5 per cent a year up to 2035 – a 73% or £2.8 billion increase.
"Applying Feeley’s recommendations adds at least another £0.66 billion a year – around 0.4% of Scotland's GDP.
"Funding options put forward by Feeley include a new mandatory social insurance and changes to devolved and reserved taxation, including the introduction of new taxes.
"More detailed work and engagement is required by the Scottish Government on understanding demand and the cost of providing new models of care and how it will be funded. A clear plan and timescales are also needed quickly."
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