NICOLA Sturgeon faces new pressure to drop her flagship policy for a National Care Service amid warnings social workers are considering quitting the profession over the reforms.

A report by the trade union Unison reveals fears among staff that the changes will lead to further strains on an already stretched service which would also have a knock-on effect on the the health service as it struggles to recover in the wake of the pandemic.

The NHS has been battling to recover from the crisis but faces challenges from insufficient places in care homes preventing many elderly people being moved out of hospital.

Unison's report also reveals just over one in 10 social work staff think the proposals will improve standards of care, while 71 per cent believe the changes would have a negative impact.

The report is the latest blow to the First Minister’s proposals and follows concerns that the cost of implementing the changes could spiral well beyond the currently-forecasted £1.2 billion.

A Holyrood committee said on Friday that the reforms under the National Care Service (Scotland) Bill should not go ahead in their current form.

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The NHS has been struggling to cope in the wake of the Covid pandemic with problems arising from insufficient places in care homes allowing some elderly people to be moved out of hospital.

Last week, The Herald on Sunday revealed that the trade union Unite was set to boycott any further involvement in the co-design of the new service.

The Unison report states: “Social work staff think the NCS Bill creates additional stress and insecurity for a workforce already overstretched and struggling to cope with demands resulting from the public health emergency.”

One social work employee told the union: “If this proposal goes through staff are going to feel concerned about their jobs and their wages and pensions and so on – the whole thing is so unsettling and I know of people already looking for jobs elsewhere. I wanted this job until I retire, now I’m not so sure. I don’t like uncertainty.”

Another said: “Stability is key for staff and clients. This is added stress in an already extremely stressful role and the significant stresses of clients who need continuity.”

A third added: “There will be constant uncertainty for staff. There is likely to be a decline in people training to be social workers.”

The National Care Service (NCS) would bring adult social care – and potentially other areas such as children’s as well as drug and alcohol services – under one national body in a bid to standardise levels of service and pay across the country.

Ministers’ control

THE reforms would see the Scottish Government set up “care boards” directly accountable to ministers that will take on functions and staff who are currently managed and run by local authorities and health boards.

It means that local authorities would no longer run social care services, with power transferred to a series of regional care boards, which Scottish ministers would control.

But concerns have been raised by opposition parties, trade unions and other groups about what they say is a lack of clarity on the face of the National Care Service (Scotland) Bill, which instead will rely on a “co-design” process to create the NCS after the legislation has passed. Unison carried out the survey at the end of last year with members taking part across all of Scotland’s 32 local authorities.

Some 1,082 social work staff completed the online questionnaire. Some 60 per cent of those who participated work in adult services, 24% in children and families teams, 5% in justice social work, and 11% in other areas including addiction services and mental health.

Among the survey’s findings are:

Just 13% of social work staff believe the government’s plans are the best way to improve the quality and consistency of social work services.

 77% say the changes will mean insecurity for staff while 64% are concerned about their pension.

 More than half of social work staff (54%) think removing social work and social care from councils will make their jobs more difficult.

Almost two-thirds of staff working in children and families services (64%) and justice social work (65%) do not support these services being removed from councils.

71% think ending direct public provision by councils will have a negative impact on the people who receive a social work service.

 Staff say what is really needed is investment in social work staffing and resources (94%), better pay, terms and conditions (85%) and enough time to build relationships with the people they support (72%).

The First Minister Sturgeon first outlined plans for the establishment of a National Care Service in 2021 following a review of adult social care by Derek Feeley. A separate review into children’s and young people’s care, “The Promise”, was published in February 2020.

She said the new service would “arguably be the most significant public service reform since the creation of the National Health Service” and that the NCS would merge social care, elderly care, family support and community healthcare into a single service which would be operational by the end of the current Parliament term in 2026.

‘Shocking’

RESPONDING to the social work survey’s findings Tracey Dalling, (pictured below), Unison Scottish secretary, said: “Staff working in social services have wide-ranging duties.

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“They assess care needs, deliver care services, and advocate for some of our most vulnerable people to get their care needs met. They also provide proactive preventative support, diverting people from the NHS, helping more people stay in their homes, or to have a short a stay as possible in hospital.

“This Unison report is comprehensive, and it is shocking that almost nine in 10 of those working social services tell us they have little faith in the Scottish Government reforms and that it will make their jobs more difficult.

“Staff say our social care system is crying out for investment in resources and staff. They say the problem is not that services are delivered by councils.

“The proposed National Care Service reforms will mean an even longer NHS crisis – including longer waits to get out of hospital which means longer waiting lists for those waiting for treatment. The Scottish Government must listen to the vast experience of those working in social care day in day out.”

Scottish Conservative shadow social care minister Craig Hoy: “The SNP, as usual, believe they know best, which is why they are ploughing ahead with their reckless and costly plans for a national care service.

“Ministers should be listening to those staff who are deeply concerned about what these changes will mean in practice and they are already thinking about leaving the sector.

“That will only put more pressure on social care staff, who are already overwhelmed. John Swinney had a perfect opportunity in his budget to divert the £1.3bn earmarked for a National Care Service but he avoided mentioning it whatsoever.

“The SNP need to urgently drop these plans and give every penny to supporting local care services.”

Need for reform

A SPOKESWOMAN for Scottish Care, which represents the independent care sector, said: “Scottish Care agrees that the National Care Service (Scotland) Bill, as it stands, does not fully embrace the ambitions of the Independent Review of Social Care. However, we believe that there remains an urgent need for reform.

“While we asked for a pause in the development of the NCS during a most pressured time for the sector, especially for those working in and accessing care and support, we believe that work on reform to achieve the outcomes as outlined by Derek Feeley must continue at an appropriate time.

“Given the current uncertainty around the development of NCS, it is yet to be determined whether that work would best sit under the NCS or not.

“Social care is experiencing the greatest workforce crisis in recent years, with difficulties in recruitment and retention, and rising vacancy levels. The proposed pay uplift to £10.90 in no way covers the impact of the cost of living, and, worse, sends a message to those working in social care that they are worthy only of an uplift that is around half of what their counterparts working in the NHS are due to receive (3.8% and 7.5% respectively).

“During the Independent Review of Social Care, Derek Feeley noted that a large number of people said that ‘if you are going to invest in one thing, invest in the workforce’. This statement completely resonates with us.

“Scottish Care has long called for investment and support in the social care workforce, to improve recruitment pathways, recognise the highly skilled and professional work that social care workers do, and allow social care to be seen as a valued career.”

Staff pressures

MINISTER for Social Care Kevin Stewart said: “Social workers make an immense and unique contribution in supporting individuals and families across Scotland. I have met many frontline social workers over recent months to discuss the issues affecting the profession and I understand the significant pressures they face.

“As we deliver on ‘The Promise’ and our commitment to set up a National Care Service, a strong and well-supported social work profession is key. The National Care Service will include a National Social Work Agency which will lead the profession and ensure the workforce is supported and rewarded, with suitable career progression and training and development – something that can all too often be lacking under the current arrangements..

“I will continue to engage with the sector including frontline social workers. This is about reinvesting in our social work profession so our social workers can deliver the ethical, human rights-based social work they aspire to.”

Meanwhile, the Scottish Government is having ongoing discussions with Cosla and stakeholders on social work workforce policy, including recruitment and retention, learning and development, pay, leadership, and workforce planning.

Work is also under way on an advanced practice framework for social workers, support for newly qualified social workers and a trauma training programme for frontline social workers.