Professor Jackie Taylor, President of the Royal College of Physicians and Surgeons of Glasgow, has welcomed the publication of the Feeley review of Adult Social Care in Scotland. The review calls for a National Care Service to work alongside the National Health Service in Scotland. While the review and recommendations have been outlined for Scotland, there is much that will resonate with other parts of the UK and indeed in healthcare systems around the world.
Along with outlining the case for a National Care Service, the review lays out a number of recommendations focused on a human rights-based approach to delivering care services, improved recognition and consistent support for unpaid carers and truly valuing and rewarding people employed on social care.
Professor Taylor said:
“This is an extremely important report, with much to be considered and is very welcome at this time when we do start to consider how our health systems will operate in the future. As we all recognise, health and social care are inextricably linked.
“While the COVID-19 pandemic has been extremely challenging and I am seriously concerned about the wellbeing of health professionals who have been pushed to the edge of endurance, there is also a great deal of learning that has happened during the past year.
“As the report states we have a real opportunity for change going forward which will come about as a result of courageous leadership and a shared will to make things better. The new system needs to work in full partnership with other aspects of our public services, not only the NHS but in conjunction with all other central services.”
One of the main recommendations outlined by the Feeley review is that the National Care Service’s driving focus should be improvements in the consistency, quality and equity of care and support experienced by service users, their families and carers, and improvements in the conditions of employment, training and development of the workforce.
Commissioning and procurement processes must be improved in order to provide a vehicle for raising the quality of social care support and for enhancing the conditions and experience of the social care workforce. Additionally, careful consideration must be given to options for raising new revenues to increase investment in adult social care support.
Professor Taylor commented:
“I completely agree with the review’s recommendation that delivering a human rights-based system in reality must become consistent, intentional and evident in the everyday experience of everyone using social care support, unpaid carers and families, together with people working in the social care support and social work sector.
“People must be able to access support at the point they feel they need it, including for advice and signposting to local community-based resources and help, and for barriers to this, such as the current eligibility criteria and charging regime, to be fundamentally reformed and removed, to allow a greater emphasis on prevention and early intervention.”
The review calls for people to be able to understand better what their rights are to social care and supports, and “duty bearers”, primarily social workers, should be focused on realising those rights rather than being hampered in the first instance by considerations of eligibility and cost.
It also highlights that carers need better, more consistent support to carry out their caring role well and to take a break from caring with regular access to quality respite provision. Carers should be given a right to respite with an amendment to the Carers Act as required, and a range of options for respite and short breaks should be developed.
Professor Taylor added:
“Prioritising investment in social care is a key feature of Scotland’s economic plans for recovery from the effects of the Covid-19 pandemic.
“Interestingly, the Feeley review has come out in the same week as the Equity and excellence: Liberating the NHS White Paper has been published by the Department of Health at Westminster. It sets out the UK Government’s plans to uphold the values and principles of the NHS that it should be available for all, free at the point of use and based on clinical need, not the ability to pay. The new proposals are launched to join up health and care services and embed lessons learned from the coronavirus (COVID-19) pandemic.
“The Royal College of Physicians and Surgeons of Glasgow welcome the principles of the White Paper which the government describes as a long-term plan to give the NHS a coherent, stable, enduring framework for quality and service improvement. It states that ‘the debate on health should no longer be about structures and processes, but about priorities and progress in health improvement for all. It is a challenging and far-reaching set of reforms, which will drive cultural changes in the NHS’.
“The Feeley review and the white paper come from two distinct and difference sources but reach the same conclusion that the integration of health and social care services is vital.”