Fiona Duncan: One question and one question only series: The Promise Scotland's approach and methodology for responding to the NCS consultation

This is the fourth, last – and longest – article in the ‘One question and one question only’ series about the Scottish Government’s consultation into the creation of a National Care Service.

For the full picture, please read the other three blogs:

1. sets the scene,
2. possible opportunities, and
3. possible challenges and risks.

This one focuses on the approach that The Promise Scotland has taken to inform its response to the consultation and the methodology deployed to reach its position.

Since the beginning of August, when the Scottish Government launched the consultation, I have listened carefully to many partners, individuals and organisations, all committed to #KeepThePromise, and am aware of the broad range of views.

Arguments have been made that the inclusion of children’s social work and social care services in a National Care Service, and the associated change effort required, will shift focus and attention away from the vision of the promise, will slow or thwart the progress underway to #KeepThePromise and ultimately make life more difficult for children and families. The opposing view has also been offered: that the proposal becoming a reality will accelerate the pace of change, make holistic family support the norm, break down structural and bureaucratic barriers, and make realising the vision more likely.

While views differ, there is a collective understanding that the status quo cannot continue and that changes and improvements must be made now to maintain pace and make the necessary progress to #KeepThePromise by 2030, at the latest.

As The Promise Scotland’s single reason for existing is to make sure the promise is kept by 2030 and it has no organisational stake in what structural arrangements should be in place for children’s services, it’s in an unique position to respond to the consultation.

Throughout its work, the sole question guiding The Promise Scotland’s approach has been: will a National Care Service #KeepThePromise?

As detailed in blogs two (opportunities) and three (challenges and risks) the team deployed a thorough, evidence-based methodology, outlined in brief below.

• Revisiting the Independent Care Review’s Evidence Framework to assess the proposals against each of its 80+ conclusions.
• Re-examining the cross-referencing work carried out in February of this year, when the Review of Adult Social Care published its 53 recommendations. This was done with a view to mapping them against the Independent Care Review conclusions published the February before.
• Assessing the implications on the live implementation plans to #KeepThePromise. This involved considering the impact of the creation of a National Care Service on Plan 21-24, which still has over two years of work ahead.
• Considered the consultation questions in relation to the twelve composite stories developed from and with the hundreds of children and young people who shared their experiences with the Independent Care Review.
• Comprehensively assessing of the implications of the proposed National Care Service.

Based on all of this work, The Promise Scotland’s position is that there is no clear evidence, as to whether a National Care Service will or will not #KeepThePromise.

This doesn’t mean that the arguments being made by others ‘for’ and against’ are not valid – in its evaluation, The Promise Scotland found that many aspects of the consultation have an equal and opposite opportunity and risk.

Early next week, when it’s submitted to the Scottish Government, The Promise Scotland will post its response to the consultation on the website.

And later that week, The Promise Scotland will invite tenders to carry out independent analysis of all published responses which make specific reference to the impact of this proposal on Scotland’s commitment to #KeepThePromise.

It is clear that the Scottish Government proposal has stimulated important discussions, debates and reflections as individuals and organisations have given very thoughtful consideration to their final responses. Many of these responses will have considered the optimal structural and organisational arrangements that are required to enable Scotland to #KeepThePromise. The Promise Scotland values feedback so the analysis it commissions will be appreciative and curious, designed to capture the range of views, assess what has informed them and positions taken, and establish what can be learned.

The Promise Scotland understands that the Scottish Government is not required to publish the responses it receives. If you have a view on the possible impact on the commitment to #KeepThePromise please do publish your response and if you are willing for it to be included in The Promise Scotland’s analysis email it to hello@thepromise.scot.

Because, regardless of the decision on structure, Scotland’s commitment to #KeepThePromise will remain, and therefore so will The Promise Scotland’s mission.

But the consultation has already interrupted and delayed both the process and pace of change.

The new uncertainty created by the government’s proposal of imminent, significant structural change has allowed inertia to thrive. It has provoked questions about whether this ‘piece’ of the system will remain or not, whether to dedicate resources to change it now, or wait

This is not new.

At any given time, over the course of its three years, the Independent Care Review tracked and connected to around 20 parallel reviews, inquiries, commissions, all examining intersectional issues from different angles, within different timeframes, and taking account to a greater, or more often lesser extent lived experience.

This potential risk that the next set of conclusions might contradict the previous one leads to circumstances that contribute to inaction or worse still permit paralysis. And when conclusions don’t align, there needs to be a change of course, a detour from the previous forward motion.

Imagine if the Homeless and Rough Sleeping Action Group (HRSAG) which ran until summer 2018, and the Independent Care Review had reached divergent conclusions. What would that have meant for care experienced people who have more than double the chance of experiencing homelessness, mainly before they reach 30? Fortunately, as a result of their complementary methodologies that listened to lived experience, and the links made between the reviews, they didn’t.

In itself, this perpetual motion is a major contributor to Scotland’s policy ‘implementation gap’.

It creates uncertainty, devours energy and resources, causes chaos and provides, for those who want to avoid change, something to hide behind.

It gets in the way of a vision.

For many organisations involved in the collaborative work to produce Plan 21-24 and Change Programme ONE, it was their shared commitment to the Independent Care Review’s vision that galvanised them.

This alignment also informs the rationale behind their argument to progress with set-up of the most substantial aspect of the National Care Service – adult social care - and postpone any decision on the inclusion of children and families until Plan 21-24 is concluded.

This does not mean to wait.

It is to proceed with implementation of most of the conclusions of the Review of Adult Social Care.

Nor does this mean to do nothing.

It is to honour existing commitments to #KeepThePromise, provide sufficient resourcing to accelerate improvements to outcomes for children and families, including the £500m Whole Family Wellbeing Fund, to invest in making sure change happens - at sufficient pace and quality.

The Independent Care Review was clear about the urgency for change, and as stated in Change Programme ONE there’s ‘no excuse for any part of Scotland’s ‘care system’ to do nothing, nor any excuse to wait’.

But I digress...

The Promise Scotland has not responded directly to the binary nature of the main questions posed within the consultation, instead it has concluded that there is insufficient evidence for or against the inclusion of children and families services in a National Care Service.

Of course, there is comfort in binary thinking when it comes to defining a solution – this or that.

But this over-simplification requires a choice of one or the other, overlooks or ignores complexity and doesn’t invite debate about alternatives, exploration of spaces in the middle.

The Promise Scotland’s position cannot be used to serve either argument – because it does neither.

It recognises that there are aspects of a National Care Service that would #KeepThePromise if other decisions, links, processes, and structures are also in place. Many are included in Plan 21-24 and Change Programme ONE, others aren’t as they are not currently of relevance to #KeepThePromise.

It was reached via The Promise Scotland’s commitment to its obsolescence, without a vested interest, with an ability to retain an unwavering focus on the change required to #KeepThePromise.

The position acknowledges there are unasked questions in the consultation that require to be answered before a full assessment can be made. Such is the case of specific requirements in relation to supporting a single planning approach for families.

This reflects the approach The Promise Scotland has taken in its response – an assessment of the extent to which the proposals as a whole, and each relevant question, will support Scotland to #KeepThePromise.

Where there are consultation questions that are not applicable to #KeepThePromise, The Promise Scotland has not provided a response.

Between now and the decision about the shape of the National Care Service, The Promise Scotland will remain engaged in this national discussion, advocating solely for Scotland to #KeepThePromise as swiftly as it can to its children and families.

Ultimately, The Promise Scotland champions people, organisations and institutions, who want to work towards the vision of a Scotland where every child grows up loved, safe and respected, able to realise their full potential. Its role is to offer advice, counsel, and support to organisations who are working towards delivering the change demanded by the Independent Care Review, and to call out shortcomings and failures.

This will not change, regardless of the decision that will be taken.

Another argument heard again recently and worth acknowledging here is that fundamentally, the ultimate structure isn’t the issue that will have the biggest impact on experiences and outcomes or matter most to children and families. Being treated with compassion and respect, getting the support needed when it’s needed, being shown love.

The Promise Scotland recognises that there is no one-size-fits-all solution: keeping the promise will take time and investment, but, most importantly, collaboration, concerted efforts, and a commitment to lasting solutions.

There is no plan B – the promise must be kept.

And there are no shortcuts to keeping the promise. The more than 80 conclusions of the Independent Care Review must all be implemented, in sequence, at pace, and in full. There may be more than one way to do this, but there can only be one outcome: a promise kept.

About the author

Photo credit: Sarah Maclean

Fiona Duncan

Independent Strategic Advisor

Fiona Duncan is the Independent Strategic Advisor on the promise, and advises Scottish Ministers in this capacity.