National Care Service Consultation Analysis

What is the best way to get the right support at the right time to children and families? Would a national model or a local model create a better space for frontline workers to show humanity and warmth in delivery of services? Would including children’s services alongside adults’ services make transition easier?

These look like a series of different questions, about support, the workforce, and transitions respectively. Not that long ago they would have been divided up and sent to various government departments to find an answer for ministers to give. Then they’d be answered, without reference to each other, citing small scale evidence of the experiences of a handful of families. Question asked and answered, next. Questioners left unsatisfied and unclear whether the answer they’ve been given is going to make any difference whatsoever to their lives.

Except, from the perspective of a child and their family, they are all the same question – how do I get the support I need, when I need it? And, the Scottish Government is attempting to answer this within the proposed National Care Service.

The problem is children and families in Scotland thought the answer to their question was already in progress. Scotland made a promise to them in February 2020 and they’re waiting for it to be kept. For them, and many working to keep the promise made to them, the August 2021 proposal to include children’s services in the National Care Service came left field and changed the question – it’s now ‘will a National Care Service help Scotland to keep the promise it has already made’? Somewhere along the way it feels like the focus changed along with the question - we were talking about what children and families need, now we’re back to talking about what the system wants to do. The difference might feel subtle, but the starting point is important.

To try to make sense of it all, The Promise Scotland commissioned research on the 1,095 published consultation responses to establish the implications of the National Care Service proposals on the promise and, ultimately, to try to find a way back to focusing on children and families. Following the publication of the interim report in March, the final report is published today.

Of the 521 respondents who offered a view on whether the National Care Service should include both children and adults, 112 specifically mentioned the promise. Across both groups, the majority tried hard but ultimately failed to reach a view due to a lack of evidence. In this sense, we’re no further forward. Any decision, made now, on the inclusion or exclusion of children’s services in the National Care Service cannot be evidence based.

But there is hope. The work done by respondents to try to answer the question identified many different angles on the problem which, when analysed, produced a series of questions on the detail that needs to be worked through before the impact of a National Care Service on children and families can be identified. In short, a National Care Service that includes children’s services has a raft of implications for Scotland’s commitment to keep the promise made to children and their families. Only once these have been fully considered can the question be answered confidently.

And, just like the barely noticeable, but definitely present, shift from talking about people back to talking about the system that the proposals brought, there is a risk that Scotland gets lost in the detail, the micro-decisions, the system-focus of the National Care Service in a desperate attempt to make it perfect, and ultimately loses sight of the reality. As one young person who spoke to the research team said, children don’t care whether those who support them work for a national or a local body, they just care they have what they need.

Deciding the best structure to meet those needs starts with focusing on people, what good looks like for them, and then deciding which structure best facilitates that. The litmus test for reaching that point must be objective - if a child and their family were standing in front of you asking whether their support coming from a National Care Service would make their lives better, could you answer them confidently?

The truth is that most people who answered the consultation questions didn’t know the answer. Yet despite that uncertainty there is a lot of hope.

Hope that the National Care Service offers an opportunity to explore what improvement in children’s services should look like. Hope that when we think ‘evidence’, we think ‘children and families’ and not just ‘datasets’. Hope that Scotland can work together and accept that there is no single process that will lead to an easy, conclusive answer. Hope that whether it ends up that a National Care Service is the right next step for children and families or the wrong one, collaboration, inclusion, respect, diligence and determination are the principles we use to work out the answer, starting from the position of what will best meet needs and uphold rights.

National Care Service Consultation Analysis

About the author

Photo credit: Sarah Maclean

Claire Stuart

Head of Insights

Claire leads the Insights Team and is a member of The Promise Scotland’s Senior Leadership Team. The work she leads splits into two parallel programmes:

• data, information and evidence used to track and monitor Scotland’s progress to #KeepThePromise and,
• data, information and evidence as improvement tools across the change landscape.

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