Published:

FAI Publications,

Social Care Reform in Scotland: context, costs and questions

In June 2022, the Scottish Government laid the National Care Bill in parliament. This followed the Independent Review of Adult Social Care which published its final report in February 2021 and a manifesto commitment to set up a new National Care Service by the end of this parliamentary term.

The Fraser of Allander was commissioned by the Coalition of Care and Support Providers Scotland (CCPS) to look at how much the National Care Service reforms would cost. The briefing we have published today provides an overview of what we know so far.

Read the briefing here.

There are a number of different parts to briefings that we have produced:

Firstly, we have looked in detail at the Bill documents, particularly the Financial Memorandum and have provided a breakdown of the assumptions within this. This is summarised in the briefing document and provided in full in Annex 3. The costings provided by the Scottish Government for the Financial Memorandum have been well thought out, and ranges have been produced to take account of uncertainty. Whilst minor issues were noted, on the whole, the costings provided are of a relatively high standard.

However, the costings provided for the Bill are not the full costs associated with the Scottish Government’s planned National Care Service.  The Bill itself only includes a couple of reforms related to carers. The Independent Review of Adult Social Care (IRASC) recommended a broad range of recommendations, including expanding provision and removing some care charges. The Scottish Government remain committed to these reforms, but they are not in the NCS Bill. The Scottish Government has committed to providing costings to Parliament as they are developed over the process of a co-design process. This is welcome, but this does mean that there will be relatively less opportunity for scrutiny than would be the case if a fuller set of NCS reforms had been ready for inclusion in primary legislation. Ultimately, decisions around sequencing and timing of legislation sit with Ministers, not those who are tasked with producing costings.

Given that there is much interest in understanding the whole scale of reform, alongside analysis of the Bill documents we have laid out as much as we understand on other reforms that are already in the system (primarily around pay) and additional reforms that are likely to come down the line. We have not produced any new costings, but have provided a breakdown of the IRASC costings. Again these are summarised in the main brief and also summarised in Annex 3.

We have not looked in detail at the options for funding the NCS reform programme, other than noting the money that is already in the system, and announcements to date on additional money available. Overall, it looks like there will need to be additional money above and beyond what has already been announced in order for the full reform programme to be taken forward as envisaged.

We hope the information provided in this briefing is helpful for those who wish to understand the known and unknown financial implications of social care reform. It appears that the National Care Bill is only the beginning of the reform journey and there will be much more to analyse and scrutinise in the years ahead.

You can read the full briefing here.

We are happy to share excel sheets that summarise these costings and the financial memorandum assumptions on request.

Authors

Emma is Deputy Director and Senior Knowledge Exchange Fellow at the Fraser of Allander Institute

Ben is an Associate at the Fraser of Allander Institute working across a number of projects areas including economic policy, social care and criminal justice.

Ciara is part of the Knowledge Exchange Team at the Fraser of Allander Institute.

Pauline Bucher