A New National Care Service: Analysis Update

–  A series of blogs about families and substance use by our Policy and Research Assistant, Rebecca McColl

In February 2022, the Scottish Government published its analysis of responses submitted to the National Care Service Consultation in October 2021, to which Scottish Families responded jointly with Scottish Recovery Consortium. You can view our full response here or read our blog post summarising our response.

The Scottish Government received a total of 1,291 responses from both organisations and individuals. Concerns we raised about the short space of time we had to submit a response and the lack of detail in the proposals were echoed by others who responded. 33% of respondents who used the online portal to submit their responses were dissatisfied with the consultation process. Others agreed with our concerns about the timeframe for the proposals, as the Scottish Government estimated the new National Care Service would be complete by 2026. This is simply too long to wait for vital changes that are needed now.

In relation to Alcohol and Drug Partnerships (ADPs), 85% of respondents felt that ADPs would have the benefits of providing greater coordination of Alcohol and Drug Services and 75% felt that ADPs should be able to provide better outcomes for people accessing care and support. Despite this, it was said that confused leadership and accountability was the main drawback of ADPs. Again, our concerns were also raised by other respondents regarding how the concept of ADPs should work would be beneficial to communities, but often this does not translate into real life. However, it was highlighted that ADPs abilities to respond to local needs and bring together a range of local resources is a strong benefit, something we were concerned may be lost as part of a National Care Service. Three-quarters of respondents said that Alcohol and Drug Partnerships should be incorporated into the proposed Community Health and Social Care Boards (CHSCBs). We had some concerns about this proposal, as it was unclear where ADPs would fit into CHSCBs, if at all, and how this would then impact local areas. There was not enough information included in the consultation for us to take a stance at the time of our response.

Furthermore, eight in ten responses agreed that residential rehabilitation services could be better delivered through national commissioning. Again, it was unclear what this would look like in practice, and we highlighted the need for more local rehabilitation facilities that will support people long-term, and prevent people from being separated from their family and friends.

The Scottish Government quoted our response regarding what else needs to be delivered through national commissioning. We highlighted how challenging it can be for people to access support for both substance use and mental health simultaneously. We would hope that in practice, a National Care Service would allow for greater joint working across services and improve outcomes for people with dual-diagnosis.

“Mental health and substance use support needs to become further integrated. We know it can be extremely difficult for people to access support for both substance use and mental health, and understand the Scottish Government is aiming to achieve integration through a National Care Service.” (Scottish Families Affected by Alcohol and Drugs (SFAD); Scottish Recovery Consortium (SRC)).

Lastly, our emphasis on the need for lived experience throughout was echoed by others who submitted a response and were acknowledged by the Scottish Government. We believe if the National Care Service is to happen successfully, lived experience must be at the heart of the creation process, and stay there.

What happens next?

The Scottish Government has said the consultation and the analysis represent the first phase of engagement for the National Care Service. They say they will continue to engage with us moving forward, putting people with lived experience ‘at the heart’ of their work. Now we need to see a clear roadmap of what the National Care Service will look like, how it intends to implement change, a realistic timeframe for completion and details on how it will be funded. At the moment, there are still more questions than answers

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