Social care improvements needed well before National Care Service, MSPs told

Auditor General Stephen Boyle said problems with the recruitment and retention of staff must be urgently addressed.

The Auditor General has warned that the social care sector needs urgent improvements ahead of the development of a National Care Service (Andrew Matthews/PA) (PA Wire)

Social care staff need to have better pay and working conditions if the Scottish Government is to establish a National Care Service, Scotland’s Auditor General has said.

Holyrood’s Audit Committee heard there are “major problems with recruitment and retention” of workers in the social care sector and existing staff do not feel valued or properly paid.

Giving evidence to MSPs about his report into social care, Stephen Boyle said improvements must be made urgently and he warned: “Some things cannot wait for the establishment of a National Care Service.

“Stakeholders have told us about services in near crisis, and that a lack of ambition now presents serious risks to the delivery of care services for individuals.

The Scottish Government now needs to take action to improve working conditions for this vitally important workforce, otherwise it wouldn't be able to deliver its ambitions for social care

Stephen Boyle, Auditor General for Scotland

“The Scottish Government needs to take a pragmatic approach and set out what can be improved now without legislation, while also taking time to determine where the National Care Service can add most value.”

The Audit Scotland report found there were 209,690 employees in the social care sector but Mr Boyle suggested the Scottish Government’s pledge to invest another £800 million over the five-year parliamentary term “hasn’t addressed the very specific challenges that the sector is currently facing in terms of very high vacancy rates in the sector, and the overall attractability (sic) of people wanting to come into a very responsible, demanding role”.

Setting out some of the “challenges that need to be addressed”, he added: “Concerns about career progression, stress, anxiety, the burden that has been placed upon people who’ve worked in a sector – particularly during the course of the pandemic – and that there are other options for people to deploy their career choices.”

Addressing the staffing crisis, Mr Boyle said: “We know that the social care workforce has been under immense pressure, both before and during the pandemic.

“The predominantly-female workforce does not feel adequately rewarded or valued, there are also major problems with recruitment and retention.

“Both the Fair Work Convention and Fair Work and Social Care Group have made recommendations. The Scottish Government now needs to take action to improve working conditions for this vitally important workforce, otherwise it wouldn’t be able to deliver its ambitions for social care.

“A quarter of staff leave within three months, nearly 90% of social care providers say that recruitment and retention is problematic, and some of the representative bodies have had to reduce the volume of care as a consequence of some of the recruitment and retention issues that they’ve experienced.

“These factors existed before the pandemic, but were exacerbated by it.”

Mr Boyle also bemoaned a “lack of collaboration” and integration across the Scottish Government, NHS Scotland and local authorities despite warnings and pleas over the last decade.

He said: “For the best part of 10 years, we’ve sought to move towards a more preventative agenda for health and social care, providing care closer to people’s homes.

“All of these factors haven’t been addressed sufficiently to lead to better experiences for people who are using and relying on the provision of health and social care.

“We’ve said over many years – frustratingly so – that some of these cultural differences need to be addressed to move to a more collaborative approach but yet we’re still here reporting concerns that culture is still getting in the way of better outcomes for people.”