8 July 2025
As the professional association for social work leaders in Scotland, we must note deep concern at the content and development process of the Health & Social Care Service Renewal Framework (SRF) 2025–2035, jointly published by the Scottish Government and COSLA. While the ambition to improve the sustainability, efficiency, and quality of Scotland’s health and care system is welcome, the Framework overwhelmingly prioritises the NHS and continues to marginalise the essential contributions of social work and social care.
As a committed stakeholder working to support and improve outcomes across the social work, social care, and health landscape, we find it particularly disheartening that Social Work Scotland – both our core team and our membership – were given no opportunity to contribute to the development of this document. Beyond its brief introduction at the COSLA Health & Social Care Board and Mental Health Stakeholders Group, there was no engagement with us during its drafting. Indeed, we were not even made aware of its scheduled publication. This lack of inclusion is not only disappointing; it undermines the very principles of collaboration and integration which the Framework claims to uphold.
The Framework fails to treat social care and social work as equal partners in the reform of health and care. While it gestures toward person-centred support and community-based approaches, it is telling – and troubling – that there is no mention of the Social Care (Self-Directed Support) (Scotland) Act 2013. This legislation is foundational to delivering choice and control in social care, yet it is entirely absent, raising real concerns that the principles of choice and control are being interpreted narrowly through a healthcare lens.
In the two SRF-related presentations attended by Social Work Scotland, NHS Boards were consistently profiled by Scottish Government officials as key stakeholders and referenced separately from Integration Authorities and Health and Social Care Partnerships. This raises questions about whether NHS Boards are now being treated as primary actors in spaces where Local Authorities have statutory parity. Moreover, repeated references in the document to “the social care system” are conceptually flawed; unlike the NHS, social care does not exist as a single system but as a diverse and complex set of services, often locally commissioned and community-delivered. Framing it as if it operates in the same way as the NHS is misleading and unhelpful.
The imbalance in the Framework stands in direct contradiction to other key Scottish Government policies. The Programme for Government 2025–26 pledges to reform public services through prevention and person-centred, outcomes-focused approaches. The Population Health Framework stresses the importance of tackling the social determinants of health. And the Operational Improvement Plan highlights the need for cross-system collaboration and integrated improvement. Yet the SRF reinforces silos and elevates medicalised, acute-focused solutions – undermining the delivery of these national ambitions.
Social work, rooted in principles of early intervention, empowerment, and community connection, is crucial to any meaningful reform of public services. Without proper visibility, investment, and strategic positioning of social work and social care in the SRF, its stated aim of transforming Scotland’s health and care landscape simply cannot be achieved. If the intention of the Framework is to focus on NHS service improvement, then it should be framed transparently and explicitly as such – and we would support that. But we cannot endorse a Framework that purports to set direction for all of health and social care while offering, at best, tokenistic consideration of key sectors and professions.
