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DateTitleDownload
13/01/2021

The impact of the COVID-19 pandemic on equalities and human rights

JOINT SUBMISSION FROM SOCIAL WORK SCOTLAND AND SCOTTISH ASSOCIATION OF SOCIAL WORK TO THE SCOTTISH PARLIAMENT’S EQUALITIES AND HUMAN RIGHTS COMMITTEE INQUIRY

13th January 2021  

Social Work Scotland is the professional body for social work leaders in Scotland. The Scottish Association of Social Work (SASW) is part of the British Association of Social Workers, an independent membership body for social workers across the UK.  Both organisations work closely with partners to shape policy and practice and improve the quality and experience of social services.  We are responding to this inquiry together, bringing together the views of frontline social workers and managers who are employed in the public, private and voluntary sectors, as well as those operating as independent practitioners. Our joint membership is diverse, and being located across all parts of Scotland, experiences throughout the pandemic have been highly variable, in line with the differences decisions and approaches taken by local areas. We profile in this submission here the common themes to emerge from their feedback over the past ten months.

KEY POINTS

  1. While acknowledging that COVID-19 has manifested some new equality and human rights issues, overwhelmingly its impact has been to exacerbate existing inequalities and lay bare the fragility of the systems (services, people) who protect and give meaning to human rights. This is particularly the case for those individuals whose rights were more vulnerable prior to the pandemic, due to age, disability, gender, sexuality, socio-economic status, race and ethnicity, housing security, mental health, etc. Well-resourced public services (such as social work and social care) as well as an active civic society (including charities, voluntary organisations, etc) are essential to the realisation of Scotland’s vision of a rights-based, equal society. Instead, the funding of the social care system has fallen in real terms over the decade of austerity – in the opposite direction to increasing need due to demographic and other changes.
  2. The many different dimensions of social inequalities create overlapping layers of disadvantage, which are multiple for many people; these have been tracked by the disproportionate impacts of the pandemic. In managing our ongoing response to COVID-19, and in our “rebuilding better” after, careful attention must be paid to the views and needs of these specific groups, ensuring plans take account of their vulnerability to the virus itself and/or its wider socio-economic and mental health effects, and deal with root causes.
  3. Social work is a critical component in many public service systems. In children, adult and justice services, social workers mediate access to a wide range of support (e.g., child and adult social care), deliver specific interventions and protect the interests of those unable to do so independently. COVID-19 has restricted social work’s ability to perform these functions, due to staff absence, work-from-home restrictions, limited PPE (in the early stages of the pandemic) and prioritisation of other urgent issues. As a result of social work being less present and accessible, the rights of some individuals will have been affected. Social workers, with colleagues across social services, have worked tirelessly to minimise this impact, but there are limits to what can be achieved through remote working or with depleted teams. Vaccination holds out the promise of a return to face-to-face interaction and relational work on a much wider scale than is currently possible. However, the impact of COVID-19 on the profession, and the organisations which employ them, is likely to stretch over a number of years. Any plan to re-address the inequities and rights impact of the pandemic must have within it a commitment to address issues impeding the delivery of effective social work practice.
  4. The pandemic has revealed the limitations of a ‘rights bearer’ and ‘duty holder’ framing of human rights. Corporate bodies, such as local authorities, may hold duties to uphold rights, but those corporate bodies are in reality just organised groups of people, all with their own needs, vulnerabilities and rights. The response to COVID-19 has, universally, forced employers to consider the welfare of their staff, and the urgency and risk of the work they are involved in. Within the NHS, that has led to the cancellation of operations and delayed treatment for thousands of people. For social work and social care, it has meant, in some cases, reductions in the level of support which can be made available. A realistic appraisal of the impact of the pandemic on rights and equality should highlight the responsibilities of employers to keep their people safe, and the enormous challenges they faced in the early stages, seeking to securing solutions which would enable professionals and others (such as social workers, social care staff and carers) to resume their work.
  5. Just as people rely on other people to give meaning to their human rights, the rights of different individuals can sometimes be in tension, or even conflict, with each other. In some cases, an individual’s exercise of their right to put themselves and/or others into potential harm. It is the unique role of social work to assess an individual’s needs, understand their wishes, and to promote their interests and wellbeing within the framework of their human rights and the current service / resource context. Sometimes this involves taking decisions in an individual’s interests which are at odds with their (or a family or friend’s) wishes. Such situations demand a high degree of sensitivity and skill to manage, and are, by their nature, often contentious and emotive. We make this point to underline the importance of taking a broad and nuanced perspective in any evaluation of how human rights have been impacted in the pandemic. Every individual’s story is complex and multifaceted, and understanding comes from a breadth of perspectives.
  6. The virus, its impact on people’s health, and the impact of the measures we have taken to contain its spread, have most affected least advantaged in our society (on all dimensions: income and wealth, housing, digital, social, etc). 2020 and 2021 will have served to exacerbate our existing inequalities. Our hope is that, in having these inequalities more clearly surfaced, and a wider proportion of the population made aware, through their own experiences, of the challenges brought about by low incomes, isolation and family stress bring, the public’s appetite for addressing the underlying structural factors will be strengthened.

QUESTION 1: HOW HAVE GROUPS OF PEOPLE BEEN AFFECTED BY THE VIRUS?

In assessing COVID-19’s impact on equalities and human rights it is helpful to distinguish between the effects related to (a) the virus and disease itself[1], and (b) the actions taken by public authorities to contain the spread of the virus and protect vulnerable groups, access to emergency services, etc. Social workers have been involved throughout the pandemic in mitigating the impacts seen in both domains (albeit the majority of our activity has focused on the issues created by state efforts to contain the virus, which have affected every member of society in some way).

(A) Impact of the disease

As has now been well documented, the disease COVID-19 does discriminate. It has, to date at least, disproportionately affected older people, those with underlying health conditions, members of our Black, Asian, and other Minority Ethnic communities, and people with low incomes or precarious employment (e.g., zero-hour contracts). The reasons for this prejudice are various, including, in these groups, higher than average numbers of people living together under the same roof (be it a care home or family home), exposure to the virus through public facing roles (e.g., public transport workers, nurses and healthcare assistants, etc.) and above average rates of pre-existing co-morbidities (e.g., diabetes, obesity, hypertension). These factors coalesce together into an increased risk of catching the virus, and then an increased risk of the virus manifesting a serious or fatal response.

The impact of these increased risks has manifested in many ways, with individuals and families affected by some or all of the following:

Stress and anxiety

  • Worry for self and family, about illness and/or social and financial impacts
  • Worry about transmission of the virus to loved ones, known contacts, professionals and carers, colleagues, other residents in home or accommodation, unknown members of the public, etc.
  • Worry about putting pressure on the health service, reducing its capacity for others.

Loss of income

  • Actual reductions in income because not able to work

Loneliness (reduced human contact and self-isolation)

  • Reduced in person contact with family, carers and professionals.

Recovered but with “long covid”

  • Development of chronic health conditions, impacting on long-term ability to work, participate in education, society, etc.

Time in hospital

  • Range of experiences including near-death and trauma, as well as the joy of survival
  • Consumption of scare resources including deferment of services required by people with other medical conditions leading to ‘survivor guilt’.

Decline in mental health

  • Various psychological impacts, exacerbating existing conditions and provoking new ones.

Death

  • Loss of future lives
  • Bereavements and long-term loss to loved ones, families, friends
  • Financial loss to families and wider society (multipliers, taxation, etc)
  • Loss of contributions to society, and local communities

This is not an exhaustive list, but it illustrates that, for those who have caught the virus the potential impact on their human rights cannot be more serious, with loss of mental and physical health, work, and even life. And with the knowledge that the COVID-19 virus does not affect all groups in society equally, but that all groups are interconnected, it is understandable that governments around the world have taken such drastic all-of-society action in their efforts to contain it.

(B) Efforts to contain the virus

The public health measures introduced to slow the spread of the virus only have historical comparators in wartime. Every aspect of life and every individual, family and community has been affected. The scale and severity of restrictions (on the economy, social contact, movement, etc.) has meant that the virus, directly or indirectly, has impacted the rights and wellbeing or every person in the UK. But as with the discriminate impact of the virus, affecting some groups more than others, the impact of efforts to contain it have not fallen evenly on society. As social work practitioners and managers we have had a front-line perspective on this throughout the pandemic; particularly in respect to people who are vulnerable or need additional support, for whom we provide or coordinate services. This includes children, families, parents, carers, adults with disabilities, older people and people involved in the criminal justice system.

Among the many impacts of restrictions over the past year, of particularly note in respect of this inquiry are:

Increased levels of poverty

  • Poverty, much of which existed prior to the pandemic, is a key underlying factor for the escalation of crisis in many households[2].
  • Financial pressures resulting from insecure or total loss of employment and/or insufficient government support (for example where individuals must self-isolate) has contributed significantly to financial insecurity. The Government’s commitment to free school meals and increased levels of financial support have ameliorated this to some extent, but the medium to long-term impact of increased anxiety within families (and to individuals within those families) may be serious.
  • Increase in food poverty (with its concomitant impact on education, health, etc.).[3]
  • Increases in applications for welfare and crisis support[4]. Accordingly, social work has faced increased demand for practical support around income maximisation and housing.

Digital poverty / inequality

  • Some individuals / families have been able to continue to participate effectively in school, healthcare, routine assessment, etc. thanks to digital connectivity. Indeed for some people the move of many services online has been beneficial, removing the need and cost of travel, etc., and changing the terms of their interaction with professionals. However, for others the move online has meant marginalisation, and the loss of support / a service. The pre-existing ‘digital divide’ – reflecting inequality of access to knowledge, hardware, software, data and support – has been exaggerated, with those most likely to lose out being those already most disadvantaged. Digital connectivity is no longer a “nice to have” when essential services move online.
  • The move online has also encouraged new types of financial fraud, increased exposure to on-line sexual grooming and the potential for other forms of exploitation of vulnerable people[5].

Disruption to referral routes for social work and social care

  • Because engagement with schools, GPs, hospitals, etc. has significantly reduced, along with home visits by nurses, voluntary organisations, etc., referrals to social work or police for vulnerable children and adults have been disrupted, leading to delays in issues being identified. Early notification of concern is critical to prevent situations deteriorating further, leading to more serious problems.

Disruption to social work, social care and community services

  • Social work and social care services entered the pandemic with insufficient capacity to meet demand related to population aging, widening inequalities and growing social care needs[6]. As the pandemic took hold, sickness, self-isolation and re-deployment reduced capacity further. Limitations on PPE, national guidance on home visiting and other factors also impacted on social work’s ability to reach people vulnerable or in need.
  • Voluntary sector and community organisations / services forced to close (e.g. day services, etc.), restricting the opportunities available to certain groups, such as those with disabilities, to leave their homes, maintain relationships, etc.
  • Public sector and independent (voluntary or private sector) providers of care and support forced to reduce the care packages they can service.

Increased isolation and loneliness, impacting on mental health and wellbeing

  • Isolation and loneliness have increased across all sections of the population, with significant impact on mental wellbeing and mental health. However, for individuals and families who were already isolated (as too many older people, adults with disabilities and parents were) the closing of services and reduction of interaction / visits from family, carers, support workers, etc. has exaggerated this further.

Increased pressure within families

  • Poverty (be it financial, food, digital, housing) creates stress within families. The government’s efforts to contain the COVID-19 pandemic have increased those pressures within many families.
  • Further pressure has been built through individuals spending extended periods of time exclusively together at home, the demands of home schooling, disruption to exams, young people’s lack of access to friends, the general social anxiety about the future, etc.

As with the impacts of the virus itself, this list is far from exhaustive. What we have tried to illustrate is that the restrictions imposed have surfaced the significant inequalities which existed in society before the pandemic. And, moreover, that the fulfilment of people’s human rights relies on a broad base of civic and public services being accessible. This is particularly true for people and families with fewer socio-economic advantages. Remove the scaffolding from around individuals and communities, and the structure is less resilient to major external and internal stresses.

QUESTION 2: WHICH GROUPS HAVE BEEN DISPROPORTIONATELY AFFECTED BY THE VIRUS AND THE RESPONSE TO IT?

  • Children and Families:

Children, as a cohort, have been particularly affected because of the disruption to education (from early learning and childcare through all stages of school) and the dramatic reduction in opportunities for play, peer and extended family interaction, creativity, learning, travel, etc. These opportunities, complementing formal learning, shape the adults we become. The absence of school and other child/youth activities has also significantly reduced the chance to identify issues early and offer help. That is particularly problematic for young people’s mental and physical health. The long-term legacy of these COVID-19 months is yet to be seen, but it is children and young people whose lives will be most shaped by it. The world of employment will be changed (possibly with fewer of the sort of jobs young people begin with), and public debt built up to underwrite the government’s response will shape public and political debate for decades to come. At an individual level, disruption to schooling and issues with mental health may determine many future choices.

Within the cohort of ‘all children’, specific groups have been affected more than others. For example, those affected by domestic abuse. Levels of domestic abuse in Scotland have been a persistent concern for social work, charities and policy makers for many years, but on the basis of calls to third sector helplines, the pandemic has led to increased prevalence. This is consistent with what we know about domestic abuse, and its relationship to wider stressors within the family. With services reduced or closed, and people encouraged to isolate as much as possible, we have reduced our collective ability to spot and respond to cases at the early stages. This has limited our capacity to protect the rights of children (and others impacted by abuse within the household). Our experience suggests that much greater support is needed for non-abusing parents and children, and that we must engage much more effectively and assiduously with perpetrators. Many local authorities and organisations were building these strengths-based approach (such as the internationally recognised Safe and Together™[7]) at the start of the pandemic, but unfortunately work in some areas has had to be delayed to accommodate other priorities.

The true extent of child sexual abuse and child criminal exploitation through the pandemic has been hard to gauge[8], but we expect it to have increased. Third sector colleagues and the police draw attention to the significance of interaction between technology-assisted and direct contact abuse, and with the move of children’s lives online, the increased risks. The pandemic has underlined the need for a closer examination of the context of abuse outside the family, and a consideration of how to intervene in both physical locations and online platforms (a theme explored in a recent Social Work Scotland hosted seminar[9]). More generally, ensuring child protection during COVID-19 has been challenging, with the everyday monitoring provided by schools and other universal services reduced or removed. Social work professionals themselves have been restricted in their ability to interact with families, with reductions in home visits, supervised contact, etc. Colleagues report concerns about patterns of Forced Marriage, Female Genital Mutilation and Honour Based Abuse.

There has also been a disproportionate impact for children involved in the Children’s Hearings System and courts. Permanence decisions have been delayed, existing Orders have been rolled forward without expiry date (meaning that families risk being subject to state intervention longer than necessary), and only priority case have been heard by Children’s Hearing panels, potentially limiting access to services from social work and others. Figures provided to the Scottish Government (as part the monitoring of COVID-19’s impact) indicate that since March 2020 there has been a significant reduction in the number of children becoming looked after away from home.[10] At this stage there is not enough data and intelligence to confirm whether this is as a result of system changes or limited access to resources and not necessarily because of reduced need or better practice. This needs to be explored to ensure that children’s rights are not at risk from inaction.

The challenge of promoting the relationships and wellbeing of children looked after away from home has been accentuated by COVID-19. Social Work Scotland has been central to the development of a framework for decision making about contact[11], assisting practitioners make extremely difficult decisions.  For example, there have been significant challenges around contact, for example between children and birth parents, balancing the benefits with risks, such as spreading the virus to foster or kinship carers (often an older population) or between different parts of the country (which may have different rates of infection and restrictions in place). The limited number of safe physical environments for indoor contact has further restricted options.

Social workers have consistently reported how stretched and affected many kinship and foster carers, and the children in their care, have been, with individuals feeling isolated and disconnected from their normal networks (formal and informal) of support. Local areas have done creative work using virtual support and new models of practical, material help, but for many of these families it has remained a very difficult year. We take heart from the adaptation and resilience the families have shown, and the positive stories emerging of, for instance, effective family group decision making taking place which have kept children out of the care system.[12]

Families with children who have complex physical or learning needs have been particularly impacted by the closure of educational settings, having to assume 24 hour responsibility for care and education. There are specific risks for these families in terms of isolation and burn out without frequent opportunities for support and respite. And for those at or near school leaving age, the crucial transition planning for people with additional support needs (enabling them to make successful moves into further and higher education, or employment) has been disrupted, opportunities restricted.

(B) Adults

Adults living in care homes, whether older people or adults with complex needs, have been disproportionately affected by the virus and the response. In the first phase on the pandemic, there were high levels of excess deaths (compared to the weekly 5-year averages for 2015-19, not all of which were recognised on death certificates as COVID-19 related during the period before testing became more widely available[13].

Some social care workers in residential homes, and also in the community, have also died as a result of contracting COVID-19 through their work, as sadly has been the case for other groups of essential workers.

From a social work perspective, it became increasingly important to ensure that people’s human rights and mental health were being considered alongside (rather than secondary to) clinical excellence and infection control. Issues as varied as discharges from hospitals to care homes, restrictions on visits, limited interaction within homes, mass testing, use of Do Not Attempt Cardiopulmonary Resuscitation forms[14], have all presented complex and nuanced decision making. And they have proved highly problematic for many care homes, especially those supporting people with cognitive needs. The enhanced oversight of care homes duty, placed on Chief Social Work Officers and other professional leaders, was an attempt to ensure a balanced assessment of risks, rights and needs in shaping local strategies. As we write, the vaccination programme is being rolled out through care homes, and we hope this will enable residents to access their rights to see family and friends, and to ensure they get the full range of services and supports they need.

At the core of the social work role is public protection; assessing risks and benefits in an ecological model, with the aim of securing the best outcomes for an individual, with their needs and wishes met and interests protected. In some instances, social workers are empowered to take actions to protect the interests of an individual, possibly bringing them into conflict with the individual or their carer / family, who wish to take a different course of action. This is a difficult but essential role in a society where not all individuals, whether due to incapacity or circumstances, are in a position to determine their best interests alone. And while families have a undisputed right to inform and lead decision-making in such instances, it is the case that they do not always have access to all the information, or necessarily have the rights, needs and interests of the individual as their primary concern. Over the course of the pandemic, with the social work profession’s ability to perform this role has been restricted, leading to concerns about the welfare of such as for adults with incapacity. Due in reduced reporting channels (fewer agencies and primary care contact with people and families at risk of crisis) and restrictions on movement and interaction, it has been difficult in some cases to ensure the rights and welfare of some individuals’ are being maintained.

Early intervention and community supports are critical to maintaining good mental wellbeing and mental health. Where these are not available, we can expect to see more people reaching mental health crises. This is likely to be compounded where the economic situation is worsened. With people’s mental health needs going unmet, detention – a deprivation of an individual’s liberty – is being considered more frequently than we, as a professional group involved in such decisions, would like to see it. As officers of local authorities within partnership arrangements, Mental Health Officers (specialist social workers with additional qualifications in mental health) are not sufficiently empowered to ensure provision meets assessed need. To ensure the rights of individuals with mental health issues are upheld, MHOs (and other relevant professionals) need access to specialist and community resources, over which people are offered choice and control. We believe that decisions regarding detention should be made after face-to-face assessment of patients, but we are aware that due to staffing constraints, this is not always the case.  Whilst the number[15] of people being detained due to their mental health has risen during the pandemic, this is in line with year on year rises. There is evidence, however, from the Mental Welfare Commission that some of the safeguards around detention have been used less frequently than previously. We are concerned about the critical shortage of both MHOs and “Section 22” medical professionals.  We note that the Tayside Independent Review report “Trust and Respect” was explicit in finding that a shortage of Registered Medical Officers impacted detrimentally on the patient’s journey.

People who are homeless initially benefitted from the programme to ensure that everyone was off the streets, and the route map for “Everyone Home”[16] has been developed to make asking about homelessness an expectation across public services.  However, in order for this success to stand beyond the pandemic, public services must continue to be resourced appropriately to attend to the multiple underlying structural causes of homelessness (including additions, mental health, debt, etc.). Otherwise, we risk returning to pre-pandemic levels of homelessness (or higher, considering the precarious financial situation many people face), with the additional challenge of a diminished voluntary sector, its finances limited after a year of reduced income.

(C) Adults involved in the justice system

Justice Social Work delivers reports to Scottish Courts, provides or commissions community-based programmes as an alternative to prison, and is responsible for a range of expert risk assessment support to the police, prison service and Parole Board.  Requirements for physical distancing, and the universal impact on staffing through sickness, isolation and redeployment, have reduced the ability of justice social workers to deliver group programmes and coordinate unpaid work activity. This has a very significant impact, in terms of rights and equalities, on the individuals subject to relevant courts orders, effectively extending sentences and prolonging involvement with the justice system.

Both Social Work Scotland and SASW[17] have articulated concerns to the Scottish Government around the backlog of community order ‘unpaid work’ hours[18]We believe that without a systematic reduction in the number of outstanding unpaid work hours (through revocation or variation of orders) there is a major risk that Justice Social Work (JSW) will be overwhelmed, with serious consequences for the wider justice system and the rights of both social work professionals and individuals and families, and victims. Whilst some funding has been made available to buy in support from the Third Sector, this will not release the number of hours necessary to meet the backlog in demand.

Before the Coronavirus pandemic there was an increasing focus on expanding early intervention measures such as Diversion from Prosecution and Structured Deferred Sentences which help individuals to avoid unnecessary contact with the criminal justice system and deliver swift interventions which can interrupt a cycle of offending. Many of the strategies now in place to deal with the backlog within the justice system require heavy input from CJSW, but simultaneously the capacity of CJSW has reduced[19].

People in prison have experienced significant additional curtailments to their rights as visits, time out of cell, meaningful daily activity and access to fresh air have all been reduced.  Numbers of people on remand have increased as has the length of time people are remanded impacting on people’s lives, housing, work finances and relationships. Children who have a parent or sibling in prison will experience the removal of the person from their lives in a more extreme way than even prior to the pandemic.

QUESTION 3: HAVE THERE BEEN SPECIFIC EQUALITY OR HUMAN RIGHTS IMPACTS ON GROUPS OF PEOPLE AS A RESPONSE TO THE VIRUS?

The Scottish Human Rights Commission (SHRC) recently published a report into changes to social care provision during COVID-19 and its impact on human rights[20].  It details the experiences of individuals receiving health and social care support, with a focus on the rights of persons with disabilities, older people, carers and children. The testimony of many of those who participated in the research is distressing, highlighting the serious consequences for individuals when support cannot be accessed.

The context around these experiences were the efforts of NHS, local authorities and independent care providers (working together as Health and Social Care Partnerships) to ensure support was available to meet all assessed (and anticipated) need, within safe staffing levels. Plans took into account high rates of staff absence, due to sickness and isolation. The restrictions, and necessary steps to protect staff, meant that many social workers and social care staff would be limited in their ability to work. The focus was on protecting critical services for those most in need. However, the timeframe for how long this would be needed was not clear at the outset, and the working assumption was that measures to reduce care packages for some (to ensure some access for all) would be required for weeks, not months. It is clear now that the impact of these measures varied across Scotland, reflecting different levels and types of pre-pandemic service provision and workforce demographics. But in all areas of Scotland those requiring social care support, and those caring for them, have been disproportionately affected by the pandemic because of the limits the reductions of support place on an individual’s independence (beyond the national restrictions everyone has had to adapt to).

Because many face-to-face support services such as day centres and support groups had their operations significantly reduced as a result of public health requirements, the pressure of continually caring for people during the crisis will also have had an effect on the wellbeing of carers. Carers who support their family members or friends to live independently have experienced isolation and reduced support, with many increasing their caring hours to protect the supported person from additional footfall into their homes and related risks of exposure to the virus.

The SHRC report calls for the social care system to be reimagined as a dynamic interplay within a social infrastructure which supports citizens’ human rights as individuals within families and communities. SASW and Social Work Scotland agree strongly with this vision, but take this opportunity to emphasise that it is only possible when the system is populated by sufficient numbers of skilled people, committed and enabled to deliver the best outcomes for individuals. Such a system, requiring a significantly larger ‘workforce’, is not possible within current funding levels. A return to pre-COVID-19 structures and mechanisms of support, even if funding were increased, would not address the issues flagged by the SHRC report.

It is likely that one of the effects of the pandemic will be to increase the number of people needing health and social work and social care support as a result of:

  • The immediate impact of illness, loss and grief and trauma
  • The economic impact which may mean more individuals and families experience derivation and poverty which is a key factor in bringing people to social services
  • The longer-term impact of long-covid, the reduction in planned health treatment and the need for physical distancing reducing opportunities for preventative and early intervention means that more people will have higher levels of chronic physical, mental health and social needs.

We take heart from examples highlighted in the Care Inspectorate’s report, ‘Delivering care at home and housing support services during the COVID-19 pandemic’[21], where local partnerships successfully adapted and flexed their support to meet people’s needs during the pandemic. Teams in local government and the voluntary and private sectors have innovated and adjusted, put people’s needs before contractual hours. The capacity for change and positive reform is in place, and we look forward to the upcoming discussions about how to realise that, in response to the Independent Review of Adult Social Care.

Question 4: What do the Scottish Government and public authorities (e.g. local authorities, health boards etc.) need to change or improve: as a matter of urgency & in the medium to long term?

This question frames a critical debate in an unhelpful way. Locating responsibility for change and improvement solely with Scottish Government and public authorities not only presumes that they have the capacity / resources to effect changes, it encourages us all to see the problem as ‘theirs’ to resolve. The issues we have profiled in this response, such as poverty, structural inequalities and the public-civic infrastructure which give effect to people’s human rights, can only be addressed through both political and societal action. As with climate change, or changes to consumption that limit our impact on biodiversity, public authorities of all kinds are key players. But in democracies like Scotland, they move and act within a space we, the public, give them. Calling for public authorities to effect changes that will require significantly more resources, without our clearly accepting the need to provide those resources (through taxes, government borrowing or reallocation of existing spend), will simply perpetuate the public policy debates we have had for the past ten to fifteen years.

The funding of social care

Social Work Scotland and SASW are particularly concerned about the impacts of the deepening financial crisis in social care, which we have highlighted recently in our respective submissions to the Independent Review of Adult Social Care (IRASC).  The crisis also exists in children and families social work services, and criminal justice social work, which are not within the scope of the Independent Review of Adult Social Care.

Adult social care spending per head in Scotland has fallen dramatically for Scotland’s older people, less so in England but more than it has in Wales (see graph in download here).

Spending per head on adults aged 18-64 – mainly people with learning disabilities or physical disabilities, or in need of mental health support — has fared better, but in Scotland is back to the 2010-11 levels whilst the numbers of people living with disabilities, or with mental health problems, have both increased in Scotland, as in the rest of the UK. (The figures in the graph come from the Treasury’s Public Expenditure Statistical Analyses 2020).

Social Work Scotland’s submission to IRASC on Demographic Change and Adult Social Care Expenditure in Scotland [22]is mostly concerned with the Scottish Government’s own H&SC Medium Term Financial Framework (2018), which estimated the increased demands at 3.5% for adult social care as a whole, and 1% for the NHS.

We found that the estimated additional spend on 3.5% per year for adult social care is well supported by research in England by the London School of Economics using sophisticated modelling from survey data not available in Scotland.  That also shows that the additional demand for services for younger adults with a learning or physical disability, due largely to improved longevity, is at similar annual percentage increases as demand from older people.

However, our analysis does not support the lower increases for the NHS in the H&SC Medium Term Financial Framework – these are 1% per year for demography, compared to estimates by the Institute for Fiscal Studies of 2.2% per year for England and the UK as a whole (in their major study Securing the future published earlier in 2018).

Our analysis also does not support the annual workforce increases set out in the Scottish Government’s Integrated Health and Social Care Workforce Plan for Scotland published in December 2010, which stated that:

The Scottish Government’s Medium Term Financial Framework (MTFF) estimates that to address the effects of demand, we will require 1.3% per annum more NHS employees and 1.7% per annum more social care employees in the period to 2023/24”.

Those figures cannot be found in the MTFF and, we believe, are incorrect. In any event, Scottish Government funding to councils for adult social care has not been increased to the level required to meet demography, yet alone address the unmet need that has accumulated for survivors of the decade of austerity. Increased funding for social care needs to fully recognise the impacts of demographic change, in line with the Scottish Government’s own medium-term planning, and on a corrected basis for the NHS in Scotland.

The role and status of social work

Social work is one of the few ‘key worker’ professions which is, when able to operate as conceived, proactive and person-led. It exists (and in legislation is empowered) to take action in defence or support of people made vulnerable by their circumstances. Those we work with may be less likely to be heard, and may struggle to stay afloat when the scaffolding of support is stripped away (as it has been during COVID-19). Social work sees people in their own individual context, recognising that an individual’s relationships, strengths, interests, etc. constitute the person, and that to give meaning to their human rights is to reinforce and promote those assets. But we must also balance individual rights with those of others, and consider the risks of certain actions to the individual themselves, their families and wider society. Our role must be to enable those people to have a voice, and to provide protective support or intervention where that becomes necessary.

As illustrated above, before COVID-19 social work (and the wider social care system it underpins) was already facing significant financial constraint; demand and aspiration not matched by available budgets. The 2019/20 COSLA report Investing in Essential Services, highlighted the challenges local authorities face to meet the outcomes and targets identified in the national performance framework within existing resources, referencing specifically child poverty and vulnerable adults[23]. The strain that the social care system is under, and the conditions in which care professionals must practice, has been well documented in a range of reports from academics and institutions. The latest such report from the University of the West of Scotland (UWS) (Decent work in Scotland’s Care Homes) highlights a sector facing ‘systemic issues, a lack of respect and in need of cultural change’[24].

Within the current landscape, social work professionals – trained to respect and uphold human rights and work alongside individuals and communities (balancing and holding needs, risks and interests) – find themselves working in systems which can force them to be ‘assessors’ of risk and gatekeepers to over-rationedrvices.[25]  This not only means we fail to realise the human rights and outcomes potential of social work, but we slowly erode the enthusiasm and commitment of the professionals themselves.

While there has been positive innovation, acceleration of developments and much useful learning from the past year, the pandemic has made it harder to work alongside people and families at the challenging points and transitions in their lives. This has posed a unique challenge to social work, which is support based within and upon relationships. Feedback from our members has highlighted a number of further issues for the profession, limiting our ability to provide support and services and significantly affecting the working conditions and wellbeing of social workers. We would welcome any opportunity to discuss this further with the Committee.

Social Work Scotland’s Chief Social Work Officer (CSWO) committee has reported that the pandemic’s impact on the social work profession has been to compound pre-existing issues. These include dealing with real term reductions in budgets (which in turn increases workload on individuals), difficulties in recruitment, lacking visibility and authority in key decision-making forums, the disparity in social work and social care’s pay and conditions between health and social care partnerships. The split professional leadership across adults, justice and children and families is also seen, by some, to weaken oversight and coordination.

In July 2020 the Social Workers’ Union[26] reported that one third of social workers are considering leaving the profession as a direct result of the pandemic. The union released an action plan calling for increased mental health support, a social work recruitment drive and a pledge not to re-introduce austerity measures post-pandemic.

As we move through and, hopefully, out of the pandemic, we would like to see and contribute to a re-imagining of the role and functions of public services. People are not simply ‘rights holders’ and professionals (such as social workers) are not simply ‘duty bearers’; we are all people, facing the challenges presented by the context, trying to deliver the optimum outcomes for individual and society, while having to balance competing interests, rights, demands and priorities. Similarly, public services must embrace greater creativity in how they support people to give meaning to their human rights and find genuine wellbeing. That will require a workforce who feel equipped and empowered to do what they were trained to do. The Human Rights Taskforce due to report in March 2021 will, no doubt, be considering a range of ways that public services and others can achieve this, and the Independent Review of Adult Social Care and The Promise are re-imagining support services for key groups.

For further information, please do not hesitate to contact:

Flora Aldridge

Social Work Scotland

Flora.aldridge@socialworkscotland.org

 

Emily Galloway

SASW

Emily.galloway@basw.co.uk

[1] See World Health Organisation website: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

[2] https://www.basw.co.uk/media/news/2020/oct/port-storm-poverty-aware-social-work-pandemic

[3] https://www.trusselltrust.org/2020/09/14/new-report-reveals-how-coronavirus-has-affected-food-bank-use/

[4]https://scotland.shelter.org.uk/__data/assets/pdf_file/0008/1934099/Shelter_Scotland_briefing_LGCC_Homelessness_and_Covid_140820.pdf/_nocache

[5] IBID page 91

[6] See Social Work Scotland supplementary submissions to the Independent Review of Adult Social Care: https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-1-DEMOGRAPHIC-CHANGE-AND-ADULT-SOCIAL-CARE-EXPENDITURE-IN-SCOTLAND.pdf; and https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-2-ASC-EXPENDITURE-IN-THE-DECADE-OF-AUSTERITY.pdf.

[7] ABOUT THE MODEL – Safe & Together Institute (safeandtogetherinstitute.com)

[8] https://www.scra.gov.uk/2020/10/sexual-exploitation-of-children-new-research-report/

[9] https://socialworkscotland.org/contextual-safeguarding-event-2020/

[10] Coronavirus (COVID-19): children, young people and families – evidence and intelligence reports (various)

[11] https://socialworkscotland.org/publication/connections-for-wellbeing/

[12] The IRISS summary of a University of Edinburgh/City of Edinburgh Knowledge exchange project illustrates the value of this rights based approach in the most urgent of circumstances https://www.iriss.org.uk/sites/default/files/2020-06/recognition_matters_briefing_june_2020.pdf

[13] National Records of Scotland: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/deaths-involving-coronavirus-covid-19-in-scotland (Week 53)

[14] OLDER PEOPLE BEING PRESSURISED INTO SIGNING DO NOT ATTEMPT CPR FORMS – JOINT STATEMENT FROM AGE SECTOR ORGANISATIONS | Media | Age UK

[15] Detentions for mental health care during the pandemic – new report | Mental Welfare Commission for Scotland (mwcscot.org.uk)

[16] route-map-4.pdf (everyonehome.scot)

[17] Letter for Humza Yousaf, MSP, Cabinet Secretary for Justice from SASW | www.basw.co.uk

[18] https://socialworkscotland.org/briefings/reducing-the-backlog-of-unpaid-work-hours-coronavirus-scotland-act-2020/

[19] https://socialworkscotland.org/consultation/pre-budget-scrutiny-2021-22-justice-committee-call-for-views/

[20] https://www.scottishhumanrights.com/media/2102/covid-19-social-care-monitoring-report-vfinal.pdf, Chapter 3, page 15

[21] https://hub.careinspectorate.com/media/4171/delivering-cah-and-hss-during-the-covid-19-pandemic.pdf

[22] https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-1-DEMOGRAPHIC-CHANGE-AND-ADULT-SOCIAL-CARE-EXPENDITURE-IN-SCOTLAND.pdf

[23] https://www.cosla.gov.uk/__data/assets/pdf_file/0021/14808/cosla-investinessentialservices.pdf

[24] https://dwsc-research.org/wp-content/uploads/2020/12/Decent-Work-in-Scottish-Care-Homes-Report-Final.pdf

[25] https://www.sehd.scot.nhs.uk/publications/DC20011129CCD8single.pdf

[26] SWU: Social Work’s Six-Point Urgent Action Plan | www.basw.co.uk

06/11/2020

Independent Review of Adult Social Care: main and supplementary submissions

INDEPENDENT REVIEW OF ADULT SOCIAL CARE:  submissions from Social Work Scotland to Derek Feeley, Chair of the Independent Review of Adult Social Care 

6 November 2020

Social Work Scotland is the professional body for social work leaders, working closely with our partners to share policy and practice, and improve the quality and experience of social services. We are a key partner in the national Adult Social Care Reform Programme, creating an operational framework for Self-directed Support across Scotland, which through the practice of relationship-based social work, supports the consistent delivery of social care that is personalised, rights-based and which supports active citizenship. Another of our current projects is aligned to a Scottish Government programme (Health and Justice Collaboration Board) to test and implement frameworks for the delivery of integrated adult social services in Scottish prisons.

We welcome the focus of the Independent Review of Adult Social Care on sustainable improvement to adult social care in Scotland within a human-right frame of reference, and we have been delighted to welcome Derek Feeley, chair of the Review in meeting with Chief Social Work Officers and members of the Social Work Scotland Adult Social Care committee. At that meeting, Social Work Scotland presented Mr Feeley with a summary report of key messages for the Review from social work leaders. Our formal submissions to the Review expand on those key messages, and we look forward to ongoing engagement with the Review.

Social Work Scotland’s response comprises:

  1. Main submission – read the full text below or download a copy of this document  (PDF)
  2. A supplementary submission which provides a brief analysis of the impact of demographic change on the need to spend on adult social care in Scotland. In particular, it reviews the most recent work by the Scottish Government on this issue, in the Health and Social Care Medium Term Financial Framework (HSCMTFF) published in October 2018, and also used subsequently in the Scottish Government’s Integrated Health and Social Care Workforce Plan for Scotland published in December 2019.  Read the full analysis here. (PDF)
  3. A further supplement, which looks at adult social care expenditure in the decade of austerity – comparing Scotland with the rest of the United Kingdom. Specifically, this document underpins the others by analysing the most recent local authority expenditure data for Adult Social Care in Scotland, from the published financial returns; and looks at whether Scottish social care expenditure has fared better or worse than in England or in Wales over the period of austerity, using available data from the Public Expenditure Statistical Analyses (PESA) for “personal social services” published annually by HM Treasury. The financial data is augmented where relevant by available service and activity statistics to help paint a fuller picture. Read the full analysis here. (PDF)

Summary of Social Work Scotland main submission

The Independent Review of Adult Social Care[1] is an important opportunity for Social Work Scotland to articulate positions in respect of the scope, nature, delivery, management, governance, regulation, funding and future direction of adult social care in Scotland. Within this, engagement with the Review (both written and in person) provide a chance to emphasise the unique role and contribution of social work, as a distinct but core component of social care.

Social Work Scotland have responded to previous inquiries and consultations looking at similar questions  (See Appendix A). Building on these responses, and following structured discussions within (a) Chief Social Work Officer and Adult Social Care Standing Committees and (b) members of the Board and partners (including Chief Officers and COSLA), Social Work Scotland has identified a number of key messages / positions to be fed into the Review. Effort has been made to ensure these messages / positions are consistent with a vision for adult social care that is ambitious but deliverable. The key points are:

  • Choice, control and personalisation should be the foundations of our social care systems, enabling an asset-based approach to assessment and support, rather than a medicalised model based on deficits and eligibility criteria. However, it is the availability and flexibility of resources in the system (money fundamentally, but principally people) which significantly determines the degree to which an individual or family experience the system as positive and enabling, or detached, bureaucratic and impersonal. The need to manage insufficient and finite budgets requires local authorities and Health and Social Care Partnerships to impose eligibility criteria that render the concepts of choice and control meaningless to a great extent.
  • Only the person living their experience, and those who are close to them, can speak to that experience, describing the good and bad, their hopes and concerns. The design of social care, from the level of an individual plan to the nation-wide system itself, must be led by people’s own experience and insight. Commitment to such an approach demands more, however, than providing opportunities for people to speak. Those listening must be motivated and equipped to understand what is being said, and take appropriate individualised or systemic action in response.
  • An effective social care system enables people to build on their own strengths, with support from others where necessary, to achieve positive, personal outcomes. Policies, structures and processes should be designed on the basis of subsidiarity, pushing power down the system, into the hands of those requiring support, and those who support them. Social workers, operating with the necessary skill, autonomy and authority, have an essential role in such a system, surfacing people’s personal choices, and balancing rights and interests with society’s duty to protect people from harm (in its many forms, including financial and emotional).
  • Social care – indeed all social services – should not just respect human rights, but proactively work to give human rights meaning and effect. That is only possible when people working in the social care system (and in particular social workers, who have statutory responsibilities to balance rights and risks in complex circumstances) feel empowered and incentivised to act in the defence or promotion of an individual’s human rights.
  • People’s circumstances are too unique, and Scotland’s physical and human geography too complex, to guarantee consistency of experience within our social care system. But we can aim to deliver consistency of practice (enabling people to determine what package of support, and level of control, would be best for them) and greater consistency of offer (the support options available to a person) in every community.
  • Social Work is a discrete but essential component of the Social Care system. Reform of adult social care, as with reform of children’s social care[2], drug and alcohol services[3], mental health[4] and justice[5], must attend specifically to the unique role and requirements of the social work profession, which holds statutory responsibilities to safeguard, to assess need and to ensure provision of care and support. In other words, reform must answer the question “what does social work require in order to fulfil its statutory and ethical functions?”
  • Reform of adult social care must be considered in the context of parallel ‘whole-system-change’ agendas, including the Promise (children’s social care) and justice. Individually, each is a positive opportunity to implement the type of public service reform identified by the Christie Commission. However, they also risk fragmenting the social work profession into separate silos, at a time when the profession’s coherence and interconnections are critical to the realisation of holistic, ecological and person-led support. People do not fall neatly into silos, and social work as a generic profession is uniquely well situated to support an individual and their family and support network to navigate the boundaries of our public services and wider societal inequities.
  • Health and Social Care integration has delivered many benefits, and while it does present challenges, we are too early in our national change journey to expect all issues to have been resolved, or to risk unpicking the progress made to date. Reform of adult social care should be focused on addressing the deficiencies of the current governance and delivery structures.
  • Social care is just shorthand for a structure within which people work with people. Real change will only come if proper attention is given to people (workforce and leaders) within those structures, utilising what we now know (in particular from research into implementation) about how to shift behaviours, practice and outcomes. A desire to change is not sufficient. Nor is an increase in resources or changes in law. Systematic work must be undertaken, over a number of years, which enables and supports the frontline workforce to change their approach. At Social Work Scotland we are attempting to incorporate the insights offered by implementation science, and encourage the Review to consider what that body of evidence tells us about effecting sustainable change.
  • The national improvement ‘offer’ for social work and social care needs to change. The recent introduction of National Health and Care Outcomes is a welcome development, but an effective national infrastructure is not in place to support sustained improvement across the sector. The conflation of scrutiny and improvement functions within the Care Inspectorate and within the Scottish Social Services Council has impacted on these organisations’ efficacy in those capacities. Decisions must be taken about the siting of scrutiny and improvement support functions so that there is maximum benefit for service delivery.
  • In attending to the unique role and requirements of social work over the long term, as well as improving consistency of practice, providing subsidiarity within the system, and offsetting the potential fragmentation of the profession, Scotland should establish a national social work agency, differentiated from a national care service. With responsibility for supporting quality and facilitating improvement, it would sit alongside equivalents already in place for education and health. This body would not have responsibility for the regulation of the workforce (which would remain with the Scottish Social Services Council) or delivery of services (which should happen at a local level), but it would lead on learning and development, implementation of new models of practice, attending to issues of professional parity, etc.
  • The delivery of social work (safeguarding, assessment, monitoring, support, advice, review) and social care (practical actions to support people meet their personal outcomes) must be local, embedded in and responsive to communities. People’s contexts, needs and environments are varied, and our social care system must reflect that; particularly if our objective is for social care to be personalised, with people having control and However, social care could be improved through the establishment of national structures which validate its central role in society, acknowledge the contribution and requirements of those who work within it, and which assist with improvement and implementation (e.g. adoption of new technologies). A National Care Service, under this formulation, would not be involved in delivery of care, but rather the management of resources within the system.
  • Social Work Scotland acknowledges improvements made to the statistical information available about adult social care in Scotland, and the ongoing effort to link this data to that available for the NHS, so that a more holistic picture can be formed about health and social care as a whole.  However, the staff resources needed to support and maintain information systems locally have been severely cut back in recent years.  As a result, the national adult social care statistics published in Insights in Social Care: Statistics for Scotland. Support provided or funded by health and social care partnerships in Scotland have many gaps which have to be estimated, where possible, making some of the data difficult to use.  Key data time-series, such as on social work assessments, are no longer published, and we are concerned that the social care expenditure information collected by the Scottish Government is being severely cut.  We agree with the recent review by the Office of National Statistics that the evidence base for adult social care is under-resourced compared to that for the NHS.
  • Above all there is insufficient funding in the social care system to deliver the improvements the Independent Review seeks in terms of the outcomes achieved by and with people who use services, their carers and families, and the experience of people who work in adult social care. Despite the best efforts of local authorities to protect social care from the effects of funding reductions over the last eight to nine years of austerity, adult social care expenditure has fallen per head in real terms, especially for older people, and the demographic challenges posed by the ageing population have largely not been met. We confidently believe significant additional investment will be needed, in the short, medium and long-term and we urge the Review group to be bold in its recommendations to deliver the investment needed to achieve the national care system its people need and want.

 

Rationale supporting our key messages / positions

Definitions

A priority in our discussion with the Independent Review is building a common understanding of what is being referred to by the term ‘adult social care’.

We believe a distinction should be drawn between social care[6], a concept that implies the delivery of a service to an individual, and social work[7], whose function is specified under the Social Work (Scotland) Act 1968 as undertaking holistic assessments and determining the level of support required to meet eligible needs. Moreover, social work is a proactive service, rather than simply a reactive one; it exists and is empowered to take action with people made vulnerable by their circumstances, balancing their rights with those of others, and the risks of their actions to themselves, their families and wider society.

The role of social work is therefore dynamic and complex, working alongside people and families at often challenging moment and transitions. In helping to protect people social workers must sometimes use statutory measures, bringing them into conflict with the individual and families. It is a difficult but essential role in a society (and social care system), where not every individual is in a position to determine their best interests alone, or the best interests of those they have responsibility for.

The position of social work as a profession within social care

Social work is currently the gateway through which most individuals access social care support funded by the state. In order for that social care provision to be delivered to the right people in the right way, social work practice needs to be independent and robust (i.e. true to its statutory and ethical underpinnings), with the knowledge and expertise to navigate a variety of settings, including home, hospital, residential care homes, homelessness and prison. It needs to be equipped to work with people of any age, in a way which situates the individual within a web of relationships and interactions. Responding to an older person affected by domestic abuse may necessarily involve family, friends and other professionals.

Among the regulated professions, Social Work is unique occupying the liminal spaces between universal services – education, health, justice, housing, welfare. Where there is contraction of universal service provision (usually followed by a heightening of thresholds) or a conflict between a universal service and an individual/family, social work responds, and in our response, we consider the person holistically. We have seen several examples of this in recent years:

  • Where affordable and/or appropriate housing is unavailable, social work is tasked to coordinate the necessary support for people to live safely in their own homes.
  • Where NHS capacity restricts (leading to longer waiting times or removal of service) social work is responsible for identifying or developing service models which can support people with very complex needs to live in their community.
  • Where clinical assessments for autism or other learning disabilities (which can appear very inconsistent between areas) limit the NHS funded options for an individual or family, social work must engage to find alternatives.
  • Where pastoral and pupil support posts are lost from schools, social work is challenged to manage the needs of vulnerable children within their families; many of whom will have complex needs of their own.

Due to a number of factors, some going back decades, the role of social work within the social care system has been pushed towards transactional care management and adherence to bureaucratic processes and procedures. In practice, this means that social work acts as both gateway to and gatekeeper of social care. Frontline social work effectively acts as a control for finite local authority budgets, and this causes us a professional dilemma. Resource allocation processes often impact on our ability to enhance human rights and on the quality of the relationship with families. It is more straightforward to develop a care and support plan for a service or a budget; it is much more time consuming to get alongside the person, consider their life complexities and the potential contribution of their community and natural support to them living a full and rich life, then work collaboratively with them on how to go forward. This approach benefits personal outcomes, but comes with a long term financial cost.

Cost-cutting and overreliance on a care management approach has resulted in proportionately fewer qualified social workers available who are able to engage in this way to support the growing population of adults with complex needs. Shifting to a more intense practice model will require additional financial and other resources, but in the end relational, therapeutic support would much better support people’s human rights, and should itself be a right. This is demonstrated where local authorities have shifted towards this approach[8].

Social work’s specific statutory duties centred on the delicate balance of rights and risks – both individual and societal – demands well trained autonomous professionals supported in their duties by their authority’s Chief Social Work Officer. The CSWO remit is wide ranging with safeguarding responsibility for individuals at risk, for proper deployment and support of the social work and social care workforce, for ensuring robust and effective systems and processes, care governance, and continuous improvement across the whole range of social work and social care services. The CSWO is directly responsible for some statutory functions which restrict personal liberty, and has specific duties in relation to safeguarding.

The widening of regulation and inspection into the social care workforce and services has, to an extent, diverted focus from social work as a distinct profession. This becomes problematic when social work enters into partnership arrangements across adults, children and families and justice, where the unique contribution of social work is lost to view. Social workers can become demoralised and disenfranchised as professionals.

Social Work Scotland believes that there is much to be gained by the proper integration of health, social work and social care. However, this needs to be on the basis of a differentiated understanding of the principles and values of all the professions involved, retaining each profession’s unique contribution and impact within local integration arrangements. To facilitate this, we are supportive of measures which would consolidate social work as a genuinely national profession, recognised and supported nationally, underpinned by common terms and conditions and a strategy for its development.

A national profession, perhaps supported by a national agency, would also provide greater opportunities for professionals to progress professionally, without having to take on management responsibilities, and encourage greater professional autonomy in the carrying out of assessment and support planning. In parallel, similar steps for our colleagues in social care roles would potentially give their essential work proper value and status.

Resources and implementation of complex change

The social care model in Scotland was not designed or funded to meet the current expectation of provision or demand. An increase in complexity of people’s circumstances has been well documented, as has the disastrous impact of UK welfare reform on the impoverishment of many people and their families. These factors serve to increase the demand on social work and social care services.

Social Work Scotland members increasingly experience the effect that real-term spending reductions is having on their ability to sustain levels of service, maintain quality and provide non-statutory early help to prevent escalation into crisis. Social services (social work and social care) as a whole system within the integration environment with health must be sufficiently funded to meet its statutory duties and have clear, fair and well-functioning mechanisms for resource allocation within the overall available funding. Despite an overwhelming commitment from social work and social care services, the fragility of the wider social care system has become all the more apparent during the Covid-19 pandemic.

Social Work Scotland believes that the system could be reimagined to be a much more dynamic interplay of social infrastructure supporting citizens’ human rights as individuals and within families and communities, with a combined workforce operating at community level.

Whilst there is much widespread agreement across national and local, public and independent sector, and national partnership organisations, as to what good social services look like (enshrined in the Social Care (Self-directed Support) (Scotland) Act 2013), the question is what will it take to design and implement the changes necessary to meet these aims for everyone in all areas of Scotland?

It is critical that we come to a collective understanding of the essential elements that contribute to successful implementation of whole-system change, including the roles and remits of regulatory bodies, improvement agencies, and vehicles of service delivery.  This is what has been missing in the implementation of recent ambitious and transformative social policy in Scotland.

Our view has been shaped by our experience progressing implementation of self-directed support in Scotland.  Approaching this through the structure and insight offered by implementation science, we have made progress in identifying the essential, non-negotiable components which need to be in place for a publicly funded social care system to enable a person and/or their families to be in control of their life, regardless of their disability (visible or hidden) or life circumstances.  Among those core components are established practices, which when reliably delivered by a well-trained and supported workforce, consistently deliver desired results. We also know what infrastructure needs to look like (including upstream community assets, accessible housing, case management IT systems, technology, administrative support, commissioning and procurement, eligibility policy, finance and budgeting systems), and what leadership needs to look like (and have as skills) in what are highly adaptive environments.

Community-based support

Over the past decade, support to build community capacity, in the shape of community learning and development services, community workers, and grants to community groups, has been critically reduced across Scotland.

Investment is required to ensure that communities are ready and resourced to engage in strategic planning and commissioning processes. Independent support organisations, such as those funded by Support in the Right Direction (SiRD), are vital in ensuring the voice of people who use services and carers are invited and heard.

Engagement should lie at the heart of decision-making and is the key to people having meaningful choice and control in their own support. Engagement supports the principles of personalisation underpinning Scotland’s Self-directed Support (SDS) legislation. Practically, good engagement that personalises social care means that care arrangements are more likely to meet needs and less likely to go wrong.

The wide range of asset-based approaches and resources already available are used in a piecemeal way across Scotland, but can be abandoned or distorted when budgets are tight. In order to implement these approaches, which often conflict with the traditional ‘way we do things’, attention needs to be given to workforce training and coaching, supportive systems and devolved leadership.

We feel very strongly that there needs to be consideration of the range of people’s lived experience when designing and constructing social work and social care services. Often the focus of public discussion around social care is older people with personal care needs. Other individual experiences, such as adults with complex learning disabilities or mental health, are not so well profiled, or held in mind. Those experiencing alcohol and drug addiction, domestic abuse and the justice system tend to come from communities experiencing the greatest health and social deprivation. An adult social care system is as much about these experiences as any other; these voices must come to the fore.

Eligibility criteria reform and human rights

Current eligibility criteria are deficit-based assessment of levels of risk to an individual if care is not provided. They run contrary to the principles of personalisation, as they drive time-and-task service provision. They are applied differently across Scotland and result in unnecessary variation in outcomes for individuals. The current approach to eligibility is impacting too severely on vulnerable people and those at the edge of social care, and we strongly recommend that the National Eligibility Criteria are reformed.

Social work and social care financing needs to be sufficient to support the quantity and types/models of care necessary to support our population. Services in many areas of Scotland are currently constrained such that they are only able to address critical risks (as defined in the National Eligibility Criteria) by the provision of personal care only, leading vulnerable people to struggle when their needs change or when their needs are social in nature rather than physical. Our work in the implementation framework for SDS shows us that the current national eligibility criteria are not fit for purpose, and indeed run counter to the values and principles of Self-directed Support. We recognise that a framework is required to ensure fair distribution of resources which should support strengths-based social work, community social work and ensures early help is provided for people with lower levels of need.

The provision of only critical level services presumes that intervention for anything less can be picked up by family or local community, and that the person has the capacity to organise and manage sometimes complex support arrangements.  In some settings (for example prison) people do not have this level of family or community support and are not able to follow signposting to where third sector support might be available.  Lack of early help precipitates crises which are costly in outcomes for the person and financially for the local authority.

There should be consideration given also to the variation in charging and contributions policies across local authority areas and their disproportionate impact on individuals with similar needs in different areas of Scotland

While supportive, we recognise the challenge inherent in determining how social care needs (as articulated in social work law) are incorporated into a human-rights-based frame in a meaningful and measurable way. Underpinning principles should cover the range of activities necessary for ‘active citizenship’, including reducing isolation, supporting people to make and maintain friendships, promoting vocational skills, supporting people to develop and enhance life skills, promoting physical and mental well-being, and mitigating health inequalities.

This would involve supporting people with complex needs in personalised ways, supporting carers, promoting SDS and personalisation within partnerships, working with people at the earliest opportunity to maintain, improve or maximise independence, building capacity in the community and with sustainable services, ensuring best value and effective partnership working, reducing dependence on high-tariff services, and creating services that are aware and confident about using and utilising technology.

This ideal approach will require considerable additional resource, particularly as applied to a growing older population. The population shift will impact disproportionately on women, who provide most of the care to family members. Consideration must also be given to how to properly resource the Carers (Scotland) Act 2016, giving real affect to the principles of that legislation.

Commissioning for personalisation

We note that the majority of pre-Covid local Commissioning Plans are weighted towards health-related matters and make little or no reference to personalised care and support. A perspective that embraces the holistic person with the right to choice and control should be central to framing more personalised commissioning practices.

SDS legislation calls for innovative solutions to allow people to hold individual service funds, necessitating a shift in commissioning practice from block funding to personal commissioning, to enable more freedom of choice and greater control.

We acknowledge that there is some financial risk in departing from traditional service models to new models that might initially be underused. We would support more discussion on how risk might be shared.

Many services commissioned and arranged by the local authority (Option 3) are delivered on the basis of ‘time-and-task’, and this is runs counter to a human rights-based approach to delivering care and support, because people’s needs and choices naturally change on a day-to-day basis. Introducing more of a personal approach to is essential to assist people receiving supports in a way that meets their personal outcomes. We believe that quantifying ‘time’ rather than ‘task’ would allow greater choice and control by individuals, whilst allowing for a budget to be allocated to meet personal outcomes.

Embedding Self-directed Support as good social work and social care

Scotland is a country with significant geographically and economically variation, with a diverse and vibrant citizenship with whom we should be aiming to personalise care and support and to offer people choice and control of how they want to manage their lives.

We recommend that the review considers what implementation science might offer in our national attempts to implement SDS consistently across Scotland. We believe that this approach is the most suited to undertaking the sort of complex, adaptive change required to meet Scotland’s ambitious progressive policies.

With national partners and local authorities, we are asking what it will take to embed SDS in a sustainable manner across the geographies of Scotland and across all care groups equally.  In accordance with best international implementation practice, this includes examining practices and tools for their effectiveness and fidelity, and understanding and promoting the system drivers necessary for adaptive change.

Going forward, we strongly support a shift from traditional ‘care management’ approach in adult social work to more relationship-based practice with the supported people at the centre of decision making. Systems and processes would need to flow from that guiding principle.

This approach would see LAs/HSCPs move away from care management to a more traditional form of social work, working relationally and enhancing the natural supports of family, friends and neighbour’s contribution through such models as Family Group Decision Making and Community-Led Support. A radical shift of focus of integration authorities to support people to self-manage, on personalising care and support at home and on effective early intervention and prevention would involve working collaboratively with a wider range of partners including education, housing and community representatives using shared decision-making processes and sharing both risk and responsibility.

Whilst housing statements are required to be considered by Integration Authorities, better arrangements are needed to influence housing providers when they’re planning adaptations to existing housing stock. We would want to see housing developers required to contribute toward the provision of community health and social services. We could require a certain proportion of new build houses to be ready for use by someone with a high level of support needs.

Technology needs to be at the heart of the future of care preserving independence and supporting social interdependency. It should not substitute for human contact. The National Digital Platform should incorporate as great a focus on technology to deliver social care as on health, and should be given highest priority as a core enabler.

Data and other systems require to be better aligned to the principles of SDS. Much time and effort is spent on managing outdated information systems that do not link well around the person. There is no national requirement to capture outcomes achieved for adults.

Data that is useful to improve frontline operations currently has less priority than aggregated performance management data, which we argue from an implementation perspective is not sufficient as little can be learned from it.

We have also found differences in resource allocation across client groups that does not comply with a rights-based approach. Algorithms underpinning local resource allocation systems favour younger adults over older adults, leading to some outcomes being unfunded or underfunded. In many cases, only critical personal care needs are resourced.

Workforce

A key driver of any adaptive system change is workforce; selection, training and coaching. In order to attract a competent and committed workforce, remuneration should reflect the complexity and responsibility of roles across a varied employment landscape. Innovation is required in how we support people to employ their own personal assistants (employed with an Option 1 Direct Payment). We need an inward migration system that can attract skilled workers into social work and social care. We need to focus on attracting workers to urban, rural and island areas and keeping them engaged and motivated. We require a gendered analysis of the workforce if we are to understand how to attract men into the social work and social care workforce and how to best support women in the workforce.

With budget cuts over the past decade, local authority social work learning and development teams have all but disappeared, impacting greatly on the ongoing training of social work and social care staff. This highlights the lack of parity of social work and social care with other professions such as teaching and nursing. If adaptive change is to be implemented effectively, then the workforce requires not only high standard skill-based training but ongoing intensive coaching and supervision, and to expect pay rises in line with those offered to nurses and teachers.

National Care Service

While we believe that social work and social care needs to be delivered locally, Social Work Scotland is supportive of the development of a national adults practice model (similar to GIRFEC) which support consistency of approach across Scotland whilst allowing for variation only where this is reasonable in the context of local geography, demography and cost of living.

However, we are unclear how the principles of choice and control central to Self-directed Support can be realised by the creation of a National Care Service if it is to be responsible for delivery of social care. It may be that a National Care Service can have most effect as a layer between national government and local delivery, driving greater consistency, improvement in the workforce, equitable distribution of resources, etc.

While the concept of a National Care Service may be attractive in some regard (e.g. a driver for consistency), we have practical concern about the design of such a service and how it might be implemented as intended within Scotland’s governance landscape.

Supplementary submissions:

APPENDIX A: SOCIAL WORK SCOTLAND RESPONSES TO RELEVANT INQUIRES AND CONSULTATIONS

Submission from Social Work Scotland to Health and Sport Committee, Scottish Parliament, 20 February 2020

Housing to 2040: Consultation on Policy Options – Submission from Social Work Scotland, to the Scottish Government Consultation, 27 February 2020

Covid-19 Workforce Planning for the Health and Social Care Workforce in Scotland – May 2020 – Submission from Social Work Scotland to Scottish Government, 26 May 2020

How well is the Care Inspectorate fulfilling its statutory role? – Submission from Social Work Scotland to Scottish Parliament call for views, 10 August 2020

Independent Review of Mental Health Law in Scotland: Submission from Social Work Scotland to John Scott QC, 29 May 2020

Submission from Social Work Scotland to IJB Chairs and Vice Chairs Executive Group, 17 July 2020

Social Work Scotland response to the Scottish Government Review of Local Authority Financial Returns – Social Work Services (LFR03), 23 August 2020

[1] https://www.gov.scot/publications/independent-review-of-adult-social-care-terms-of-reference/

[2] In reference to implementation of the Promise.

[3] For example, the Drugs Deaths Taskforce

[4] For example, the Review of Mental Health Law in Scotland and Forensic mental health services: independent review

[5] In reference to development of the Community Justice agenda.

[6] “Social care means all forms of personal and practical support for children, young people and adults who need extra support. It describes services and other types of help, including care homes and supporting unpaid carers to help them continue in their caring role.” Scottish Government. A Social Work Scotland definition would expand this to include care and support provided at home.

[7] “Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work.  Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social work engages people and structures to address life challenges and enhance wellbeing.” IFSW, July 2014

[8] Thematic review of self-directed support in Scotland – June 2019, Care Inspectorate

Ends

27/10/2020

Pre-Budget Scrutiny 2021-22: Justice Committee call for views

PRE-BUDGET SCRUTINY 2021-22

SUBMISSION FROM SOCIAL WORK SCOTLAND, TO SCOTTISH PARLIAMENT JUSTICE COMMITTEE’S CALL FOR VIEWS

27.10.2020

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to feed into the Justice Committee’s scrutiny of the Scottish Government’s budget for 2021-22.

  1. What is your view on the current trends in funding in the justice portfolio and the Scottish Government’s rationale for these? 

Social Work Scotland supports the Scottish Government’s Community Justice: Reducing Re-offending priorities set out in the Scottish Budget 2020 – 21, with its aim of “increasing the use of community-based interventions and reducing the use of imprisonment”[1]. Research points to “a number of studies (that) have found […] community sentences are more effective in reducing reoffending than short-term prison sentences”[2]. However, whilst we endorse the presumption against short term sentences (PASS) we do not yet see the paradigm shift required in funding community sentences in Scotland that evidences a commitment to putting policy into practice. At 24 October the prison population was 7,439[3].

In this current year we welcomed the specific additional funding for the Multi-Agency Public Protection Arrangements (MAPPA), to further extend bail supervision, and to develop or establish structured deferred sentence (SDS) schemes, which came in Part 2 of the grant allocation (referred to as s27) to criminal justice social work (CJSW). Prior to the Coronavirus pandemic there was an increasing focus on expanding early intervention measures such as Diversion from Prosecution and SDS. We support this for many reasons, e.g. they help individuals to avoid unnecessary contact with the criminal justice system and they enable swift interventions which can interrupt a cycle of offending and/or prevent further offending. However, looking ahead, increasing the number of cases without a concomitant increase in resources will undermine the potential for successful interventions. Many of the strategies now in place to deal with the backlog within the justice system require heavy input from CJSW, but simultaneously the capacity of CJSW has reduced; (we discuss this further later in this submission).

Moreover, specific programmes of activity require greater investment if they are to deliver socially significant outcomes. For example, work currently underway to implement the expansion of electronic monitoring (EM) capacity, for bail and as a new requirement of a community payback order (CPO), promises to reduce the high numbers on remand in Scotland’s prisons and support robust and effective community disposals. However, as the Electronic Monitoring in Scotland Working group report makes clear, “if longer term desistance is required it must be combined with measures which help individuals to change their behaviour”[4]. The expansion of EM will require additional funding to ensure this support is provided by both statutory and Third Sector services. Not to do so risks undermining the efficacy of EM policy.

The Scottish Budget 2020 – 21 refers to “appropriately resourced community-based interventions”[5] in order to achieve the community justice priorities. We argued in our submission to the Justice Committee in September 2019 that “Despite the seismic change in the demands and requirements placed on CJSW since the early 2000s, there has not been a comprehensive review to quantify and accurately cost the component parts of the work CJSW does”[6]. This state of affairs has not changed, and the perspective of CJSW managers and practitioners (the people SWS represents) is that current levels of funding do not accurately reflect the true cost of delivering a Community Justice agenda. This particularly applies to the core of CJSW work, such as CPOs and the associated delivery of programmes such as the Caledonian System for perpetrators of domestic abuse and Moving Forward: Making Changes (MFMC) for sex offenders.

The fact remains that unless and until this systemic underfunding is addressed, the ability of CJSW (in partnership with the third sector) to consistently provide high quality interventions is restricted or reduced. To illustrate, in reference to the Caledonian System mentioned above, funding for the original 13 local authorities involved has flatlined since its inception in 2011. Consequently, one local authority, Falkirk, is dismantling the Forth Valley Programmes team they host (on behalf of Stirling and Clackmannanshire) as the costs of running the service far outweigh the funding received. Falkirk can no longer afford to subsidise the funding from the core CJSW grant allocation. (Moreover, funding from Scottish Government for this flagship programme to tackle domestic abuse is still not available to all 32 local authorities leading to a postcode lottery for perpetrators and victims.) This is not an isolated example.

Without question there is a rich and diverse array of services provided by the Third Sector that are available across the country. We support the current delivery model where CJSW services procure and commission services from Third Sector partners according to identified local need and priority, e.g. for employability services for individuals that have offended, mentoring services or offending behaviour programmes. We would welcome increased core funding to CJSW to unlock this potential, building on the community justice partnership model that is now well established, implementing plans which are based on local needs assessments.

  1. What has been the impact of the current COVID-19 pandemic on the activities of your organisation and its spending requirements?

Social Work Scotland set out the impact of the pandemic relating to unpaid work in our position paper to the Cabinet Secretary on 16 July[7]. We understand this was forwarded to the Convenor of the Justice Committee on 20 July. We concluded that due to the accruing backlog of hours (now approximately 720,000) and the reduced capacity resulting from Scottish Government restrictions relating to Coronavirus that there was an urgent need to proactively address the pressures faced by CJSW. We made it clear that action was required under the Coronavirus (Scotland) Act 2020 to vary existing orders relating to unpaid work or other activity to the total number of outstanding hours to be worked by 450,000. This remains the case.

However, the pandemic continues to affect all aspects of CJSW business. During the initial phase of lockdown staff, particularly those facilitating unpaid work, were redirected to assistant with the emergency response. COVID-19 has reduced our capacity to deliver all services, particularly those which require face-to-face activity or which are difficult with social distancing. Options are also limited by the individual restrictions involved with track and trace, local lockdowns, and pressure on the use of buildings and associated health and safety requirements. This means the number of staff in an office at any one time is reduced by up to two-thirds in order to protect both staff and individuals. Criminal justice social work reports and assessments take longer and whilst many areas have re-started group work this is with much reduced numbers. Some individuals are now finishing their CPOs or prison licence without completing crucial offending related interventions, e.g. sex offending programmes – “There is accruing evidence that offenders who do not complete treatment are at greater risk of recidivism than those who do complete treatment[8]. The Third Sector and other statutory services have been similarly affected.

It is important to remember that when we talk about the ‘resources’ required for most public services we are actually talking about people; bodies on the ground, with the necessary skills, who can do the work. This is particularly true in CJSW, where typically 70 – 80% of overall budgets is personnel. Whilst private business has the autonomy to reduce their activities (however painful that might be financially), public bodies must still meet their statutory duties, and CJSW cannot reduce the demand on our services.

This will not change in the foreseeable future, and even if a vaccine were available soon, we expect the impact of the 2020 pandemic to affect CJSW capacity and activity throughout 2021/22 at least. Indeed, crucially, the backlog of outstanding court business (due to closures of courts this year) will extend far beyond 2021/22 – modelling[9] seen by SWS suggests that relative to the baseline of 2018/19, for example, there will be a significant year-on-year increase in CPOs until at least 2025 of up to 38%. Therefore, urgent action is required now by the Scottish Parliament to allow all justice sector agencies (a whole system approach is critical) to put plans in place to address the current and looming crisis. From a CJSW perspective, the risk of not doing so will lead to services being overwhelmed, individuals not receiving the vital services and interventions they require with a concomitant increase in the risk of reoffending. This will, in turn, undermine the confidence of the judiciary and the public in community sentences. And we would stress that there is not a viable alternative to community justice. Prisons are not only much more expensive, but also less effective in delivering the changes in individual behaviour a modern criminal justice system must seek to deliver. It we are, collectively, interested in ‘value’ from our public spending, our efforts must be focus on ensuring our community justice infrastructure is fit to meet the demand we put on it.

Over the last few months there has been significant strain in existing CJSW budgets. there have been additional costs to employ temporary, sessional staff to increase capacity in unpaid work squads. This is because CJSW has had to limit the number of individuals a supervisor can safely supervise, and due to a decrease in the availability of individual placements. There have been costs associated with making changes to buildings (new doors, flooring, chairs etc.) to meet health and safety guidance, e.g. increased cost for PPE, cleaning materials, transport for unpaid work, Portaloos (where public toilets are closed), installation of Perspex screens in interview rooms, the upgrading of IT connectivity – Smart Phones and headsets as well as equipment for safe working from home (chairs, desks etc.), increased welfare need and associated payments, predominantly related to mental health and drug and alcohol, and other essentials for individuals (e.g. phone, food etc.).

CJSW continue to use phone and virtual platforms to engage with individuals. However, for the majority of individuals they need to be seen and work needs to be carried out directly with them. We know that this professional relationship is critical to effective interventions[10].

  1. What is the likely change to your needs in the financial year 2021/22 because of COVID-19 and more generally?

CJSW will need to manage the balance between the reduced capacity for staff to be in buildings, working from home, and having sufficient staff to cope with the expected increase in workload due to the backlog of court business, on top of the existing backlog of work. There will be the need to increase staffing to meet the demand and the reduced capacity in order to ensure individuals complete their unpaid work hours and receive the interventions on orders that they are assessed as requiring – in the coming year that is likely to mean employing locum social workers, paying existing staff overtime, recruiting additional unpaid work supervisors and para-professionals, commissioning services from the Third Sector etc.

We would argue for an increase in funding to allow plans to be put into action to increase capacity and meet these challenges in order to protect communities, keep victims safe and hold individuals to account. Recent increases in staff costs have been met from wider local authority budgets in some areas, whilst other areas face the prospect of a detrimental impact on non-staff funds/service delivery; some are not filling vacancies due to budget constraints. There have been other ongoing pressures, such as auto-enrolment for pensions which have driven up the cost of employer contributions (£100,000 in one council). The cross-subsidising of CJSW from other budgets is becoming unsustainable, when all public service budgets are under such strain. This is set against a backdrop of prolonged austerity for many parts of local government, with continued year-on-year budget reductions, now coupled with the impact of the pandemic.

As referred to above (in question 1), local authorities were awarded additional funding this year for SDS and bail services. Scottish Government stipulated this could be utilised as a response to the pandemic. This is welcomed but it remains unclear whether this is a recurring amount; this creates uncertainty – some CJSW have created short-term posts funded to March 2021 as a response to the pandemic.

There is also likely to be additional capital expenditure in the year ahead, e.g. additional workshop facilities or to replace existing infrastructure no longer fit for purpose.

The current funding formula was introduced 4 years ago and 2021/22 will be the last year of the transition period to protect those local authorities adversely affected by this, e.g. in one local authority the net reduction in the CJSW Budget from 2016/17, the last year of the old funding model, to 2019/20 was £672,000. The annual funding model currently used is not fit for purpose. It restricts our ability to plan and sustain services, including services purchased from the Third Sector. It leads to short-term contractual arrangements and undermines our ability to retain staff. As an outcome of the comprehensive review of costs associated with Scotland’s community justice approach (which we have called for over a number of years), a new funding model should be adopted.

  1. How has your organisation adapted to working during the pandemic, what further changes are needed and what changes are you planning to retain after the pandemic has ended?

Throughout the national lockdown, except for unpaid work (now restarted), CJSW maintained the delivery of services and continued to manage the risk of individuals, albeit remotely and at a reduced levels focussing on higher risk of harm and the most vulnerable individuals. MAPPA, MARAC (to protect those at risk of domestic abuse) and MATAC (targeting perpetrators of domestic abuse) continued uninterrupted, with meetings moving to virtual platforms or using phone conferencing. However, most offices were shut, and staff worked from home. As indicated above, whilst there has been a return to offices this is at a much-reduced capacity and the mix of home and office work will continue for the foreseeable future. The complex services CJSW deliver legally require specially trained and qualified social workers. However, there is greater capacity to deliver alternative to prosecution and custody services by para-professional staff and/or third sector partners. This will require further structural and financial change, introducing greater flexibility into the system.

CJSW continue to explore the virtual delivery of services. For example, the delivery of the ‘other activity’ component of an unpaid work requirement through online modules (mental health, employability etc.) which an individual can access from their home and discussions are ongoing with the Third Sector offering advice and guidance as to what is required.

The issue of digital poverty has been highlighted by the pandemic and well-articulated[11]. CJSW are engaged with the development of the virtual custody initiative. We believe there is the scope to further deliver services virtually to individuals. For example, establishing a secure and reliable platform to effectively ‘FaceTime’ individuals regularly whether they are in prison or the community. This will not be appropriate for all and would require assessment on a case-by-case basis, but for lower risk individuals or where a person has completed interventions and is effectively being monitored this would provide an efficient additional method of supervision, i.e. a blend of contact in person and remotely. This has particular, post-pandemic applicability in remoter rural and island authorities. Ideally, all justice sector agencies should use the same platform for improved reliability and connectivity.

  1. What other matters and pressures on spending do you wish to bring to the attention of the Committee?

There are risks and opportunities in the urgent drive to ‘build back better’ across the justice sector. Local authority criminal justice social work will be central to that effort, given the range of statutory responsibilities it has. But securing long-term change requires capacity; people with the skills and time to facilitate the change, and sufficient numbers of people to deliver the changed system that we’re building. Lack of attention and investment in either of those elements will mean we are left with sound plans but limited success.

We have outlined above some of the many challenges and pressures on CJSW pre-dating coronavirus. These will continue to affect service delivery across Scotland for the foreseeable future, but now with the added complexity of covid-19. If we are truly serious as a nation in creating a modern human rights-based justice system that reflects and addresses the needs of individuals and victims, and one that is evidenced based, we cannot afford to continue to lock up so much resource in prisons. The 2020-21 budget is an opportunity to seize the moment and make the necessary paradigm shift. That requires courage and boldness from our political leaders and representatives; a willingness to stand up to vested interests and a commitment to a fundamental reappraisal of the funding and delivery landscape, led by the evidence and our country’s belief in human rights and best value.

For further information, please do not hesitate to contact:

 

James Maybee

Chair of Social Work Scotland’s Justice Standing Committee & Principal Officer (Criminal Justice Social Work), The Highland Council

James.Maybee@highland.gov.uk

 

 

[1] Scottish Budget 2020-21 (Scottish Government, 2020)

[2] What Works to Reduce Reoffending: A Summary of the Evidence, pp5, Dr. Maria Sapouna et al, Justice Analytical Services, Scottish Government, May 2015

[3] Scottish Prison Service 24/10/20 https://www.sps.gov.uk/Corporate/Information/SPSPopulation.aspx

[4] Electronic Monitoring in Scotland Working Group, Final Report pp4-5, Scottish Government 2016

[5] Ibid.

[6] Pre-budget scrutiny for 2020-21 Budget Submission from Social Work Scotland 27/9/20 https://www.parliament.scot/S5_JusticeCommittee/General%20Documents/submissions_prebudget.pdf  pp67 – 74

[7] Coronavirus (Scotland) Act 2020 Position Paper, Submission from Social Work Scotland to Scottish Government 10/7/20 https://socialworkscotland.org/briefings/reducing-the-backlog-of-unpaid-work-hours-coronavirus-scotland-act-2020/

[8] Is treatment non-completion associated with increased reconviction over no treatment? Mary McMurran & Eleni Theodosi, Journal of Psychology, Crime & Law pp333-343, 9/7/07

[9] SWS acknowledges a degree of caution as to the precise accuracy of the modelling which is unpublished; however, that there will be an impact is undisputed. We urgently call for clear modelling in order to allow agencies to comprehensively plan during and after the pandemic.

[10] For example, see A desistance paradigm for offender management, Fergus McNeill, Universities of Glasgow and Strathclyde, Criminology & Criminal Justice. 2006 SAGE Publications

[11] How having a mobile phone can save your life, Karyn McCluskey, The Scotsman 4/5/20

07/10/2020

Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill

Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill

SUBMISSION FROM SOCIAL WORK SCOTLAND, TO EDUCATION AND SKILLS COMMITTEE CALL FOR VIEWS

02.10.2020

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We have engaged closely with Scottish Government and local government partners in the development of the Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill, setting out our position on key matters in response to the pre-legislative consultation (November 2019).[1]

Our response to the Committee’s call for views has been developed by Social Work Scotland’s national Historical Abuse Practice Network (which supports professionals involved in supporting survivors’ applications for records and redress) and Social Work Scotland’s Children and Families Standing Committee (senior managers in social work services). In response to the Education and Skills Committee’s questions:

  1. The people who are eligible to apply to the scheme.

We agree with the proposed criteria for those eligible to apply, but note that Scottish Ministers will have the power by way of regulations (subject to the Scottish Parliament’s approval by affirmative procedure) to adjust the definition of “relevant care setting”. This would be by adding to or varying the descriptions of types of residential institution listed in section 18(3), or by modifying the detailed descriptions of each type of residential institution provided for in section 19.

The power to modify the definition of “relevant care setting” is said to be based on experience gained through the advance redress payment scheme, which has shown that additional types of care setting may come to light once the scheme is operational (paragraph 85 of the Policy Memorandum). On this basis the power seems pragmatic, providing potential flexibility in the scheme as we progress through installation and implementation. However, in view of the complexity of the care system and individual’s experiences, it is reasonable to assume that cases will present challenges to the current definition, and pressure for revisions. While we do not necessarily oppose future adjustment, the consequences for both the management and costs of the scheme may be considerable, and any such step must be fully consulted on (with all organisations and people affected) and properly scrutinised by Parliament. Indeed it may be desirable now, at this early stage of the Bill, for Scottish Government to provide some examples of the possible additional types of care setting which they predict may emerge, to ensure a full and detailed debate over how they should be treated.

  1. The Bill’s definition of abuse

We agree with the Scottish Government’s intent to base the definition of “abuse” on that as set out in the Limitation (Childhood Abuse) (Scotland) Act 2017 (“the 2017 Act”). The broad definition provides a flexible and a proportionate approach, focussing on the experience of the survivor, rather than making a judgement that any form of abuse is, in and of itself, more severe than another. Recognition that abuse takes a variety of forms, and that all have damaging, long-term impacts must be respected. Each case must be evaluated independently, against the agreed assessment criteria.

  1. The dates used in the Bill to define ‘historical abuse’

The dates used to define historical abuse, as that which took place before 1 December 2004, is appropriate. In opening up the scheme to those where the abuse took place before 26 September 1964, it will be demonstrably more inclusive than existing remedies.

  1. The Bill’s definition of ‘in care’ and the places in which that care took place. 

There is no definition of “in care” within bill.  Therefore, it is understood that this question relates to the definition of “relevant care setting” as defined in sections 18 to 20. We have no specific issues with the two categories of care setting described; firstly, a residential institution in which the day to day care of children was provided by or on behalf of a person other than a parent or guardian of the child, and secondly, a place, other than a residential institution, in which a child resided while being boarded-out or fostered. We are also content with the definition of “residential institution” to mean a children’s home, a penal institution, a residential care facility, school-related accommodation, and secure accommodation.

However, in our response to the pre-legislative consultation we expressed unease about the exclusion of children who were in the care of medical professionals but for whom parents retained long-term responsibility for them. We noted that this “risks denying many individuals the right to redress for abuse suffered while in the care and protection of the NHS. It also insulates the NHS from appropriate accountability around how it fulfilled its responsibilities to the children in its care. […] The primary consideration in determining eligibility should be whether the state had a significant role or power in determining the placement of the child, and when the child was in that placement, had responsibilities for their care and protection.” We have engaged with Scottish Government on this point, and appreciate the complexity, and potential financial challenge, of including such situations in the statutory scheme. But we take this opportunity again here to stress that, as with some individuals who were placed in boarding schools for reasons other than simply parental choice, the Redress Scheme is likely to seem unfair. Moreover, as currently constructed the Redress Scheme situates the failures and responsibilities of the state with local authorities; as independent inquiries into historical abuse have consistently found, formal ‘in care’ settings are only part of the picture.

  1. The process of applying for redress and what advice and support applicants might need, particularly in relation to the waiver scheme.

The process of applying for redress, and the advice and support provided to applicants, must be considered beyond the relationship with the Financial Redress Team alone. The scheme’s intention is to give survivors more, not less, choice as to how to pursue financial reparation. Accessible, independent legal advice is critical, as the introduction of the redress scheme does not, in itself, replace existing avenues of financial reparation. Civil litigation will remain an option, and in some cases may lead to higher settlements and a more definitive sense of closure / redress. However, survivors must be supported to understand these options fully, including the likely legal fees levied on a successful civil claim, and the nature of what is an explicitly litigious process. In our view, it is a considerable unknown around the Bill whether there will be a substantial increase in legal fees once the scheme is live.

For the waiver to operate effectively, it must clearly and specifically outline the period, people and organisations, and instances of abuse for which the survivor is accepting the redress payment. It is crucial that survivors have independent legal advice at this stage in order to make a fully informed decision.

Subject Access Requests will be critical to the process; in many cases provision of information to the redress scheme can only be met by invoking this right. Significant resource will be required by public authorities to fulfil their obligations to the statutory requests for personal information which the redress scheme will provoke. Comprehensive consideration must be given to how organisations covered by Subject Access Request duty are supported to undertake the work. Local Authorities increasingly experience demand outweighing resource. We strongly urge the Scottish Government, in the interests of applicants to the scheme, to fully fund public authorities in the delivery of this function. A constructive conversation has begun with Scottish Government on this matter, and we hope over the course of scrutiny of the Bill that our members can be reassured that demand created by the Act will be met by appropriate investment.

Inclusive to the process of applying, at point of entry to the scheme survivors must be offered counselling and support services. The impact of the redress process including accessing records, living through the redress process itself and re-living abusive experiences cannot be understated. A significant risk to survivors is being re-traumatised through this journey. Counsellors, social workers and support workers will be critical to supporting individuals through this process safely. Further detail on this critical provision, including how it will be resourced, would be welcome in the Bill’s accompanying documents.

  1. The level of payments offered to survivors.

 We are broadly content with the levels of payments offered to survivors. Arguments may be made for higher or lower levels of payment, but we are satisfied that the Scottish Government has balanced the various factors in its calculation.

  1. What you believe to be a ‘fair and meaningful’ contribution to the scheme from organisations responsible for abuse

 The details of this contribution, including the amount, structure, and timeframe, are not specified in the Bill or its accompanying documents. A key area of concern is the unknown quantum of the contribution. While it is assumed to be a significant proportion of the costs of redress payments as set out in the Financial Memorandum (£350m), there are various unknowns which will determine the total payments which will be made and, in turn, the extent of the financial contribution from organisations responsible for abuse.

We are aware conversations between Scottish Government and COSLA are ongoing, and a collective response from local government will emerge. The priority for Social Work Scotland is on the operation of the scheme itself, the support available to applicants, and the impact on social work departments. But from discussions among our members, a preferred approach to securing a “fair and meaningful contribution” was for SG to fund the entirety of the scheme in the first instance, with individual local authority contributions assessed on the profile of claim’s and liabilities of the former regional councils. Where areas have higher numbers of successful claims, clarity on equal or variance of contribution would need to be confirmed. Other members pointed to models such as the CNORIS (NHS) scheme, whereby costs are apportioned according to the losses by region. There is an annual actuarial review to assess the contributions made by each NHS board. However, we do recognise that such approaches would create a level of uncertainty for each local authority, which may not viable in terms of budgetary planning.

Indeed, bearing in mind the financial position that COVID has left authorities, we do think it is important that, whatever mechanism is agreed, phased payment of contributions will be necessary, to avoid a negative impact on services available to the public.

The civil litigation risks also cannot be understated or excluded from consideration. Whilst the redress scheme may award up to £80,000, there may be cases where the survivor has been advised by an independent legal advisor that their claim may result in a higher settlement through civil action. There may be a substantial increase in civil claims, with the associated increase in legal fees and compensation awards. All such cases would fall outwith the Redress scheme’s scope, and the calculation of ‘fair and meaningful’ contributions.

  1. The process for dealing with applications to the scheme from people who have serious convictions.

 We agree with the process proposed for dealing with applications to the scheme from people who have serious convictions, on the basis that a public interest / human rights-based approach will be adopted.

  1. The process for family members to make an application on behalf of a survivor who has since died.

We agree with the process for family members to make application to the scheme, as a ‘next of kin’ payment.

  1. How to ensure that non-financial redress (e.g. an apology) meets the needs of survivors.

It is noted that the bill says very little about apology. Apology is referred to once in section 91, regarding reporting requirements. Public apology is without doubt a key aspect of non – financial redress and Scottish Ministers should continue to publicly acknowledge survivors’ experiences. Survivors should be consulted on how non-financial redress should look and feel for them, and further detail should be provided by Scottish Government on how priorities will be met. Social Work Scotland looks forward to working with Scottish Government and other partners on these aspects.

For further information, please do not hesitate to contact:

Ben Farrugia

Director, Social Work Scotland

ben.farrugia@socialworkscotland.org

[1] https://socialworkscotland.org/consultation/financial-redress-for-historical-child-abuse-in-care-pre-legislative-consultation/

11/09/2020

The Impact of COVID-19 on the Financial Sustainability of Local Government in Scotland

SUBMISSION FROM SOCIAL WORK SCOTLAND, TO THE SCOTTISH PARLIAMENT’S LOCAL GOVERNMENT & COMMUNITIES CALL FOR VIEWS

Q.1. How has COVID-19 impacted the local government sector, in particular, council
finances? Which council responsibilities are most impacted?
As the Committee’s 2019 inquiry into the long-term financial sustainability of Scottish local government confirmed, council finances were under considerable pressure before the pandemic. Restricted in their ability to raise funds themselves, councils have become increasingly reliant on the annual local government settlement agreed with the Scottish Government. Over the past five years to 2018-19 that settlement has not kept pace with the demand for council services, with overall funding falling in real terms for local government.

Within these totals, additional funding has been largely concentrated in specific, ring-fenced areas, delivering on Government manifesto commitments (e.g. expansion of Early Learning and Childcare hours). While such policy developments are welcome, the move to ‘targeted investment’ (ring-fencing) at the expense of sustaining ‘general local authority revenue’ has forced councils, as policy and spending demands increase, to make deeper cuts in ‘unprotected’ areas.

To illustrate the pre-COVID-19 financial situation for local populations, the graph below (see download)
presents local government expenditure on a per head of population basis, from 2013-14 (after police and fire functions had been transferred out to national bodies) to 2018-19 (with planned expenditure shown for 2019-20). On these figures (from PESA 2020) local government spend in Scotland reduced by 6% in real terms per head between 2013-14 and 2018-19. Outturn for 2019-20 is not yet available in this data set, but planned spend was due to increase.

Of particular relevance to Social Work Scotland has been local government budgets relating to social work and social care.). As Audit Scotland noted in December 2018: Councils’ social work departments are facing significant challenges because of a combination of financial pressures caused by a real-terms reduction in overall council spending, demographic change, and the cost of implementing new legislation and policies. […] The report goes on to restate the finding of Audit Scotland’s 2016 report that, unless there is radical reform in way council and Integrated Joint Boards deliver services, councils’ social work and social care spending would need to increase by between £510 and £667 million
by 2020 (a 16–21 per cent increase on the £3.1 billion spent in 2014-15). Yet in the absence of substantive reform, such investment has not been forthcoming.

Using the Treasury’s Public Expenditure Statistical Analyses (PESA), which provide net service expenditure data (current plus capital) for personal social services (in this context, a term equivalent to social work and social care), it shows that Scotland spent £3.4bn on social care in 2018-19; the only UK nation to be spending less (-3%) in real terms than it was in 2010-11. (Detailed figures are in an appendix to this submission.)

Despite significant policy developments over this period spend per head in real terms was 6% smaller in 2018-19 compared to 2010-11; the largest percentage reduction among the UK nations (see the second of the graphs in download below). Spend per-head figures provide a better indication of the availability of public services to council residents than whole budget numbers. (A budget may increase, but if the numbers requiring support also increase, available spend per person may actually fall.)

However, while spend per-head takes into account total population change, it does not reflect population ageing. And as has been noted extensively in other submissions to the Committee, the increasing number of people aged 75 years and over, and of 85 and over, have greatly increased the need for social care services for older people. Improvements in medical care have also increased the demand for services among children and working-age adults with moderate and severe learning disabilities. Expansion of council duties towards looked after children (such as Continuing Care) have extended support throughout young adulthood.

Unfortunately, in the run up to COVID-19, investment in social work and social care was not sufficient to keep up with the increasing demand. The Scottish Government’s Health & Social Care Medium Term Financial Framework (October 2018) estimates that 4% growth per year is required for social care from 2016-17, including pay and price inflation; for demographic change alone the annual growth figure is 2.8%. Into this context, COVID-19 has created new challenges for local government, increasing its
financial fragility in general, and for its social work and social care services specifically.

Over recent months local authority social work teams have had to redesign services and redistribute resources at a scale and pace never seen before, ensuring staff can work safely and effectively from home or with personal protective equipment. Homeless people have been accommodated, and Humanitarian Assistance Centres established to provide food and services for those most in need. Systems have been created to support those shielding, and hundreds of offenders released from prison early. As the situation in Scotland’s care homes became clear, new structures of oversight and assurance have been built.

Now, as we move through the route-map out of a national lock-down, the reopening of regular services (day centres, respite, Children’s Hearings, schools, etc.) introduce another layer of issues; not least an operational challenge in having to sustain multiple access and support options simultaneously, to meet the varied needs of local populations.

Scottish Government has been bold and determined in its efforts to shore up public services, allocating significant extra funds at various stages. But the challenge for local government, and for social workers within that, is in estimating levels of need and demand for services in a constantly changing environment, where the public’s behaviour is unpredictable, and government policy driven by competing priorities (e.g. infection control vs. revival of the economy). Services are stretched.

And as universal services continue to re-open, referrals to social work are expected to increase; for example, child protection interagency referral discussions are currently at levels significantly above the average for August and September; as courts re-open we expect to see new Unpaid Work hours to be allocated to offenders, adding to the current back-log of over 700,000 hours; assessments for social care support, withheld by individuals or families over lock-down, are now being requested.

Unpaid carers, both “informal” (largely families and neighbours) and ”formal” (volunteers), have made a massive contribution to carrying the social care sector through the lock-down and initial stages of the route-map; as the furlough scheme ends and offices reopen, a proportion of that personal care and support will be removed, requiring a response from national and local government and Health and Social Care Partnerships.

Work on the costs of Covid-19 for local government in England published in August by the Institute for Fiscal Studies, found that social care accounted for 41% of financial pressures (p14), due to “increases in spending as a result of additional demand, increased payment rates and other support for providers, workforce sickness and other pressures, the cost of personal protective equipment and other costs” (page 53). There is no reason to think the situation is different for Scottish local government. And while the emergency investment from Scottish Government has undoubtedly gone some way to meet the costs of the pandemic, it is too early to tell if it will be sufficient to meet all of the increased costs (including those which are to come, in the delivery of a post lock-down, COVID-aware system).

Meanwhile, local government income has been lost from the closure of leisure facilities and other services carrying charges, and by delayed payments of council tax. The financial situation for Scottish local government is perilous.

Q.2. Which parts of local government have been least affected or most resilient?

We concur with the views of the Accounts Commission/Audit Scotland, in their evidence to the Committee on 28 August, that “very few, if any, council services have been unaffected by the impact of the pandemic through lockdown and social distancing”. Every part of local government has been pressed into service as part of the COVID-19 response, with staff and resources redeployed, priorities changed.

What has been remarkable is how resilient and flexible the system as a whole has been, drawing strength in the breadth of skilled professionals, budgets, etc. at its disposal. As we begin, post-COVID, to consider further reform to our public services (such as the introduction of a National Care Service), we believe it is important that weight is given to local government’s capacity to adapt in times of crisis. A critical factor in our assessment of proposals must be whether any future system will have the capacity, as local government does, to withstand and flex to a significant external event, such as a pandemic.

Q.3. What help will councils need in future from the Scottish Government or others to overcome the ongoing financial strain?

The first priority for the Scottish Government will be to identify with COSLA all additional spend and income reductions that council have experienced, so that any shortfall in the COVID-19 funding already provided can be clarified, and met. As the Accounts Commission stated in their evidence to the Committee on 28 August, “we cannot say that the [Government funding] increase in itself has significantly relieved the pressure on the sustainability of local government”.

The Scottish Government’s Summer Budget Revision stated that local authorities were being provided with an additional £155m for social care COVID-19 support. However, the Programme for Government 2020 (Protecting Scotland, Renewing Scotland) states: “During the pandemic, we put in place a number of interim measures to support the social care and support system. This includes £100 million of funding to meet any additional costs of COVID-19 and support the sustainability and resilience of the sector” (page 74). We have asked Scottish Government for clarification as to whether the £155m been reduced to £100m; or whether £100m been provided to date, with a further £55m still to come in 2020-
21. However, either way, commitments have been made by Ministers to the public, for example the resumption of care packages and reopening of day-care services. These commitments require follow-through investment to match the costs associated with delivery.

The impact of Covid-19 has perhaps been most visible in care homes. Joint research by Professor David Bell of Stirling University with colleagues in other universities shows that, during the weeks ending 13 March to 26 June, care homes accounted for 47% of deaths in Scotland recorded as associated with Covid-19, compared to 30% in England. In Scotland, 65% of care homes reported Covid-19 infections, compared to 44% in England. However, a better measure is “excess deaths” compared to the expected deaths based on the average for the period in the last five years; the research found there was “a 76% increase in mortality over the pandemic period in English care homes compared to 62% in Scotland”.

Earlier work by the Office for National Statistics has shown that, measured by total age standardised excess mortality (in all settings, not just care homes), Scotland ranks third highest in Europe, after England and Spain.

Local government and its partners (Integrated Joint Boards, providers) are going to need considerable ongoing help to recover, rebuild and – if reform is forthcoming – relaunch adult social care. The Account Commission / Audit Scotland’s reports into social work, social care and integration, over the past few years, have underlined the need for continued reform and investment. One without the other is highly unlikely to deliver meaningful improvement for communities.

Finally, before the Covid19 pandemic, the Accounts Commission had already expressed concerns about reduced council reserves, and their “ongoing use [of reserves] to manage funding gaps”10. Linking with our response to question 1, the increased use of reserves is clear evidence that funding for local government is not keeping pace with the population’s demand for services (both in respect to demographic changes, and the Scottish Government’s legislation placing new duties onto councils).

Q.4. What can the local government sector do, in the short and long term, to manage
the financial impact of the crisis? What positive examples can councils and others
share about the good work done at local government and community level to lessen
the crisis?

In respect of the positive examples from local government, much has been written over recent weeks documenting the extraordinary lengths councils have gone to in order to maintain services and support for communities. We would note the recent achievements of homelessness teams, working closely alongside social landlords and the charitable and private sectors, to accommodate rough sleepers throughout the pandemic, and to provide greater security to people with precarious housing. Elsewhere, justice social work teams have adapted rapidly to ensure continued, effective supervision of offenders in the community, and have helped facilitate the early release of prisoners (reducing pressure and infection risk within the prison estate). Social work managers from local authorities have stepped into care homes to provide additional leadership and capacity at a time of acute pressure, while others have been approved as foster carers in order to provide safe, loving homes for children who could not remain with their families.

The Accounts Commission have already mentioned community hubs in their oral evidence
to the Committee:

A lot of councils and their partners have created community hubs to enable
services to come together to provide the most effective support for people who
have been shielding, people who require support with food deliveries and key
workers who need help with organising childcare and so on. A lot of that happened
with real speed. [ …] In setting up community hubs, moving thousands of people to
work from home and collaborating with partners from the third and voluntary sectors
as well as other public service bodies, councils have done tremendous work.
[Official Report, 28.8.20, Columns 12 and 15]

Q.5. How soon do you think the sector will be back to normal? Or is this time for a
“new normal” in the way we deliver some council services or practice local
democracy? If so, what will it look like?

In our opinion the framing around COVID-19 of “back to normal” and a “new normal” are unhelpful. Prior to COVID-19 there was significant variation across the country in respect to people’s experience of public services, and the level of ‘change’ forced on some local areas by the pandemic has been less than others.

For those working in social work and social care, the past twenty years (and arguably longer) have been a continuous process of change, adjusting first to policy backed with investment, then post the financial crisis, to policy underpinned by austerity. In this context, COVID-19 has been an exaggerated, accelerated version of “normal”, demanding energy be ploughed into adaptation and innovation. Of course, elements of the past six months are new, such as social distancing, extensive use of PPE, track and trace, etc, and will need to be continued until vaccination or exposure creates sufficient immunity. But in the expansion of home working or greater use of digital platforms for service delivery (among other examples), COVID-19 has simply truncated processes which were already ongoing, forcing us into decisions sooner, rather than later.

Our priority now is in re-locating the individual person back at the centre of public services, reaffirming the principles of personalisation, choice and control. This was not the ‘normal’ prior to COVID-19, but it was the aspiration, and although the environment has changed it should remain the focus of our collective efforts.

Finally, we would draw the Committee’s attention to a number of critical issues which, while
all pre-dating COVID-19, now require immediate action if public services are to remain
sustainable into the future.

  1. Funding of Social Work and Social Care. Austerity had a negative impact on all public services, but social work and social care have been particularly hard hit, situated as they, to a significant degree, within local government. Social Work Scotland welcomes the inclusion of funding within the terms of reference for both the Independent Review of Adult Social Care, and the Promise following the
    Independent Care Review, and we will urge the Chairs and their advisory group to look at the system as a whole, including social work as well as social care.
  2. Health and Social Care Integration. Integration is an ongoing task, and the pandemic has provided valuable evidence on the extent of progress to date. In the months ahead attention must be squarely focused on the development of structures which best serve the delivery of personalisation, the realisation of human rights, and empowered, well-supported professionals.
  3. Local Government funding formula. Picking up on the Accounts Commission oral evidence to the Committee on 28 August, the “Grant Aided Expenditure” methodology has been largely frozen since the 2007 Scottish Government-COSLA Concordat. We believe the existing funding formula is in urgent need of reform – especially for social work and care. We agree with the Accounts Commission that insufficient weight is placed on poverty as a driver of demand; however, it is
    important to recognise that the area deprivation measures referred in Audit Scotland’s Local government in Scotland – Overview 2020 report (June 2020, page 15) need to be combined with household deprivation data, since, we understand, less than half of deprived households are in the most deprived areas.
  4. Climate Change. The pandemic has provided us with an unwelcome but invaluable opportunity to stress-test our public services in the context of a global external emergency. That learning must now be deployed in the planning for other such externalities, such as future pandemics, and climate change. More informed work can now take place on the adaptations to housing, infrastructure and models of professional practice which are likely to be necessary, and on the adoption of new technologies. Preparedness will provide Scotland with the best chance of success in dealing with future crisis.

For further information, please do not hesitate to contact:
Ben Farrugia
Director, Social Work Scotland
ben.farrugia@socialworkscotland.org

26/08/2020

Response to the Scottish Government Review of Local Authority Financial Returns – Social Work Services

Social Work Scotland response to the Scottish Government Review of Local Authority Financial Returns – Social Work Services (LFR03)

23 August 2020

  1. General comments

Social Work Scotland welcomes the opportunity to comment on the proposed changes to the LRF3 for 2019-10.  We sympathise with the position of Councils (and the Scottish Government) which have less staff time available for statistical returns, due to the pressures of dealing with Covid19.

Nevertheless, the proposed radical reduction in the data collected for social work and care services via the LFR3 will make the financial statistics much less useful to users, and significantly reduces the information in the public domain about a large volume of public expenditure amounting to £4.5 billion (gross) in 2018-19.

In its UK role, ONS last year reviewed the Adult Social Care dataset in Scotland and found important gaps; unfortunately, their review did not include financial information, however their findings do not seem consistent with the LFR3 direction of travel, especially if the data reductions were to become permanent.

Unfortunately, the brief “summary of changes” document issued with the consultation does not identify which changes are intended to be temporary, and which changes are due to “information already gathered as part of the LFR03 review” and might therefore be permanent. The LFR3 review is described as not yet completed as a result of reduced capacity due to Covid-19.  Social Work Scotland is not aware of consultation with service users on any prior proposals from the review.  We were involved in an earlier review three or four years ago which stalled – is this the same one? We would welcome involvement in the review when it is re-starts.

In our view, permanent changes of this magnitude require very careful consideration and a fuller consultation than can be done in present circumstances.  Meanwhile, we strongly urge all changes to the 2019-20 LFR3 to be temporary until the review can be reconvened with data user representation, and a fuller consultation paper prepared.

We understand the desirability of temporary change to reduce the workload this year, and possibly next if there is no vaccine or widespread vaccination by then; and we appreciate the need to simply the recording of transactions between councils, IJBs, and heath boards.  However, we have concerns about the statements that “these changes are focussed on reducing the volume of data collected to that which is required for a clear and specific purpose” particularly in the “additional information section” where the only examples given of recognised data needs are “figures that are required for ONS and Eurostat data collections, or are used within the Local Government Benchmarking Framework”. (Later we query whether the ONS requirement has been met).

However, there are other essential uses for the data which are not routine, involving the policy divisions of the Scottish Government, MSPs, COSLA, other stakeholders such as the Third Sector and Social Work Scotland; “think tanks”, research institutes and academics; and campaigning groups. Examples of such uses of LFR3 data known to Social Work Scotland include: costings for policy initiatives such as free personal care and changes to charging policy; work on the financial memoranda for new legislation (integration, children services, carers); post-implementation work on costs and the adequacy of funding (eg FPC, Children, Carers); campaigns by groups opposed to charging for social care; calibration of indictors for funding distributions; work on future expenditure requirements as a result of demographic change, for workforce planning and future funding options for social care.

In a democratic society, the purpose of financial statistics about public expenditure needs to be set more widely than the necessarily aggregated information needed for the national accounts and statutory reporting.  The whole concept of “additional information” as something secondary to this narrow focus is itself unhelpful.

 

  1. Treatment of transactions with IJB and NHS

This is an important area which we have not yet worked through in terms of the current LFRs and the proposed changes to LFR00 and LFR3.

One issue which does not appear to have been addressed is the lack of service expenditure data for adult social care client groups in the LFR3 returns from Highland for the last few years. This has been a problem since Highland adopted the “single agency” approach to Health and Social Care integration, whereby Highland Council delegated its legal duties and powers in relation to adult social care to NHS Highland, and NHS Highland delegated certain legal duties and powers in relation to children’s services to Highland Council. This has been interpreted as meaning that most adult social care services are no longer part of the local authority financial return, albeit that the ultimate legal responsibility for these services still lies with the delegating authority, Highland Council.

Certainly, in the first part of this period, NHS Highland provided civil servants with an annual LFR3 showing the service expenditures for Adult Social Care, to allow the full Scottish totals for service spends to be calculated as when they were needed.  I do not know if this helpful practice has continued. However, these were never incorporated in the official LG statistics which simply did not include adult social care service expenditure in Highland. Unfortunately, not all users of the LFR3 statistics are likely to be aware of this problem if they are only using the Scottish totals.

 

  1. Support services

We also have no comments on the changes to Support Services, other than to note that in the 2018-19 LFR3 returns it appears gross in row 9 at £150m, again gross in row 51 at £142m, and net in row 85 at £140m.  The proposed removal from the service expenditure sections from 2018-19 seems sensible, but will reduce total service spend, so therefore needs to be added to a long list of changes that data-users need to know about time-series comparabilities.

 

  1. Proposed aggregation of five Adult Social Care client group columns into one

We do not support the aggregation of the five adult client groups into one single category of Adult Social Care. This represents a huge loss of financial information, and would mean data users seeking information on social work/care spend on older people, or people with learning disabilities, or physical disabilities, or mental health needs, would only have the gross (and not also net) spend totals (from the proposed new rows at 49-53), but no information at all on the expenditure on the different services funded, apart from the new lines for older people only for care homes and home care.

For example, local authorities spent well over half a billion pounds (£578m gross) in support to people with learning disabilities in 2018-19: the suspension or abolition of any detail about this spend on services below the total is unwarranted on materiality, equalities and policy grounds, and is not in the public interest.  Similar remarks apply to support for people with physical disabilities (£268m gross in 2018-19), mental health needs (£187m), and other needs (£71m).

The LFR3 return has required a service/client-group split for at least 18 years.  While local authorities need to use service statistics to split any generic categories in their financial ledgers which are not already split between the adult client groups, they all will have systems in place for doing that.  They will need to use such systems to produce the five Adult Social Care client group sub-totals in rows 49-50.  But how will they do that? In the existing LFR3, this is done by adding up the service spends for categories already coded to a particular client-group, to which are added the results of splitting generic categories of spend – the total gross (or net) spend for the client-group is therefore a result of adding together the service-specific data.  So, if this work has to be done anyway, there is little time saving in deleting most of the gross expenditure service rows from the LFR3.

Of course, there is another way of producing the client group totals in rows 49-53, which is to take the results from last year and apply them as proportions to the total Adult Social Care gross expenditure. Such a short cut would save time, but contradicts one of the stated aims: to improve data quality. In general, it is a mistake to think that data quality is improved by higher levels of aggregation, when aggregates are not available independently of adding sets of lower-level data; all that is achieved is that the data quality problems become harder to spot.

 

  1. Children with disabilities (Memorandum item)

The “summary of changes” document simply states this column is to be removed, without giving the rationale. While children with disabilities are an important group, they have never been properly incorporated into the LFR3, only appearing as a memorandum item which made the data capture seem less important.  In 2018-19 only 13 out of the 32 authorities reported any spend; the Scotland page in the workbook shows gross expenditure of £11m, down from £24m in the previous year. However, there was an error in the calculation which omits Glasgow: the correct figure Scotland for 2018-19 is £16,385m.  However, that is clearly an undercount, since 19 councils made no returns.

The Carers Act, and associated funding, apply to carers of children and young people with disabilities, and (all other things being equal) could be expected to increase spend on services for being cared-for in order to assist carers.  However, it is clear that collecting spend data on children with disabilities has not worked on a memorandum basis, and that now is not the time to do the work to establish how reasonably robust financial data can be collected for this group.  Since partial collection serves little purpose we agree with the deletion of this item.

 

  1. Changes to service rows

The service rows have been significantly reduced, particularly for gross expenditure. However, the points made earlier suggest that the time-saving delivered will be less significant than it seems.

Turning briefly to the gross expenditure service rows that are retained, it seems anomalous to ask for Accommodation-Based Service totals only for Children and Families, but not for Adult Social Care.  Accommodation-Based Services has a number of sub-categories, of which only Care Homes have been retained, this time for both Children & Families and Adult Social Care.  There is a complete loss of information on gross (and net) spend on Residential Schools (£127m gross in 2018-19) and Secure Accommodation (£12.8m).

There are currently no net expenditure totals requested for the five Adult Social Care client-groups (ie the net equivalent of rows 49-53). This will be a problem for many users of LFR3 data, including Social Work Scotland, and possibly also for UK and Scottish public expenditure statistics. The Scottish tables including Personal Social Services in Chapter 10 of HM Treasury’s Public Expenditure Statistical Analyses 2020, published last month, must be derived from the LFR3 and appear to use net expenditure (since the PSS total for 2018-19 is £3.370 billion, which is similar to the LFR3 net total of £3.246 bn).  PESA also requires separate figures for “Sickness and disability”, “Old age”, and “Family and children” – the latter figure is very close to the net LFR3 total, but PESA appears to count some expenditure for older people under “sickness and disability”.  Nevertheless, if the ASC client-group split is not available for net expenditure on the five client groups, the OSCAR system which produces PESA will have to be fed estimates not actuals.

In 2012 Social Work Scotland calculated the impact of demographic change on future expenditure needs for a submission to the Scottish Parliament’s Finance Committee.  LFR net expenditure data for older people was used with national activity data to estimate age-specific spend.  We plan to update this work, but that would not be possible on the current LFR3 reduction proposals, without total net expenditure for older people to act as the control variable for the baseline.  A similar methodology may have been used in the Scottish Government’s Health Social Care Medium Term Financial Framework (2018), which again will need updating before it expires in 2023. Improved methodologies require unit costs to weight service durations or events, separately for age/sex groups, from the social care person-based datasets developed initially by ASD and now by ISD.  (Methodologies are need to project future numbers of people with learning disabilities – the large increase in spend over the last 10-15 years has not received the same attention as the growth in the elderly populations).  The cost numerators must largely come from the LFR3, if Scottish social care data is to be used.  This requires maintaining the full Adult Social Care client group structure in the LFR3, and a reasonably detailed set of services.

Generally, less service rows have been cut from Net Expenditure than from Gross Expenditure, but there are some exceptions where the service appears under Gross but not under Net Expenditure, but no rationale is given in the text document on the changes.  Should (Row 58) Fostering/Family placements be moved to Net? The same question arises for the three Self-Directed Support rows, which are in Gross (lines 42-44) but not in Net.

Row 44 is new: “SDS3 Support arranged directly by the Council”.  Option 3 of SDS is where people ask for their support to be arranged and managed for them by the Council. Services will then be provided directly by the Council or purchased by them. It is not clear why this row is necessary, since by definition the services provided or arranged will appear in other service rows.  The 2018-19 LFR3 guidance makes it clear that the SDS2 row (now 43) is only to be used for any service spend under this options which is not already counted elsewhere in the LFR3.  Is the new row 43 intended to capture similarly residual spend? It seems likely to be much smaller than other service categories which have been cut.

The Total “Accommodation-Based Services” is retained in Net Expenditure, but the problem created by the aggregation of the five ASC client-groups is addressed only for older people (row 71) and “people aged 18-64 with physical or sensory disabilities” (row 70).  The former accounted for the largest accommodation spend in 2018-19 (£593m) and the latter for £57m, far less than for learning disabilities (£160m), which should also have a new row (unless you restore the full client-group columns).

As remarked earlier, care homes for children and young people are retained, but not Residential Schools (£125m net in 2018-19) or secure accommodation (£12m); these are significant services in policy terms and should be reinstated.

The Care Home sub-divisions are fine, as this level of detail is needed for ongoing monitoring of Free Personal Care.  However, the “Care Homes – Other” row had been deleted.  In 2018-19 a massive £566m (excluding children) was coded against this row on the LFR3, 80% of all spend on care homes for Adult Social Care!  Is the view that the other care home categories are exhaustive for Adult Social Care, and that data quality would improve if councils were forced to code this to the FPC/FNC combination rows?  Perhaps the new LFR3 guidance notes should ask council to let LGFS know if there is any ASC spend which should be in the deleted “other care home” category.

Similar comments apply to the Home Care rows. Again, more is spent on home care for learning disabilities than for physical disabilities so to select only the latter (row 82) is anomalous. The two rows (82 and 83) for non FPC Home Care should be retitled “Other Home Care …….”

The retention of Day Care and Equipment etc is welcome, but what is the rationale for retaining “Supported Employment” when spend in 2018-19 was only £7m?

The loss of Services to Support Carers is problematic, when the Scottish Government has stated it is monitoring the impact of the new Carers (Scotland) Act 2016.  To be sure, only £25m was recorded against this in 2018-19; the cost of carers assessments, and services provided to the cared-for person as replacement care, or to otherwise support carers, will be coded to other services rows.  Nevertheless, since there remain some concerns about the adequacy of the Financial Memorandum funding, it is not appropriate to be cutting this information now, particularly as LGFS already cut the respite care accommodation expenditure data a couple of years or so before the Carers Bill was passed.

All “Other” categories have been deleted, eg Other Accommodation-based Services, Other Community-based Services. There is a view that the inclusion of “other” in classifications encourages miscoding; however, there is a counter evidence that the absence of “other” actually encourages miscoding to other categories.  The data quality benefit of showing “other” categories is to highlight to data providers and senior staff signing off the returns possibly anomalously coding issues.  These “other” rows could be reinstated as ones automatically populated by the difference between the stated sub-categories and the category totals, to help highlight the data quality issues.

 

  1. Income from charging people who use services

According to the 2018-19 LFR3 returns, income from charging for social work/care services provided income of some £243m for councils, which is about 19% of the total social work/care service income (as derived from subtracting Net from Gross service expenditure).

However, charging for social work and care services remains controversial, despite free personal care for older people from July 2002 and since April 2019 for people aged under 65 years.  Unlike almost all NHS services, social care is not free at the point of consumption. In recent years, campaigning groups opposing charging for social care have use LFR3 data on income from charging in submissions to Scottish Parliament Committees and in publicity. Such use of the LFR3 data would be difficult or impossible in future, if, as seems likely, the proposed data reductions became permanent.

Turning to the detail, the proposals for Children & Families appear to make no sense. All data cells are blanked out except for “Assessment, Casework, Care Management & Occupational Therapy” – in 2018-19 this accounted for £1.4m of charging income out of a Children & Families total of £4.6m.  However, the total cell shows “PASS” so must simply be copying the Assessment etc figure.  That means a loss of information about the total charging income from other Children & Families services.  In 2018-19, there was also income of £2.2m for community-based services, and £0.9m for accommodation-based services.  While these are not large sums, they are significant in policy terms, and also to the people who have to pay them.

Similarly, the amalgamation of the five adult client groups into “Adult Social Care” means that the impact on council income of free personal care on the under 65s from 1.4.19 will not be able to be monitored via the LFR3.  There also continues to be public concern about the impact on older people and their families of charges for specific services such as residential and home care – the income from such charging (£200m in 2018-19) will also be no longer transparent nationally.  Such data is still very necessary to inform future public discussion of social care reform. At the very least, income from charging should include all chargeable services for which there is gross or net expenditure retained on the proposed 2019-20 LFR3, or which are added back as a result of this consultation – for, as well as the points just made for older people, the impact of the new legislation on free personal care for people under 65 on the local authority incomes from charging needs to be known separately for adults with learning disabilities, physical disabilities, and mental health problems.

The proposed shorter service detail for charging people who use services is also problematic. The “Assessment, etc” row (£3.6m in 2018-19) is retained: fine, it needs some investigation as to what exactly is being charged for here, as none of the named services are normally chargeable. The amalgamation of “accommodation-based services” is fine.  Total “community-based services” is in, but of its 7 service rows only “Equipment and Adaptations” and “Supported Employment” have been retained, despite the latter having no income shown against it in the 2018-19 returns!  The service detail needed is: Home Care; Day Care; Equipment and Adaptations, and Other Community-based services.  Finally, the SDS1 and SDS2 items disappear and so should be retained (perhaps aggregated) to ensure the total charging income is complete.

Mike Brown
Treasurer, Social Work Scotland

mike.brown@socialworkscotland.org

12/08/2020

Covid-19 Workforce Plan Discussion Paper

 COVID-19 WORKFORCE PLANNING FOR THE HEALTH AND SOCIAL CARE WORKFORCE IN SCOTLAND – MAY 2020

SUBMISSION FROM SOCIAL WORK SCOTLAND TO SCOTTISH GOVERNMENT

26 May 2020

 

  • Do you agree with how we propose to develop new assumptions and the evidence base? Do you have any alternative or additional suggestions that we should consider?

We agree that workforce planning in the light of Covid19 must separately consider the immediate, medium term, and long term contexts and objectives. (para 7i).  In Annex A, these are described as Respond, Recover, Renew.

Scotland and the rest of the UK is not yet at the end of the Respond period.  While there is evidence that social distancing and lockdown has reduced the virus transmission rate, there are still new cases and fatalities especially in care homes and the community. A cautious and phased approach to lockdown remains essential but, despite improvements, this will be hampered by the insufficient supply of PPE for all who need it, by the current limitations on the volume of “test-trace-isolate” initiatives in the health and social care sectors.

Providing adequate support to NHS, care homes, home care, mental health, domestic abuse, financial support, food banks, volunteer coordination, and other essential services must remain the top priority of the Government, the public sector, and society.

It is not obvious how changing the Workforce Plan at national level can assist that work at local level.  Rather we all need to learn from what has been done well and what hasn’t in the response so far to the virus.

Apart from the shortage of PPE and testing, lessons need to be learnt from discharging untested patients from hospital to care homes because they were considered “medically fit for discharge”, and its contribution to the high rate of death from Covid-19 in care homes.  Lessons also need to be learnt from the failure of the NHS to meet normal demand while freeing bed capacity for Covid-19.  Some of the excess mortality in this period will be due to cancelled diagnosis and treatment for people with cancer, heart disease or other life-threatening conditions.  In both these cases, the lesson is that too narrow an understanding of “Protect the NHS” costs lives as well as saving others.

Health and social care integration requires both parts to be considered equally. While the current Integrated Health and Social Care Work Plan is a significant step forward, it is noteworthy that there are far fewer specific commitments relating to social care than health, despite the fact that their workforces are of broadly similar size.

We consider that additional resource is most likely to be required across mental health services for all ages, and across social care. The independent sector will require to adjust to the impact of Covid-19, and this will impact on capacity at local level and the support required from councils and partnerships.

 

  • What should we do about our existing Integrated Workforce Plan and workforce commitments?

We think it is too early to make significant changes to the Workforce Plan for the longer term, as the “Renew” landscape will be not yet clear. There is growing support in Scotland for a fundamental review of social care, including funding and care models, and that is something Social Work Scotland welcomes and will support.

There are some critical key questions whose answer will form the main parameters of the next phase:

 

  1. Does exposure to the virus create immunity, and if so, for how long?

 

  1. Will an effective vaccine to Covid19 be found soon, and be produced at scale and reasonable cost to governments, so that it can be used world-wide?

 

  1. Will the virus mutate, either to a new equally virulent form, or, like the common cold, to a much less harmful form?

 

  1. Can PPE be produced, purchased and distributed in larger volumes to meet all needs for protection?

 

  1. Can the testing for live virus be massively increased, with associated contact tracing, so that people infected can be isolated, and transmission stopped? Health and Care staff, and the people using their services need such testing frequently. The contract tracing human resources needed are significant and in need of planning.

 

  1. Can the random sampling for live virus, which has only recently started in England (in a joint project between ONS and Oxford University), be increased to show the variation around the average prevalence (currently 1 in 400) between different areas of the UK, and urban versus rural areas, in order to provide the firmer epidemiology necessary for current and future planning?

 

  1. Can this random testing be combined with antibody testing to provide evidence of re-infection rates and possible “herd immunity”, also needed to provide the firmer epidemiology necessary for planning renewal?

The current Workforce Plan commitments were based on meeting identified needs, which have not gone away.  The question now is whether there are more important Covid19-related priorities for the resources allocated to these commitments; if so, then the commitments should be deferred. We are sure that all stakeholders, especially Integration Authorities, Councils, and the NHS will already be acting pragmatically.  Covid-related priorities must include restoring essential health and social care services for people on waiting lists whose diagnostic tests, assessments, treatments or support have been deferred, and for people who have not been referred not come forward because of current Covid19 priorities.

  • How do we best manage workforce planning as a whole-system endeavour, across the integrated health and social care landscape?

See the points made about information under questions (4) and (6).

Urgent consideration needs to be given to increasing the flexibility of the workforce to operate across health and social care sectors, and public and independent sectors, understanding that this will require regard to terms and conditions, training and professional registration.

The voice of people who use services should underpin assumptions about workforce demand across the system. The usual pattern of care delivery has been temporarily altered to a significant extent, as some partnerships have sought to reduce their volume of service delivery, some have restricted flexibility and some have increased personalisation. Some people have opted of their own accord to temporarily reduce their reliance on directly funded social care, due to risk of contracting Covid-19, others have been approached by partnerships requesting to reduce their POC, others have changed their Self-directed Support option in order to find the model of support that best suits them at this time.  Preferences  In short, their experiences are significantly different to what they were prior to the pandemic.

The experience and needs of the Personal Assistant workforce should be drawn out, as they are a small but crucial sector in the delivery of personalised social care.

Local governance arrangements require to be strengthened and closely aligned with national workforce priorities. The statutory role of social work needs to be accommodated in national and local workforce planning.

Lessons learned from the pandemic about effective use of flexible working, home and remote working, and the use of digital meeting platforms should be incorporated.

  • What kind of workforce plan do you think will be required to cope with rapidly changing circumstances throughout the pandemic and after?

The role of the Scottish Government here is to support, with information, guidance, and resources, the relevant public bodies at local level.  Many aspects of the current Workforce Plan will remain: we need to continue all the actions that ensure we have a well-trained, educated, and supported workforce at sufficient volumes to provide the services society requires.

We envisage the need for short-, medium-, and longer-term plans based on current knowledge and insight. As new service models emerge, based on changed requirements, and ideally evidence of “what works”, then the Plan can change accordingly. The possibility of further lockdown needs to be incorporated into planning assumptions.

New models of community supports need to be sustained to ameliorate the requirement for directly provided care, for example renewed consideration could be given to a Buurtzorg model of community support, and from the early adoption of Community-led Hubs (Health Improvement Scotland).~

  • Are there any assumptions you would add?

One specific commitment needs some attention in any event.  The first bullet in para 5 of the Discussion Document states you will “As a baseline, look again at the modelling and financial assumptions set out in the integrated workforce plan published at the end of 2019”.

This is welcome as there is some lack of clarity in the statistical information underpinning the current Integrated Workforce Plan:

  1. The numbers of combined health and social care are given on page 8 of the Plan as “over 368,000 headcount” and “291,000 Whole Time Equivalent”. These are said to be the most up to date available data, but no weblinks are given. The “as at” dates are not given for these baseline staffing numbers; the counts are not given separately for NHS and Social Care, as they need to be; and it is not clear whether  any categories of NHS or social care staff been excluded from any of these counts (eg staff at the State Hospital).

 

  1. Page 8 of the Plan states that “The Scottish Government’s Medium Term Financial Framework (MTFF) estimates that to address the effects of demand, we will require 1.3% per annum more NHS employees and 1.7% per annum more social care employees in the period to 2023/24”. We could not find that information in the Health and Social Care MTFF published in October 2018,  which refers to annual growth rates of 3.5% in demand for health services and 4% for social care (H&SC MTFF pages 10 and 11). However, these are the total expenditure growth rates required to 2023/4, and include pay and price rises and other non-demographic factors.  If we strip those out using the data in Figure 8 of the H&SC MTFF, then the average annual growth required in activity year on year becomes 2.9% for social care and 2.4% for health.  That is still a lot higher than the 1.7% and 1.3% figures. Could we please be provided with a table showing how these staffing increases in the Workforce Plan relate to the H&SC MTFF financial projections?

 

Underpinning question 2. Is our concern that the staffing growth implied by the Scottish Government’s 2018 Medium Term Financial Framework has not been correctly stated in the 2019 Health and Social Care Workforce Plan, perhaps due to a statistical calculation error.  For example, taking the Workforce Plan to the next stage would mean discussion of what kinds of health and social care staff are needed in the future, but if the national financial parameters are wrong, then that will impact negatively on that work.

 

  1. Page 9 of the Plan includes a chart showing how “assumed demand” will increase total WTE staffing from the baseline of 291,287 WTE, to 310,758 WTE by 2023-24, before “mitigations” bring this down to 301,808. No figures are given for the elements of increased demand, or for the individual mitigations, which also should be separated between NHS and Social Care – otherwise there is no clarity.
  • How would you prefer to be updated on progress with this work? 

 The Integrated Workforce Plan would benefit from a dedicated page on the Scottish Government website. This should include key documents, any toolkits, useful contacts, links to other sites, etc.  It should also include and Excel Workbook holding the relevant staffing statistical time series starting with the Plan baseline dates, by type of staff and setting, and updated regularly by NES and SSC, with a summary page for Scotland, and in time separate pages for each Partnership area.  That would provide transparency about the actual direction of travel and enable more rapid monitoring of the Plan delivery.

Ideally, members of networks and stakeholder groups would be able to sign up on the website for email alerts to updates. Meanwhile communications can continue via email.

27/11/2019

Financial redress for historical child abuse in care – pre-legislative consultation

PURPOSE AND PRINCIPLES OF THE REDRESS SCHEME

  1. We are considering the following wording to describe the purpose of financial redress: “to acknowledge and respond to the harm that was done to children who were abused in care in the past in residential settings in Scotland where institutions and bodies had long-term responsibility for the care of the child in place of the parent”. Do you agree?

Yes, in general terms we agree with the proposed purpose of financial redress. However, in the drafting of the legislation we would encourage greater alignment with the wording used in the Limitation (Childhood Abuse) (Scotland) Act 2017, to ensure it is clear that the scheme applies only to individuals who sustained harm, rather than any child who was placed in a particular setting. Furthermore, the term ‘long term’ should be removed; ideas of what constitutes ‘long-term’ are contested (one month, one year?) and no clear definition exists or is likely to be agreed. The only relevant factors are that a child was placed in a setting by a public body (i.e. the state) and in that setting they suffered abuse. The length of time the child was in care should be immaterial.

If some version of the phrase “responsibility for the care of the child in place of the parent” is maintained in the description, it would be prudent to consider how the Redress Scheme will treat cases where institutions and bodies facilitated private arrangements within families, supporting relatives or family friends to provide care for the child in place of the parent. In these cases the state may never have assumed formal responsibilities for a child, but could still have had a significant role in determining with whom the child was placed; who may subsequently have subjected the child to abuse, or sent the child to a setting where they were subjected to abuse. While likely to affect only a few individuals, an equitable and effective Redress Scheme must be clear on how to treat these and other marginal cases.

2. Do you agree with these guiding principles?

Yes, we agree with the guiding principles proposed. But we feel that the list of principles should be extended further. Firstly, to include an explicit principle that individuals applying to the scheme are provided with specialised support from the start, designed to minimise the potential for future harm through the process (building on Principle 5), and also to ensure as strong an application as possible. This is to ensure equity of access to the Scheme, as some eligible individuals may have more experience, confidence, skills or support that others.

Secondly, while we agree the primary focus of the principles should be on the experience of the persons applying, we believe it would be helpful to have additional principles related to how public bodies and other organisations / institutions will be treated. For example, there could be a principle that the Redress Scheme will not put at risk services currently available to nurture and protect children looked after by Scottish local authorities. A clearer statement of how affected organisations can expect to be treated will not only help manage their engagement, it should improve transparency around a critical dimension of the Scheme for individual’s applying.

ELIGIBILITY

 3. Do you agree with the proposed approach in relation to institutions and bodies having long term responsibility for the child in place of the parent?

No. As noted previously, the notion of what constitutes ‘long-term’ is subjective and contentious, and the phrase should be removed, in favour of simply “responsibility in place of the parent”. The factors which need to be established are whether institutions and bodies had responsibility for the child (in place of the parent) at the time abuse took place.

Similarly, we would recommend removing the term “morally responsible”. We assume this has been included to highlight that the state (through its institutions and bodies) had ethical and moral responsibilities towards the children in its care. However, in this context it appears both anachronistic and, possibly, trivialising of the extent of responsibility. We would favour instead “…and were legally responsible for their physical, social and emotional needs in place of parents” or “…and were practicably responsible for their physical, social and emotional needs in place of parents”.

4. Subject to the institution or body having long term responsibility for the child, do you agree that the list of residential settings should be the same as used in the Scottish Child Abuse Inquiry’s Terms of Reference?

Broadly, yes. The list of residential settings should be the same as used in the Scottish Child Abuse Inquiry’s Terms of Reference.

5. Where parents chose to send children to a fee paying boarding school for the primary purpose of education, the institution did not have long-term responsibility in place of the parent. Given the purpose of this redress scheme, applicants who were abused in such circumstances would not be eligible to apply to this scheme. Do you agree?

No. While we understand and broadly agree with the rationale for excluding from the scheme children who were placed in fee paying boarding schools by parents who were free to choose, the current wording does not take into account the complexity of the UK’s history or individual family situations. As a result, individuals may be unfairly denied access to the Redress Scheme.

For example, how should the scheme treat children who were sent to fee paying boarding schools because of the parent’s employment abroad for the state, such as in the military, as colonial officers, or on diplomatic missions? In some cases the state itself will have paid the fees for these boarding schools, either directly or through supplements to parents. In these circumstances, did the parent’s ‘choose’ to send their children to boarding schools? Furthermore, in such circumstances it may be argued that sending children to such schools was for not primarily for the purposes of education, but also of care.

Related to points already made, there may also be situations were institutions and bodies (of the state) facilitated the placement of children in fee paying boarding schools, securing the financial support of relatives to keep the child out of formal state care. The Redress Scheme does need boundaries, but it must also be flexible enough to take account of the immense variety and complexity of individual circumstances. That will require skilled professionals, supporting individuals with their applications from the very start. And where people / groups are excluded from the Redress Scheme, we should be confident that those individuals have recourse to redress through other means. (Even then, we are concerned about the potential disparity which may emerge between two school peers, both victims of abuse, but one able to access a supportive, person-focused Redress Scheme, the other only with access to the courts.)

Finally, if a version of this exclusion is adopted, it will be important to communicate that it does not apply to people who were directly placed in boarding schools by institutions and bodies who had parental responsibilities towards them.

6. Where children spent time in hospital primarily for the purpose of medical or surgical treatment, parents retained the long-term responsibility for them. Given the purpose of this redress scheme, applicants who were abused in such circumstances would not be eligible to apply to this scheme. Do you agree?

No. We are very uneasy about the exclusion of children who were abused while in hospital for the purpose of medical or surgical treatment, where parents retained ‘long-term’ responsibility for them. As with boarding schools, the lack of nuance here risks denying many individuals the right to redress for abuse suffered while in the care and protection of the NHS. It also insulates the NHS from appropriate accountability around how it fulfilled its responsibilities to the children in its care. We fully accept that local authorities had responsibilities towards children who were then victims of abuse, but that is equally true of hospitals and NHS Boards.

The primary consideration in determining eligibility should be whether the state had a significant role or power in determining the placement of the child, and when the child was in that placement, had responsibilities for their care and protection. A parent whose child requires medical treatment does not ‘choose’ to leave them in hospital; they follow the recommendations (and often decisions) or doctors. Nor does the parent remain totally responsible for the care and protection of the child over that period; the hospital (and NHS more generally) assumes responsibilities too. These dynamics are true today, but were perhaps even more of a feature in the past, where deferential attitudes towards medical professionals would have meant less challenge of their decisions, and where hospitals were less welcoming of parents and families (with strict visiting times, etc.). By any common sense account, children in hospital for medical or surgical treatment were (and are) in the care of the hospital and its staff. That should be reflected in the eligibility to the scheme.

By our understanding of this proposed eligibility criteria, if a group of children had suffered systematic abuse in a Scottish hospital (such as Jimmy Saville perpetrated in an English context) only those who had been formally ‘looked after’ by a local authority would be eligible to apply to the Redress Scheme. This does not seem fair on the victims (who may legitimately feel the hospital had responsibilities to keep the safe) nor on the local authorities and other organisations who will participate in the Redress Scheme.

DEFINING ABUSE

7. We intend to use the same definition of abuse as the Limitation (Childhood Abuse) (Scotland) Act 2017 for the purpose of the financial redress scheme. This includes sexual abuse, physical abuse, emotional abuse and abuse that takes the form of neglect. Do you agree?

Yes. The same definition of abuse as the Limitation (Childhood Abuse) (Scotland) Act 2017 should be used for the purpose of the Redress Scheme. We also support the link to the Child Protection guidance.

In determining how specific applications to the Redress Scheme are handled, we believe the interpretation of this definition should be expansive, taking into account certain actions which do not correspond obviously to sexual, physical or emotional abuse. For example, in situations where there is inappropriate administration of drugs, whether as means of control or as part a fabricated induced illness.

8. In our view 1 December 2004 represents an appropriate date to define ‘historical’ abuse for this financial redress scheme. Do you agree?

Not sure. Any date is going to exclude people, however, in the interests of making the Redress Scheme as inclusive (and final) as possible, should we not set a date somewhere closer to the present? Particularly as the scheme is not expected to be in operation until 2021. Moreover, the rationale given for the December 2004 date feels weak; we are concerned that victims / survivors of abuse may not feel the date of a public apology is a sufficient milestone. Perhaps a more suitable alternative would be the start of the public inquiry, in 2015.

If the 2004 date is chosen, clear guidance on alternative routes to redress must be made available to those who suffered abused at a later date.

9. Do you have any comments you would like to make in relation to child migrants who also meet the eligibility requirements of this redress scheme?

We are supportive of the proposals around child migrants. It is both logical and fair that these individuals are considered eligible to the Redress Scheme, if they suffered abuse within Scotland while in the care of the state. This should apply even if they have also received or applied to the UK child migrant scheme.

10. Do you have any comments about the eligibility of those with a criminal conviction?

Criminal convictions should be no barrier to accessing the Redress Scheme. Eligibility should be determined by the circumstances of an individual’s childhood, not what the individual did or went on to do. We understand that for some it will be unpalatable to award financial payments to individuals convicted of offences (particularly sexual offences against children), but ultimately that is a political, presentational problem. The scheme can only live up to the principles on which is supposed to be based if it is open to all, irrespective of the actions of individual applicants. Moreover, if any restrictions were to be introduced, they are likely to be challengeable under the Human Rights Act 1998.

11. Do you have any other comments on eligibility for the financial redress scheme?

It may help if the eligibility criteria were clear on characteristics like citizenship. Our assumption is that the Scheme would be open to anyone who suffered abuse in Scotland while in the care of public bodies, regardless of their citizenship at the time or now.

We also recommend that powers be taken by Scottish Ministers to review and adjust eligibility criteria, and for these to be formally reviewed after the first couple of years of the scheme’s operation.

EVIDENCE REQUIREMENTS

12. What options might be available for someone who has been unable to obtain a supporting document which shows they spent time in care in Scotland?

Those who are unable to produce documentary evidence of being “in care” are ineligible for an Advanced Payment; it makes sense that the full Redress Scheme mirror this. However, individuals applying to the full scheme should have the option to give evidence on oath, submitting an affidavit for determination.

Assuming that individuals will receive support with applications from the start, it may also be possible to triangulate from other documentary evidence, including individual’s personal records, to a high degree of certainty that an individual was at a particular place when abuse took place. This could be validated by a version of the ‘in care confirmation letter’ developed for the Advanced Payment scheme.

13. Do you think the redress scheme should have the power, subject to certain criteria, to require that bodies or organisations holding documentation which would support an application are required to make that available?

Yes. To deliver the Scheme efficiently and effectively relevant bodies and organisations should be required to provide information which would support an application. This power would replicate that of the Scottish Child Abuse Inquiry. It would also help ensure all relevant parties share the load of facilitating the work of the Scheme.

However, the provision of information is not a cost free exercise. In fact it can be a highly onerous one, and detailed consideration will need to be given to how organisations covered by this power are supported to undertake the work requested. Resourcing (human and financial) and imagination will be necessary. It could be worthwhile, for example, to establish within the Scheme’s statutory body a team of sufficient size that they can directly assist data / evidence providers (who otherwise may need to recruit and train additional staff). In all instances, adequate, realistic timescales must be given for compliance.

The key consideration for the design and management of the Redress Scheme must be that attention and resources are not diverted (more than is absolutely necessary) away from the current provision of services, and the support of children and adults (some whom may also be applicants). The redress scheme will be unsuccessful and self-defeating if it saps the strength of today’s public services, through the reallocation of money, or people’s time and energy. The operation of the Redress Scheme must be fully funded, including the cost requirements of local authorities and others, whose staff will be central to making the Scheme work.

14. For Stage One, what evidence do you think should be required about the abuse suffered?

For the Stage One payment, the evidential test should be the same as currently in place for the Advance Payment scheme. We should be confident that abuse did take place at an institution while the individual was placed there, but not need to have proof of the specific instances of the individual’s abuse. Individuals should be able to submit what information they see as relevant to assist their application, including a written statement, but it should not be required. Similarly, a short written description of the abuse and its impact should not be required; the Stage One scheme, as proposed, would not be about assessing the extent of impact, so this would not be relevant. The act of describing the abuse may also, in itself, be re-traumatising. It should be choice whether they wish to disclose this, as part of a Stage 2 application.

15. Do you have any additional comments on evidence requirements for a Stage One payment?

No.

16. For Stage Two, what additional evidence of the abuse, and of its impact, should be required for the individual assessment?

  • Any existing written statement from another source which details the abuse in care? Should be encouraged to submit, not required to.
  • Oral testimony of abuse and its impact? Should be an option if people wish to, but not a requirement. See answers below.
  • Short written description of the abuse and its impact? However, the notion of ‘short’ is imprecise. The requirement should be on providing sufficient detail, not length. See below.
  • Detailed written description of the abuse and its impact? However, the statement should be able to be provided by a third party (i.e. a family member, friend, professional), or through the provision of specific support for the individual, with the production of this statement as its aim.
  • Documentary evidence of impact of the abuse: Existing medical and/or psychological records? New medical and/or psychological assessment? If no prior records exist, yes.
  • Supporting evidence of the abuse/impact from a third party? Should be encouraged to submit, but not required to have such evidence

17. Do you have any comments on evidence requirements for a Stage Two payment?

While the evidential test for a Stage Two payment should be appropriately more demanding than Stage One, the process for assessing claims must remain victim centred, flexible and focused on enabling and empowering an individual to secure redress (rather than meeting requirements or thresholds). This is likely to mean a process heavily dependent on skilled professionals and volunteers, including social workers, councillors, therapists, archivists, etc. That must be taken into account in the design of the scheme, and the structure and costs of the structure / organisation delivering it (e.g. a new public body).

18. Do you think applicants should be able to give oral evidence to support their application?

Yes. They should be able, but not required, to give oral testimony. They should have this option even if there is sufficient documentary evidence for their claim. This option should also be utilised where it is difficult to assess a case on the basis of available information.

19. Do you have any views on whether the length of time in care should be factored into the Stage Two assessment?

Length of time in care should be a consideration, but not a determinant or indicator of any impact. Being in care for two years and suffering abuse three times is not necessarily less significant than being in care for fifteen years and suffering abuse three times. Length of time in care should be something the professionals undertaking the assessment take into consideration, drawing on evidence about how individuals deal with trauma in different contexts, with different support structures, etc.

20. Do you have any views on the balance the assessment should give to different types of abuse (physical, emotional, sexual, neglect)?

Each case must be considered independently, and the focus must be on assessing the impact abuse had, whatever its form, on the individual. Establishing a hierarchy of abuse, as this question suggests, risks marginalising some victims’ experiences.

The process of assessment must be rigorous and forensic, but also sensitive and person-centred. It will not work if it becomes either a tick-box exercise or an opaque, subjective judgement. Maintaining the central, delicate balance will require very skilled professionals, using tools and their judgement, backed up by case notes and managers, and case discussions within small teams (to ensure individual assessors’ prejudices and assumptions are being challenged). Critically, individuals should have the right to appeal assessments.

21. What are your views on which factors in relation to the abuse and its impact might lead to higher levels of payment?

This should mirror the approach currently taken by civil courts.

22. Do you think (a) the redress payment is primarily for the abuse suffered; (b) the redress payment is primarily for the impact the abuse has had; (c) both the abuse suffered and the impact it has had should be treated equally.

It is unclear whether this question relates to Stage 1 payment, Stage 2 payment, or both. Assuming it refers to the Stage 2 payment, then its primary purpose is for the impact the abuse has had. The Stage 1 payment should be about acknowledging the abuse, and the second payment about its impact.

23. How do you think the scheme should ensure all parties are treated fairly and that the assessment and award process is sufficiently robust?

Again, the question is unclear about whether it applies all or part of the Scheme. Assuming that it refers to the Phase 2 payment, ensuring parties are treated fairly and the process is robust will depend on (a) the skills of the professionals undertaking the assessment, (b) transparency of the criteria being considered, (c) opportunities for review and appeal of assessment decisions, (d) strong structures of supervision for those undertaking assessments, (e) close work as a team to ensure consistency, and (f) constructive internal challenge.

Fairness is not something which can be baked into a system, or achieved through process or criteria. It is something experienced by individuals, and it will be determined in the relational space which the scheme’s employees offer. If individuals feel listened to and treated with respect, and that assessors took everything possible into account when making their judgement, and that decision makers give clear reasons for their judgement, applicants are more likely to feel the Scheme was fair, and accept decisions.

24. Do you agree that anyone who has received a payment from another source for the abuse they suffered in care in Scotland should still be eligible to apply to the redress scheme?

Broadly, yes, we agree that individuals who have received a payment for another source should still be eligible to apply to the Redress Scheme. However, the amount received should be deducted from any future redress payment. And where a court has made a determination about a previous claim, the Redress Scheme must handle applications very carefully, to ensure that an award does not contradict the court’s decision.

Our rationale for supporting this eligibility to the scheme is one of equity and fairness. We considered an example where two individuals experienced similar abuse, in the same institution, at a similar time. One of the individuals has successfully secured redress through the courts or another scheme, while the other chose not to. The latter individual now makes a claim through the Redress Scheme, and is provided with a more substantial award than that offered to the first individual. While we expect variance even between two very similar cases (due to variable impact of abuse), it does not seem fair that one is entitled to make the claim and the other excluded.

25. Do you agree that any previous payments received by an applicant should be taken into account in assessing the amount of the redress payment from this scheme?

Yes.

26. Do you agree applicants should choose between accepting a redress payment or pursuing a civil court action?

Yes. We agree that applicants should choose between the two routes to redress. However, we do have some concern about the availability of quality legal advice to people having to make this decision, and the potential for individual’s to be exploited. There is already anecdotal evidence of some legal firms encouraging individuals to make civil claims (sometimes on a no win, no fee basis).

MAKING AN APPLICATION

27. We are proposing that the redress scheme will be open for applications for a period of five years. Do you agree this is a reasonable timescale?

Yes. However, it would be advantageous if the legislation permitted an extension of the scheme, with the approval of relevant stakeholders, if demand, logistics, etc. justified it. Furthermore, if there is to be a deadline for applications (e.g. five years after the scheme opens) it will be necessary to build in some form of public information campaign to ensure eligible people know and understand the deadlines.

It is also important that we distinguish the timeframe within which applications can be submitted, and the timeframe of the scheme and associated public body. Processing applications may take some time (well beyond the closing date of applications) and, moreover, it would be a lost opportunity if the public body did not complete some research and publications before it was wrapped up. Further communications around the Scheme should make clear that the public body may be in operation for longer than the Scheme itself.

28. Should provision be made by the redress scheme administrators to assist survivors obtain documentary records required for the application process?

Yes. However, in part this should be achieved by properly assessing and resourcing the archivist and data retrieval functions of data holders (such as local authorities). Ensuring that these organisations have the capacity needed to meet demand would achieve the same result, but also have many more attendant benefits (freeing up front line social workers, for example). Locally embedded capacity could also work in local projects around record retention and access more generally, and would hold out the potential for skills to be developed locally, rather than in a public body which will eventually be dissolved.

Should a national database be developed with admission and boarding-out-register data (as is currently being considered) there is an opportunity for the Scheme to access the data directly and where the person is discovered this will negate the need for further documentary evidence.

This will not fully negate the need for survivors to be assisted to access records though, and whether the necessary support is provided by the Scheme or other organisations, it should be a priority in both the legislation and implementation. And the support for survivors will need to go beyond practical documentary evidence gathering, extending to emotional and legal guidance too. The complexity – and cost – of providing such support should not be underestimated.

29. In your view, which parts of the redress process might require independent legal advice? Please tick all that apply.

  • In making the decision to apply? If there are legal consequences associated with receiving a scheme redress payment, then legal advice should be available at the outset, as the process of applying will not be entirely cost free.
  • During the application process? Do not necessarily think it would be required often, but on the basis that in some circumstances it may, it should be available.
  • At the point of accepting a redress payment and signing a waiver?

30. How do you think the costs of independent legal advice could best be managed?

If it was possible, perhaps a measure of legal advice for free (provided by legal professionals employed or contracted by the statutory body). Then if an application is taken forward, this should be supported through legal aid (if the individual is eligible), with a cap on the maximum amount charged.

NEXT OF KIN

31. What are your views on our proposed approach to allow surviving spouses and children to apply for a next-of-kin payment?

Some provision for close, immediate family seems appropriate as a recognition on the impact the abuse may have had on the family. If the individual has died, the payment may also act as posthumous recognition of that individual’s experience.

It may the case that multiple family members may apply separately, but in our view only one payment should be available per survivor who has died. The Scheme will need to determine how a payment is then subsequently sub-divided between next-of-kin applicants.

We are supportive of the proposal to limit the next-of-kin definition to surviving spouses and children, as long as ‘surviving spouses’ includes civil partnerships and those who in long term relationships. Cases may become further complicated where ex-‘spouses’ feel justified to a claim on the basis that relationships with the abuse victim broke down in part because of the abuse the deceased individual had experienced. And there may also be difficulties with assessing the validity of children who were estranged (questions about whether the victim / survivor would have wanted them to receive funds), as well as those individuals who were not biologically or legally a victim / survivor’s children, but who were treated as such (e.g. children who grew up in informal kinship arrangements, with uncles, aunts, grandparents, etc.).

32. We are considering three options for the cut-off date for next-of-kin applications (meaning that a survivor would have had to have died after that date in order for a next-of-kin application to be made). Our proposal is to use 17 November 2016.

We do not have a firm opinion on this, but suggest that a single date be agreed to mark the various thresholds and cut-offs relevant to the Scheme. Previously we had suggested 17 December 2014, the announcement of the Scottish Child Abuse Inquiry.

33. We propose that to apply for a next-of-kin payment, surviving spouses or children would have to provide supporting documentation to show that their family member met all the eligibility criteria. What forms of evidence of abuse should next-of-kin be able to submit to support their application?

Next of kin applicants should have to provide the same proof as required by living applicants, as well as proof of their relationship. That should include any existing written documentary evidence of the abuse, and here necessary, written or oral testimony in support of their application.

34. What are your views on the proportion of the next-of-kin payment in relation to the level at which the redress Stage One payment will be set in due course?

50%

FINANCIAL CONTRIBUTIONS

35. We think those bearing responsibility for the abuse should be expected to provide financial contributions to the costs of redress. Do you agree?

Yes. Attributing responsibility for abuse will, in many instances, be complex and contentious. But, if we work from a position that certain parties had a responsibility to keep children safe and protected from abuse, we can build a framework within which relevant parties (i.e. those who should make a financial contribution) can be identified. This would include the government (now Scottish Government), local authorities and institutions.

Determining liability with regard to local government is likely to be very complicated, and we urge Scottish Government to work closely with COSLA and others to identify and properly stress-test different contribution models, before any legislation is introduced into Parliament. A suitable model can then be agreed in advance, supported by the relevant parties.

36. Please tell us about how you think contributions by those responsible should work. Should those responsible make?

No answer to this question.

37. Are there any barriers to providing contributions, and if so, how might these be overcome?

No answer to this question.

38. Should the impact of making financial contributions on current services be taken into account and if so how?

Yes. It is critical that the Redress Scheme does not impact detrimentally on current services. That most obviously includes those services available to today’s children and families, but also extends to the adult services (disability, drugs and alcohol, social care) which many victims / survivors will rely. If the Scheme was found to be negatively impacting on current services (for instance through reducing available funding), public support for the Scheme would likely wane, and it would potentially create risk within families.

In respect of how the impact on current services is monitored, individual organisations will have mechanisms for this, but there is also potentially a role for Audit Scotland and OSCR, keeping under review the financial statements of the organisations involved to ensure that changes in the availability of funding for certain services are flagged, and the reasons behind them interrogated.

39. What other impacts might there be and how could those be addressed?

Harder to identify than financial impact on current services, but possibly no less important, are the risks of vicarious trauma and burn out among the professionals supporting applications. We already have examples, driven by the demands of the Historical Abuse Inquiry and Advance Payment scheme, of resources having to be diverted, teams stretched, and individuals requiring time-off (due to over-work or discomfort with the material). Many people assume that identifying and processing records (i.e. for a Subject Access Request) is a purely administrative and bureaucratic exercise, but in reality it is one which exposes individual workers to stories of abuse and neglect. That exposure has an impact, and with the expected increase in requests for documentation which will follow the opening of the Redress Scheme, it will need to be properly taken into account.

40. How should circumstances where a responsible organisation no longer exists in the form it did at the time of the abuse, or where an organisation has no assets, be treated?

No answer to this question.

41. What is a fair and meaningful financial contribution from those bearing responsibility for the abuse?

No answer to this question.

42. What would be the most effective way of encouraging those responsible to make fair and meaningful contributions to the scheme?

No answer to this question.

43. Should there be consequences for those responsible who do not make a fair and meaningful financial contribution?

No answer to this question.

CONTRIBUTIONS TO WIDER REPARATIONS

44. In addition to their financial contributions to the redress scheme, what other contributions should those responsible for abuse make to wider reparations?

For the redress scheme to be more than just an acknowledgment of abuse, and for us to take this opportunity to address the harm done by the abuse and subsequent response (or lack thereof), it is critical that financial redress is just part of wider package of support.

In our opinion there should not be a distinction between the redress scheme and wider reparations. The Redress Scheme should cover all aspects, with financial awards representing one component. The financial contributions from relevant organisations and bodies would therefore be for the entire Scheme.

Within the package of wider reparations should fall the support provided (either directly by the Scheme or by relevant bodies and organisations) to applicants, such as help finding documentation, psychological support, etc.

DECISION MAKING PANEL FOR REDRESS

45. Do you agree that the decision making panel should consist of three members?

It is unclear again if the question is referring to a decision making panel for Phase 1, Phase 2 or both. If for Phase 1, then a three person panel seems excessive. An individual, suitably supervised and peer reviewed, should be sufficient.  This would be in line with the current Advance Payment scheme. If the question relates to Phase 2 or both, we agree that the panel may consist of only three members. This is a fairly standard size for tribunals, and seems proportionate.

However, we think it should be clear that this panel will not be working alone, and that they will need to be supported by a range of professionals (employed directly or indirectly by the public body) whose purpose it is to support individuals with applications, assess the seriousness of impact (and validity of experiences, in some cases), etc. These professionals will play a key role in ensuring the information submitted to the Panel is as complete as possible, but they should also have role helping the Panel come to decisions (where necessary).

All processes, discussions and decisions of the Panel and supporting professionals should be recorded, transparent, accessible and challengeable.

46. Do you agree that the key skills and knowledge for panel members should be an understanding of human rights, legal knowledge, and knowledge of complex trauma and its impact? Are there other specific professional backgrounds or skills you feel are essential for the decision making panel?

Yes, agree with the proposed knowledge and skills. No, there are no other skills or professional backgrounds which need to be represented in decision making panel. But as noted in our answer to Q.45, the panel – and individual applicants – should be supported by other professionals, who can be called on to help plug gaps in knowledge and expertise. The skills necessary for this scheme to work well should not – and cannot – be contained within a small, three person panel.

47. We propose that a Survivor Panel be established to advise and inform the redress scheme governance and administration, ensuring survivor experience of the application process is considered as part of a culture of continuous improvement. Do you agree? How do you think survivors should be recruited and selected for this panel?

Yes. This would represent an important aspect of governance and continuous improvement, including rapid responses to challenges as they emerge. Survivor experience should also be reflected in the schemes overall governance (i.e. the Board).

Selection should be on the basis of open invitation and competition (on transparent criteria). Organisations should be encouraged to support members to apply. Representation should be broad enough to ensure all perspectives are being heard.

PUBLIC BODY

48. Do you agree that the financial redress scheme administration should be located in a new public body?

Not sure. The consultation document presents this as the only option, but for such an important decision it would be helpful if other options available were presented and evaluated (i.e. costs, benefits, risks, issues, etc.). For example, Social Work Scotland members have queried why the Redress Scheme cannot be located within the Scottish Courts and Tribunals Service, on the basis that it already has relevant expertise, and has judicial oversight and appeals processes built in. Others also raised concern that a new public body would not be seen as sufficiently independent of Scottish Government or local authorities, on whose resources the public body is likely to rely.

49. Do you have any views as to where the public body should be located and what it should be called? What factors should be taken into account when deciding where the public body should be?

We do not have views on what a new public body should be called, and the right choice of location(s) will be significantly determined by the public bodies’ functions. For example, if the public body is going to provide a structure for the provision of support services for victims, the body should perhaps have multiple locations across Scotland. Its headquarters could be in a significant town, easily accessible by public transport. Access for survivors and participating institutions, bodies and professionals should be the primary consideration.

50. How can survivors be involved in the recruitment process for these posts? How should survivors be selected to take part in this process?

Through the recruitment process there should be scope for survivors to interview and be part of the assessment process for panel members. Their feedback would provide an additional perspective which will ensure the people on the panel have good interpersonal skills, are empathic and personable. It may also help to run a national campaign inviting survivors to apply to be panel advisors.

There are strong parallels here with recruitment of panel members and senior staff at Children’s Hearings Scotland. Engagement and learning from CHS’ experience would be advantageous.

WIDER REPERATIONS

51. What are your views on bringing together the administration of other elements of a reparation package such as support and acknowledgement with financial redress? What would be the advantages? Would there be any disadvantages, and if so, how might these be addressed?

While we acknowledge the advantages of bringing together the administration of the wider reparation package (in respect of improved coordination, governance, efficiency, joint-working, single-point-of-entry, etc.), we have concerns about breaking the link for people with established local support services. As a result of the centralisation of support ‘under one roof ‘, funding for local services may be put at risk. These are services which have established relationships within local areas and with local areas, and which, if properly resourced and supported, may outlive the public body running the Redress Scheme.

Furthermore, many aspects of supporting individuals and facilitating applications are currently provided by local authority social work. The relationships local professionals have developed will be difficult to replicate quickly in a national body. Ultimately, individuals live in local communities, and will benefit from being linked into a web of support which is itself local and accessible.

For these reasons, while we do see the advantages of bringing administration together, the case for doing so must be very convincingly made, its potential benefits clearly outweighing its risks of disrupting the existing mix of local and national provision.

52. Do you agree that it would be beneficial if the administration of these elements were located in the same physical building? What would be the advantages? Would there be any disadvantages, and if so, how might these be addressed?

No answer to this question.

53. Should wider reparation be available to everyone who meets the eligibility criteria for the financial redress scheme?

Broadly, yes. Access to the wider reparations should be on the basis that the individual experienced abuse while in the care of the state, between certain specified dates. However, we would favour a more nuanced approach to determining access to support than the criteria set for eligibility to financial redress.

Support should begin from initial inquiry, and be available (if desired) in the preparing of applications for financial redress. By virtue of this though, it would not be possible to determine whether someone is eligible for wider reparations on the basis of whether they are eligible for financial redress, as this may not have been decided yet. It may be the case that an individual applications for financial redress is turned down, but that they receive a measure of support through the process, and access to other services.

54. Should there be priority access to wider reparation for certain groups, for example elderly and ill?

Yes. A form of triage and prioritisation will be important, to ensure those in most need, and those with life limiting conditions are responded to early. Each person applying for wider reparations should have their needs and context assessed appropriately.

55. If a person is eligible for redress, should they have the same or comparable access to other elements of reparation whether they live in Scotland or elsewhere?

Yes. However, the services should be made available in Scotland, and people’s actual access to it will be determined by their proximity to relevant offers (groups, etc.) or access to appropriate technology.

It would not be feasible to extend all aspects of the wider reparations to people living in other countries. They should equal right to access, but not have services taken to them.

ACKNOWLEDGEMENT AND APOLOGY

56. To allow us more flexibility in considering how acknowledgment is delivered in the future, we intend to include provision in the redress legislation to repeal the sections of the Victims and Witnesses (Scotland) Act 2014 which established the National Confidential Forum. Do you have any views on this?

In our view the powers should be taken. The decision whether to use them should be considered further, but it is important that Scottish Government and its stakeholders have the ability to make changes in the future, if so decided.

57. Do you have any views on how acknowledgment should be provided in the future?

No.

58. Do you think a personal apology should be given alongside a redress payment? If so, who should give the apology?

No answer to this question.

SUPPORT

59. Do you think there is a need for a dedicated support service for in care survivors once the financial redress scheme is in place?

Yes. There is a need for a dedicated support service with a single point of entry and access to multi-agency services. Care experienced people who are no longer receiving services, and who are or wish to access their records, are a high-risk group who must be considered within the scope of these services. Moreover, for some survivors they will already have a key person who is offering support, and any development of dedicated service will need to take account of and incorporate these existing relationships.

We think it is odd that these questions of support have been located outwith the sections of the consultation concerned with wider reparations. In our view it is a mistake to separate these things out. The provision of high-quality, person-centered support (including but not limited to assistance in making applications for financial redress) represents reparation. Making amends for failures in the past by ensuring that today eligible individuals have access to all the support they need. Indeed, the Redress Scheme should be constructed with a view to the Self-Directed Support (Scotland) Act 2013, providing people with control over how they wish to direct and receive support. (In contrast to a national public body commissioning services which victims / survivors then have to ‘fit’ into.)

60. Do you have any initial views on how support for in care survivors might be delivered in Scotland, alongside a redress scheme?

Please see answers to earlier questions.

 

For further information, please do not hesitate to contact:

Ben Farrugia

Director, Social Work Scotland

ben.farrugia@socialworkscotland.org

 

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27/09/2019

Priorities for 2020-21 Budget – SWS Justice Submission

This paper has been written in response to the pre-Budget Scrutiny request for the Justice Committee. With further change expected on the horizon, our submission calls for the Scottish Government and its partners to take a forensic look at how the justice system is working (and CJSW place within it), with a view to establishing a clearer, collective vision of what we are trying to build in Scotland.

  • Download a referenced copy of the submission here.

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to feed into the Justice Committee’s scrutiny of the Scottish Government’s budget for 2020-21.

Budgets provided to the public, third and voluntary sectors for health, education, employment, through-care, family-contact, rehabilitation/re-offending, in-cell technology and other services provided to prisoners

Criminal justice social work (CJSW) provides a range of statutory services to individuals in
the community and prison at different stages of the criminal justice system. These include:

  • Bail supervision;
  • Alternatives to prosecution measures such as Fiscal Work Orders and Diversion
    from Prosecution;
  • Criminal justice social work reports;
  • Risk and need assessments using accredited tools, e.g. the Level of Case Management Inventory (LS/CMI), Stable & Acute 2007 (SA07), Spousal Assault Risk Assessment (SARA;
  • Community Payback Orders (CPO);
  • Delivery of accredited programmes, e.g. Moving Forward: Making Changes and the
    Caledonian System;
  • Throughcare services to statutory prisoners (i.e. long-term prisoners serving more than 4 years or short-term sex offenders released on licence), including community and prison-based assessments and reports for parole;
  • Supervision of individuals released from custody on licence, e.g. parole, extended sentence, supervised release order, Order of Lifelong Restriction); and
  • Voluntary Throughcare to short-term prisoners and the Throughcare Addictions
    Service.

CJSW therefore plays a central role in the justice system, and in particular the rehabilitation and management of individuals subject to community-based supervision. As the responsible agency for managing the risk of serious harm and the needs of people subject to statutory supervision, the ‘risk’ sits squarely with CJSW.

Funding is provided to local authorities in a ring-fenced grant provided under sections 27A
and 27B of the Social Work (Scotland) Act 1968 as amended (referred to hereafter as the
S27 grant). There are currently a number of acute pressures on local authority CJSW. Scottish
Government Justice Analytical Services estimate a 7.5% increase in CPOs as a result of the extension of the Presumption Against Short Term Sentences (PASS). As Community Justice Scotland (CJS) point out:

“Of the forecasts provided by Justice Analytical Services, even a ‘LOW’ uptake would result in approximately 1,300 additional people across Scotland receiving community sentences. If the policy has greater impact, then numbers could further increase. It is likely some of this number will require additional support to complete their sentence successfully. Local Authority areas and service providers need to be able to meet this demand for support.”

The report goes on to argue that research undertaken by Progressive Partnerships, an independent research organisation, suggests that “a proportion of these people (i.e. those currently receiving a prison sentence of up to 12 months that might now get a CPO) may have more complex needs that will require more support than the current ‘average’ person completing a CPO”.

It is true the total number of CPOs in Scotland has declined since their introduction in 2011 from a peak of 19, 451 in 2015-16 to 17,834 in 2017-18.3 However, notwithstanding the impact of PASS described above, there have been several practice developments in the last 10 – 15 years that have had a significant impact on CJSW workloads and the ability of services to work effectively with individuals and are not fully funded. These include, but not limited to:

  • Structured and accredited risk assessment tools – a range of tools have been introduced, all of which require substantive training and time to complete. To reference only three:
    • (1) the introduction of the Level of Service & Case Management Inventory (LS/CMI) at the turn of the decade, an assessment and case management tool completed on all individuals which underpins all CJSW statutory work with individuals at both the criminal justice social work report stage and postsentence (it requires a 5 – 6 training course);
    • (2) Stable & Acute 2007 and Risk 1 Sentenced to Smart Justice: A report on proposed extension of the Presumption Against Short Sentences, May 2019. Scottish Government, Criminal Justice Social Work Statistics in Scotland, 4/2/19 Matrix 2000 for sex offenders (requires 3 day training); and
    • (3) the Spousal Assault Risk Assessment (SARA v3) for domestic abuse, again resource intensive.
  • ViSOR – this electronic Home Office sex and violent offender register requires social
    workers to regularly input information.
  • MAPPA – the Multi-Agency Public Protection Arrangements require significant commitment from CJSW, from joint visits and assessment with Police Scotland, attendance at meetings to comprehensive risk management plans.
  • Order of Lifelong Restriction (OLR) – introduced to manage the risk of individuals posing the very highest risk of serious harm, local authorities are responsible for managing individuals in the community subject to an OLR and are required to commit significant resources to manage these individuals and submit ongoing detailed risk management plans to the Risk Management Authority for approval. Whilst the numbers in the community are currently small, this will only increase in coming years.
  • Moving Forward: Making Changes (MF:MF) – this (no longer) accredited sex offender programme (currently being reviewed and revised) requires significant resource both from teams delivering the group work programme, but also, and crucially, CJSW social worker case managers.
  • Caledonian System – whilst funding is provided separately by Scottish Government, this accredited domestic abuse programme, available only to approximately two-thirds of local authority CJSW due to lack of central funding, places significant demands on CJSW social worker case managers (for example, they are responsible for delivering the lengthy pre-group programme work that is not covered by the Caledonian funding).
  • Multi Agency Risk Assessment Conferences (MARAC) – protecting victims of domestic abuse, MARAC requires significant input from CJSW, including chairing and attending meetings, providing background information and contributing to action plans.
  • Multi-Agency Task & Coordination (MATAC) – focussing on perpetrators of domestic abuse, this is a further additional commitment for CJSW.

Additionally, other developments in the justice environment continue to increase workload and pressure on a strained and over-stretched CJSW system. Many of these developments are, in themselves, welcome. But most are driven forward in isolation, with too little consideration given to the compound effect they collectively impose on CJSW. For example, Social Work Scotland members report a very significant rise in the requirement for CJSW to attend Parole Tribunals and Hearings in prisons. As this mostly requires attendance in person this development absorbs worker’s time. Relatedly, the lack of availability in the Scottish Prison Service of reliable connectivity limits CJSW ability to use videoconferencing with prisoners, for both Integrated Case Management (the process by which SPS manage statutory prisoners) and the development of CJSW report. Other examples of developments putting pressure on CJSW is the push to increase bail supervision numbers, and to offer Diversion to greater numbers.

Despite the seismic change in the demands and requirements placed on CJSW since the early 2000s, there has not been a comprehensive review to quantify and accurately cost the component parts of the work CJSW does. The S27 funding formula has been reviewed, but this was limited to how the grant is distributed. (In simple terms, the workload element was reduced from two-thirds to half, a rurality element was introduced and social and economic indicators are applied.) We believe the funding formula now requires comprehensive review.

Under the current formula, CJSW are actually penalised for reducing re-offending, as retrospective three year activity levels are the basis for allocation. Moreover, there is a clear case to consider more than one year grant allocations, as the current approach limits effective planning, being confirmed only in December of the preceding year (limiting our ability to respond constructively to reduced allocations). Previously, under the previous funding formula, whilst not entirely satisfactory, there was a mechanism to ‘soften’ any significant reductions in allocation from one year to the next.

We believe there is also a clear case for removing the separation of Part 1 and Part 2 funding, and instead providing local authorities with one S27 grant allocation. This would enable greater flexibility to allocate resources in accordance with local strategic plans and priorities.

In 2014 the Scottish government initiated research into the unit cost of a Community Payback Order (CPO). We are not aware that the final report was published, perhaps reflecting the complexity of establishing a ‘unit cost’ of a CPO, given the diversity and geography of Scotland and/or the difficulty of assimilating all the relevant expenditure/resources involved in delivering CPOs. In the absence of that research, in 2015-16 the cost of a CPO was estimated at £1,771. This figure was calculated by dividing
total recorded expenditure on Community Payback Orders across the 8 Community Justice Authority’s by the volume of those disposals. Importantly, the expenditure figure did not include the costs of delivering some services which may be accessed by offenders as a consequence of requirements imposed with these orders. Working off this basis, over the past four years the cost of managing an individual CPO has increased to approximately £2,000+. But as noted above, we would strongly suggest that this is a significant underestimate of the average cost of a CPO.

Indeed looking at the system as a whole, the actual cost of delivering CJSW services in line with National Outcomes and Standards for social work services in the criminal justice system and associated Scottish Government practice guidance, including the alternatives to prosecution schemes (Diversion, Fiscal Work Orders) and statutory community supervision (e.g. Throughcare services both during a prison sentence and post release) has not been accurately costed this century. Despite the fact that since 2000 the demands on CJSW have increased exponentially, driven by successive waves of criminal justice policy innovation and reform. Such an analysis, to identify the current actual cost of CJSW, could be done by conducting a time and motion study to assess the cost of producing a CJSW report, completing LS/CMI (including the extensive risk of serious harm component), managing an individual on a prison licence, etc.

This is not a call for a return to a justice system (and associated policies and practice) of the 1990’s. Social Work Scotland, along with many other informed stakeholders, strongly support many of the developments of recent years, encouraged that policies are driven by evidence and a commitment to human rights. But we cannot build or maintain a system on the strength of ideas alone. The system must be built methodically, on robust, appropriately resourced foundations; of which CJSW is one. This argument was made repeatedly in the written submissions and oral evidence (including from Victim Support Scotland and the Sheriff’s Association) heard by the Justice Committee this year, in considering the proposed extension to PASS. These made explicit reference to the need for more resources for
CJSW, without which it is difficult to see how the extension of PASS will succeed. Social Work Scotland supports the principle of community justice partners leveraging and sharing resources (in its broadest sense, including money, accommodation, data etc.) but this assumes there is significant spare capacity across the criminal justice system. There is not.

In considering the resource requirements of the criminal justice system, another factor which must be taken into account is the recent national public sector pay award. This has not been funded by Scottish Government, and in the six months since coming into effect Social Work Scotland members are reporting a serious impact on budgets. A survey of local authorities showed that, of the 23 that responded, 21 are required to fund the pay award from the S27 grant. One local authority calculates that they will have to find almost £1 million to cover the pay award between 2018 and 2021; that money will have to come from CJSW budgets. In another local authority, their small uplift in Part 1 funding in 2019-20 of £50,000 is less than the cost of the pay award. This situation creates serious challenges in filling posts when they become vacant, and creates pressure to re-design or re-organise services to meet the budget short fall. However, the time required to do this properly, with the requirement to consult and work with staff and unions, inevitably means that savings are not going to be achieved until future financial years. And in that time there will no doubt be further changes and funding reductions.

It is understood the S27 grant is made up of the ‘criminal justice social work’ allocation in the Scottish Government budget, topped up from money in the community justice ‘offender services’ budget. The former budget has remained static for several years at £86.5 million.

In 2017-18 the total allocation to CJSW including money from ‘offender services’ was £98,819,949; since then there have been marginal increases to £100,080,038 in 2018-19 and £100,115,038 in 2019-20. As set out in the paragraphs above, we believe that this has led to significant, systemic underfunding of CJSW. This is impacting on the ability of CJSW to deliver on the three key outcomes set out in NOS – reducing reoffending; promoting social inclusion; and public protection and community safety. And this will, in turn, impact on the system’s collective ability to deliver key Scottish government policy initiatives, such as PASS, community justice and bail supervision. CJSW is centre stage in efforts to
modernise Scotland’s justice system, and under the spotlight in managing the risk of individuals subject to statutory supervision, or coordinating interventions and services to rehabilitate and transform lives.

The resource requirements of such a key player must be properly understood and fully met. Longer-term challenges and financial requirements to tackle issues such as staffing levels in prisons, over-crowding, drug use, safety and security of staff and prisoners, the use of the open estate and an ageing prison population.

A number of developments are currently underway which will present financial challenges. Perhaps most significant is the work instigated by the Health and Justice collaboration Board to integrate health and social care in prisons. This is a programme Social Work Scotland is proud to be involved in, and tests of change are currently underway in six prisons. The integrated health and social care in prisons programme gives us a valuable opportunity to explore how health, well-being and social need affect the risk of offending in the future, and to work across statutory and voluntary throughcare systems to deliver a more holistic, individualised and integrated response to individuals, reducing the risk of
reoffending. Following an evaluation report in autumn 2020, the responsibility for integrated
health and social care services in prisons is likely to fall to local health and social care partnerships. Only 13 partnerships have prisons in their areas, but these partnerships will in due course face a significant pocket of need for services.

Elsewhere in the justice landscape, there are some potential efficiencies to be made in developing integrated, multi-disciplinary services and by reviewing and aligning third sector services in prison. To date these have grown organically, rather than through any strategic needs assessment and commissioning plan. It is likely, therefore, that they will not cover all current (and the expected increase) in needs which we will see in our prisons. In the context of integrated health and social care provision in our prisons (as described in paragraph above) we will need to review which and how services have been delivered in prison, and consider provision within the wider commissioning and procurement framework.

There remains a lack of data around the health and social care needs of people in prison, which some tests of change and a Government commissioned strategic needs assessment will seek to rectify in the next few months. Like the Scottish population as a whole, the prison population is ageing, meaning there will continue to be a greater number of people who are frail, and require additional support. But the prison population also has significant levels of need in terms of mental health, addiction, learning disability and neuro-diversity.

These needs impact on people’s capacity to make use of any opportunities for learning and development in prisons and then to successfully reintegrate into their communities on release. The prison estate does not currently have the capacity to meet the needs of a growing population of people with complex age and/or health related conditions. Without investment in the estate, this means care will likely be delivered in inappropriate settings, potentially without the equipment that would be deemed necessary in community settings. This not only places people in receipt of services at risk, but workers too. The Justice Committee may want to consider the elements both of the prison estate and the delivery of a whole systems approach to health and social care in a justice setting in its future planning.

Views on how to achieve a rebalancing over the longer-term in expenditure on prisons and that of community-based alternatives to incarceration and preventative spend, including the challenges of provision in remote or rural areas.

If we are to achieve this re-balancing, and potentially unlock resources to re-distribute to community-based alternatives, Scotland needs first to agree and articulate what the role of prison is. If our national aim, as articulated by Professor Cyrus Tata and others, is that imprisonment should be used sparingly, only where warranted on the grounds that the risk of serious harm is so great as to require confinement, and never on the basis of ‘rehabilitation’ or ‘self-improvement’, we should say so clearly, and work out the policies to achieve it. Over time we would see a reduction in the prison population, freeing up
resources to be transferred elsewhere.

With such an agreement about the role of prison in place, the change itself would require robust strategy, energy, collaboration, and, perhaps most importantly, bold leadership and financial investment. The newly established Community Justice Leadership Group, co-chaired by the Cabinet Secretary and COSLA’s Community and Wellbeing Spokesperson, offers an opportunity to explore whether this is possible. The group could set a clear vision for what the justice system in Scotland to look like in 20 – 30 years’ time, and agree the outlines of how we get there. (An example of this scale of ambition is the Housing to 2040 vision.) The group could crystallise what a compassionate justice system looks like, how it balances responsibilities, and identify the milestones on the journey to achieve it. Critically, the group could set coherent ‘stretch aims’ for the system, such as limits on the number of
people in prison by a certain time. Without such clear stretch aims it is too difficult for a disparate system to coalesce around a shared vision, or agree on the scale of change needed.

However, to do this right requires both time and investment. A system built up over decades, which itself reflects public attitudes and culture with roots which go even further, cannot be transformed through policy documents and rhetoric. Vested interests will need to be challenged, all parts of the system be open to radical change, and resources made available to facilitate the transition. Simply put, the current system will need to continue to be maintained (and improved) while the new one is built. That cannot be done (or at least cannot be done quickly) with no increase in overall spending. For example, to win public (and some professional) support for a compassionate justice system, significant investment will be needed in deploying and evaluating the effectiveness of community-based interventions. We know such interventions work, but to fundamentally rebalance the system Scottish Government and its partners will need to go further than securing the support of experts.

The alternative is that public sector money will continue to be invested in an increasingly complicated version of the current system, with policy innovations woven into a prison-centric infrastructure. That will fail to unlock the potential of those policy innovations, and make it less likely that we develop across Scotland the integrated services needed to prevent offending and re-offending in our communities. It will also mean we fail to unlock the significant resources allocated to a growing and aging prison population.

For further information, please do not hesitate to contact:
James Maybee
Chair of Social Work Scotland’s Justice Standing Committee & Head of Criminal Justice
Social Work, Highland Council

26/07/2018

Health and Care (Staffing) (Scotland) Bill Response

Social Work Scotland submission to Scottish Parliament committee.