28 April 2025

The National Care Service: Where Now?

Six sector membership organisations have joined together to produce a paper to help drive urgently needed reform of social care now, as the 2026 Scottish election approaches, and in the next Parliament

Following January’s collapse of proposals to set up a National Care Service through legislation – and ongoing uncertainty about effective next steps – a new paper shares key thinking on the priorities for social care reform.

Rooted in the vision set out in Derek Feeley’s highly regarded 2021 recommendations for social care reform, this paper has been developed by six membership organisations representing the interests of people supported by social care, unpaid carers and social care providers.

CCPS, the Coalition of Carers, Glasgow Disability Alliance, the Health and Social Care Alliance Scotland, Inclusion Scotland and Scottish Care want this contribution to help drive much-needed, long-promised reform with full cross-party support now, as the 2026 Scottish election approaches, and in the next Parliament.

Download the paper

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26 February 2025

“Success at Westminster, dismay at Holyrood. But on eNICs exemption, we are back in the running”

Rachel Cackett responds to yesterday’s vote in the House of Lords on amendments to the National Insurance Bill – and the passing of the 2025-26 Scottish Budget

So, first the good news. Last night the House of Lords voted through amendments to exempt the vast majority of the health and social care sector from catastrophic NI increases, as set out in the National Insurance Contributions (Secondary Class 1 Contributions) Bill. The Lords also passed a key amendment which would make the government report on the impact of national insurance changes.

Over the past few weeks, we’ve been discussing the National Insurance Bill with MPs and engaging with peers on amendments. Many of our members have shared their own organisation’s perspectives about how the eNICs change would impact them, and the consequences for the people they support and employ. I want to thank all the members of the House of Lords who worked on and laid amendments yesterday, and every single peer who listened and voted for exemption to save social care. We can’t tell you how much your advocacy matters for social care in its time of crisis.

Yesterday’s votes give us hope, but the changes aren’t in the bag yet. Now they go back and forth between the Lords and Commons and we will need a lot of Labour MPs to stand up for what is right here, if these wins are to hold. But yesterday morning we saw no room to manoeuvre; today we are back in the running. We’ll take that for now.

In contrast to events in the Lords, yesterday the Scottish Budget was passed at Holyrood with zero commitment to eNICs cost recovery for providers from the Scottish Ministers and only cursory mentions of the sustainability crisis in our sector. This, despite us sharing compelling evidence of the disastrous consequences the policy will have for not-for-profit providers and the people they support.

Earlier this month we conducted a 24-hour survey of our member organisations. Over 50 members participated, representing a combined expenditure of over £850m, employing around 28,000 staff and supporting over 230,000 people across the whole of Scotland. Amongst the sobering responses, we learned that:

  • 57% of respondents are seriously considering handing contracts back to commissioners next year
  • 67% of respondents are budgeting for 2025-26 on the basis that they only expect to reach financial balance through the use of reserves. And of these providers: 91% would no longer be a going concern within four years, if they continued to reach financial balance through drawing down reserves in this way.

With an election year just over a year away, and with so much at stake for the Scottish people, we are surprised the Scottish Government seems ready to live with the consequences of choosing not to fund our sector and supported people. We are just as surprised that a new UK Labour Government chose to put the entire sector at risk through this deeply ill-judged tax, which disproportionately impacts low- paid women. Looking at headlines from the last couple of weeks from both sides of the border, it seems emergency funds can be found for other things – but not vulnerable people. It was ever thus.

But where both elected governments have failed the sector so far, the Lords have provided. So, our energy now turns back to Westminster and efforts to persuade MPs to see the value of social care – and how destructive the eNICs policy would be. There is – thanks to yesterday’s actions – still track ahead.  Please, UK Labour and Rachel Reeves, don’t waste this opportunity.

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23 January 2025

“The government must get to grips with the level of risk faced by providers and the people they support”

Our CEO Rachel Cackett responds to today’s announcement in parliament that the National Care Service won’t go ahead as previously envisaged

“There is a crisis going on in social care right now and immediate action is needed – otherwise we won’t have a sector to reform.

Nothing else in today’s statement in parliament about the National Care Service reflected the reality of that crisis, and none of what was said changes the status quo.

We urgently need the Scottish Government to recognise and get to grips with the level of risk currently faced by providers and, by extension, the people they support across Scotland.

While we were pleased to see the commitments made on enshrining Anne’s Law and breaks for unpaid carers, we are frustrated that so much well-intentioned work on the NCS over the past three years appears to have been for nothing.

However, we remain committed to working with the Scottish Government on the reform that’s desperately needed. This can include collaborating with them on the shape and remit of the proposed Advisory Board.

But we need to see a change in culture whereby recommendations made by experts in the sector, in good faith, are acted upon and put into practice rather than overlooked.

The reform agenda, including on the vital issue of sectoral bargaining, must keep moving, driven by the innovative thinking and solutions of social care providers.

And on the political front, with the 2026 Scottish election in sight, all parties need to think hard about the solutions they can offer for social care.”

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2 December 2024

It’s time to give the gift of Fair Pay…

As we enter Budget season, we’ve launched a campaign urging Scottish Government to invest in the workforce and cover the costs of the NI rise

Social care staff deliver vital public services in communities across Scotland, and they should be paid more than the minimum it costs to live.

They are working in a context where public sector cuts, lack of Fair Work and impending changes to Employers’ National Insurance are risking the viability of many services.

So we’ve launched a campaign urging the Scottish Government to give them More Than Warm Words this winter.

For the 2025-26 Budget we’re calling on them to:

  • Take a genuine first step towards the promise of Fair Work. Invest in our people by committing to the Real Living Wage + 10% in 2025-26, as the minimum for all frontline support staff. Stop the loss of essential workers
  • Cover the full costs of ongoing eNICs changes for not-for-profit social care providers, even if Westminster won’t. Otherwise, watch services disappear, unemployment rise, unmet need increase and the NHS crisis worsen.

Across the Scottish Budget period, we’ll be sharing messages and videos from our members in support of the campaign.

We’ve sent our members, and parliamentarians, a mug emblazoned with the campaign message.

And we’ll be calling on MSPs to speak up for the social care workforce and help give them the gift of Fair Pay.

Read the Budget briefing we sent MSPs

Read our press release about the letter we sent the Chancellor on NI

Follow the campaign on our social channels with #MoreThanWarmWords

For more information about the campaign and how to take part, email of Communications & Engagement team: comms@ccpscotland.org

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29 November 2024

Media Release: Over 80 Scottish social care leaders sign letter urging Chancellor to change course on National Insurance

Our members have supported a CCPS letter to Rachel Reeves urging her to provide relief on increased NI bills

“This policy will not save public services. It will crush them”

More than 80 not-for-profit social care organisations have signed a letter from the Coalition of Care & Support Providers in Scotland (CCPS) to the Chancellor urging her to provide relief on increased Employers’ National Insurance bills for them as providers of crucial public services.

Read the letter to the Chancellor

The letter, from CCPS members, makes clear the devastating impact the policy would have on organisations providing social care, and on people receiving support.

CCPS estimates that not-for-profit social care providers will face an additional bill in the region of £30 million next year to cover both the NI rate increase and the threshold reduction – money that providers do not have, and have no means to raise.

The signatory organisations span all aspects of not-for-profit provision in Scotland for adults, children and young people.

Rachel Cackett, CEO of the Coalition of Care & Support Providers in Scotland, said:

“As the representative voice for the sector, and on behalf of our community of providers, we’ve written to the Chancellor to make absolutely clear the existential threat this policy poses to not-for-profit social care, and the wider consequences it would have.

“The relief apparently being offered by the Chancellor to the public sector quite simply fails to recognise the reality of contemporary public services. Our providers deliver public services, largely through publicly funded contracts with the public sector.

“The eNIC policy is being introduced at a time when social care providers are already at extreme risk. In March this year, over 80% of our members who responded to a survey told us they were delivering public contracts despite a deficit budget.

“And as our letter states, these pressures are not limited to Scotland; the effects of long-standing under-investment in support services are being felt across the UK. Social care is pared to the bone.

“How can the UK Government claim that those with the broadest shoulders should pay more when this policy will impact not-for-profit organisations supporting some of the most vulnerable people in our society?”

“Services cannot continue if they are not financially viable. This policy will impact jobs – particularly for women – and risk the loss of crucial community-based provision for people who desperately need more well-resourced, rights-based, accessible, quality support.”

She added:

“We urge the Chancellor to provide relief at source to providers, with a recognition that not doing so will devastate public services, including those provided by the senior leaders who have signed this letter – services which  are central to the UK Government’s ambitions.”

(ends)

Rachel Cackett is available for media interviews today (Friday 29th November).
Senior leaders from organisations in CCPS’s membership will also be available by request.

Media contacts: Chris Small chris.small@ccpscotland.org
and Anna Tully anna.tully@ccpscotland.org


Notes for editors

CCPS is the voice of the not-for-profit social care providers in Scotland. Our vision is for people and communities to thrive with the support of a rights-based, sustainable system of social care and support.

More information here.

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14 November 2024

Through a glass darkly: the progress of a National Care Service

Our CEO Rachel Cackett responds to the latest news about the NCS Bill

Ah, the irony.

Today CCPS was to publish its proposals for amendments to the National Care Service Bill. It’s later than we’d have liked because it’d been hard to know what we are attempting to amend. Is it the Bill that was laid, which has been completely overtaken by events; or the proposals for an amended Bill, which the Government published in June – including a shared accountability agreement that has been blown out the water – but which can’t technically be amended, because it’s not an actual bill?

You see our dilemma?

But we’ve done our best because, if the Scottish Parliament has decided to take the Bill this far we have a duty to do all we can to make it work for our social care provider members, their staff and ultimately the people they support.

Then this morning the news broke: the Bill is scrapped… or perhaps bits of it are scrapped…. or perhaps none if it is scrapped but just delayed while it’s re-written again.

So here we are.

In the meantime, far too many people who need support can’t get it, providers are seeing budgets cut, and now we are staring into the face of catastrophic changes to Employers’ National Insurance Contributions.

Ever since Derek Feeley published the Independent Review of Adult Social Care we have been clear: our sector desperately needs reform and we will do all we can to collaborate with government and anyone else who can effect good change. CCPS members have the experience and expertise to help. It’s not always been easy to be heard.

But our commitment remains – and we will still publish our ideas on the Bill as a marker of the commitment (see links below) – but I now make a heartfelt plea.

We’ve been attempting to inform and improve this Bill for nearly three years while at the same time trying to support members through an ever-increasing real-time crisis. So, my plea is for clarity and a shared purpose across the political spectrum as we head towards the 2026 election.

There are many routes to positive reform – and an a much-improved NCS Bill may be one of them.

But either give us the timescales for legislative change and a space for our voice to shape collective reform, or look at alternatives to the current Bill and let us get on with those. Political wrangling, backroom deals and power-struggles for another 18 months won’t help the people who any NCS is meant to be for – the people across Scotland who really need well-resourced, rights-based, accessible, quality support.

Those of us trying to keep a woefully under-resourced sector afloat for the people who need it need more than the hope of reform; we need to know that something better is really coming our way.

Read our Briefing on Priority Areas of Focus for Amendments to the NCS Bill at Stage 2

Read our Thematic Assessment of the Alignment of Principles to Underpin a National Care Service

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31 October 2024

“Civic society – and the people it serves – must be respected as an equal partner in public service”

CCPS CEO Rachel Cackett responds to the UK Government’s budget, commenting on its implications for our members

So. The budget.

As the dust settles and we all get our head around the implications of Rachel Reeves’ speech, what’s emerging is a pretty mixed picture – but one issue is causing deep consternation among the not-for-profit providers of social care I represent.

But let’s start with two positives – albeit qualified positives.

Overall, the austerity message has been very slightly tempered by some positive, discrete changes, such as revisions to Universal Credit debt deductions (though the two child cap remains, of course). But there are department cuts to come, pressures on benefits and on other areas which will put significant pressure on family finances.

The news of an increase to the Scottish block grant this year and next is, of course, incredibly welcome. Now we need to see the Scottish Government make some wise choices and focus on the sectors that will actually help it deliver its own priorities before the 2026 election. In a week in which local headlines in the Scottish capital are writing large the perilous position of third sector organisations in our integrated health and care sector, the urgency of this couldn’t be clearer.

We want to see a fair, progressive settlement for social care and support in the 2025-26 Scottish Budget. The government needs this for a healthy civic society and economy.  It needs a healthy social care sector to stop the NHS falling over any further (as I know many NHS leaders recognise). The government needs a well-resourced social care sector to deliver on the rights-based society it has promised citizens. And at the heart of this is a much-needed fair wage settlement for staff, so CCPS providers have a hope of recruiting and retaining the skilled people needed to deliver crucial support to people and families. Talk to us and our partners about directing additional service-focused funds to best effect. We can help make it work.

And this brings me to my final point.

CCPS members are not-for-profit organisations delivering public services, mostly funded by the public purse. Yet it seems – though this is all a bit murky just now – that the relief being proposed for the public sector for the hike in employers’ National Insurance does not extend to the charities I represent. Messages of panic started coming to me almost as soon as the Chancellor sat down. CCPS members are already seeing swathing cuts to funding that was already too little; these are organisations where over 80% have reported delivering public services on deficit budgets. Ultimately, this means that fewer of the most vulnerable people in our society receive the services they need, and human and financial costs rack up.

Adding the double whammy announcement yesterday of increased employer NI contributions and a reduction in the NI threshold will be catastrophic for CCPS members and many other charities, unless some form of exemption is set or contracts are increased to fully fund the policy.

So this is a plea to both the Chancellor and Scottish Ministers. Please, please work together now to ensure that a social care sector that is already at breaking point is not sunk by baking in inequities in the application of NI relief.

Let’s not see the increased block grant – that could do so much – having to be eaten up by reversing the negative impact of this NI policy. Civic society – and the people it serves – must be respected as an equal partner in public service.

Because let’s be honest: you really can’t afford not to, and nor can the people in our communities who need support.

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8 October 2024

Research highlights ‘uneven landscape’ of social care commissioning and procurement

Two new reports published by CCPS today explores current context and shares ideas for improvement

Two reports published by CCPS today examine the current reality of commissioning and procurement of adult social care (ASC) support and services in Scotland.

The first report, by Professor Stephen Gibb, brings together the results of a scoping literature review of published evidence on ethical commissioning, summarising the context for strategic planning, commissioning and procurement of ASC in Scotland.

Written by Professor Anne Hendry, the accompanying study presents the results of qualitative interviews with a sample of national and local stakeholders involved in commissioning and procurement of ASC support and services.

Together, the research makes clear the complexity and contradictions of adult social care policy, funding, regulation, planning, commissioning, procurement and service delivery.

Drawing on views from a range of interviewees, Professor Hendry’s report shares ideas for improvement, including on the role of Integrated Joint Boards.

Reflecting on what she had heard as part of the study, Professor Hendry said:

“It was a privilege to learn from the experience of people directly involved in commissioning adult social care support and services across Scotland. Commissioners and providers alike called for simpler processes that enable more collaborative commissioning.

“There was a strong sense that this need not, and indeed cannot, wait for new legislation or new structure and it was refreshing to hear what can be achieved now with a strong focus on value and outcomes.

“However, sustainable change requires investment in the social care workforce supported by collaborative leadership, culture and relational practice that respects place and rebalances power.”

Professor Gibb highlighted the distinctive nature of commissioning and procurement in social care and the need to support innovation. He said:

“There are big gaps in the literature, recognising that in principles and practice the commissioning and procurement of social care is distinctive and different from other kinds of purchaser-provider relations.

“Changes like ethical commissioning may bring fresh impetus to better connect and channel the strategic intents of purchasers, local and national government with service providers. Enablers of change need to be identified, for fair funding of collaborations which give the right providers the resources they need for enabling services that matter and their improvement.”

Welcoming publication of the research, CCPS’s CEO Rachel Cackett said:

“At a time of intense debate about reform of social care, these reports provide our members, the wider sector and parliamentarians with valuable insight into the uneven landscape of commissioning and procurement in 2024.

“Having an overview of current guidance and hearing from a spectrum of stakeholders about their experiences helps to strengthen our understanding of the degree of inequity in the system, and what improvement could achieve.”

The research was conducted on behalf of CCPS between March and June 2024, in advance of the publication by the Scottish Government of its draft amendments to Stage 2 of the National Care Service (NCS) Bill.

It builds on previous related publications by CCPS, including a series of interviews with representatives of third sector providers about the viability and future of ethical commissioning and procurement.

Stephen Gibb is Professor of Human Resource and Organisation Development at the University of the West of Scotland.

Anne Hendry is Senior Associate, International Foundation for Integrated Care (IFIC), Director, IFIC Scotland and Honorary Professor, University of the West of Scotland.

Read report 1: ‘From strategic intent to procurement of adult social care and support in Scotland: Literature Review’, by Professor Stephen Gibb.

Read report 2: ‘From strategic intent to procurement of adult social care and support in Scotland: Analysis of current experience and ideas for improvement’, by Professor Anne Hendry.

The reports were produced by CCPS’s Commissioning and Procurement programme through funding from the Scottish Government.

 

 

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24 September 2024

‘Welcome focus on rights and people, but government’s winter plan will meet hard reality’

CCPS’s CEO Rachel Cackett responds to today’s publication of the Scottish Government’s Health and Social Care Winter Preparedness Plan 2024-25

Responding to publication today of the Scottish Government’s Health and Social Care Winter Preparedness Plan 2024-25, CCPS’s CEO Rachel Cackett said:

“We welcome an emphasis on people and rights at the start of the Scottish Government’s Winter Preparedness Plan, published today. We are also encouraged to see that our members – not for profit social care providers working in communities throughout Scotland – are acknowledged as an integral, vital part of the system.

“It’s true that the Scottish government cannot address the crisis in our sector effectively, and ensure people who need support can have their rights upheld, without finding shared solutions in partnership with us.

“However, we are concerned that the plan does not capture the reality of what is taking place on the ground and the experiences reported by our members on a daily basis, particularly around the absence of progress on delivery of Fair Work. We are also concerned that some solutions listed won’t be ready to deliver improvements for people this winter.

“In the depths of last winter, 82% of CCPS members who responded to a survey described service demand as ‘high’ or ‘extremely high’, with referrals well beyond capacity to respond. By the end of last winter, 83% of responding members stated they were providing a public service despite a deficit budget.

“Since then many of our members report an ever greater squeeze on the budgets they are given to provide a public service for the people of Scotland.

“Despite all this, the word ‘investment’ is completely missing from the publication. For providers already struggling with capacity and a lack of funding to meet people’s needs, this is a stark omission – and makes it hard to see how this plan will address the social care crisis for people before winter starts.”

Read the plan here

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5 September 2024

Tracking Real Living Wage on pay ‘disrespects professional workforce and will not advance government’s other commitments’

Our CEO Rachel Cackett responds to yesterday’s publication of the 2024-25 Programme for Government

Responding to yesterday’s publication of the 2024-25 Programme for Government, our CEO Rachel Cackett said:

“We welcome and acknowledge the First Minister’s pledge in the Programme for Government to eradicate child poverty and the priority given to this. We urge him to ensure that the Whole Family Wellbeing Fund is aligned to delivery of The Promise, previous commitments to funding are kept, and for the government to work with the sector to ensure this is achieved.”

“What about progress on pay and Fair Work for the sector though? We were incredibly surprised to not hear the First Minister mention social care at all in his speech to parliament. Deep in the full text of the Programme for Government the document mentions prioritising funding in 2024-25 in order to:

‘increase the pay of workers in adult social care who are delivering direct care in commissioned services, early learning and childcare workers delivering funded hours, and children’s social care workers, so that they are paid at least the Real Living Wage from April 2025’.

“We are extremely disappointed that, despite having signed up to the recommendations of 2019’s Fair Work in Social Care Report, the Scottish Government still appears to believe that, on sector pay for those in not-for-profit organisations, tracking the Real Living Wage and no more is sufficient. It is not.

“The reality is that this approach disrespects a professional, regulated workforce and will do nothing to advance the government’s other stated commitments on growing the economy, ensuring high quality and sustainable public services, and reducing poverty.

“On 10 July, we wrote to the First Minister challenging the Scottish Government to fund a fair 2025-26 pay deal for staff in our sector who deliver public services to the people of Scotland.

“We presented compelling evidence from our members about current intolerable pressures on not-for-profit social care, and explained why investing in the sector would mean investment in a whole-system solution. And we made the case for investment in staff – mostly women – to take forward the Fair Work agenda and value their contribution to communities across Scotland.

“We have yet to receive a reply, but yesterday’s announcement tells us that provider organisations, care and support workers in our not-for-profit social care sector – and most of all – people who need care and support continue to be overlooked in the government’s plans.”

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