We should think about National Care Service outside of ‘institutional architecture’, says John Swinney

The proposed National Care Service (NCS) in Scotland should be thought of outside an “institutional architecture,” the country’s First Minister has said, as he urged focus on how it could improve services.

The Scottish Government paused plans for the NCS – which would take control of adult social care – last month amid haemorrhaging support from trade unions, local authorities and opposition parties.

But speaking to the PA news agency, John Swinney tried to shift focus away from talk about the creation of a new institution to how it could impact Scots in social care.

Delayed discharge – where a person remains in hospital despite being healthy enough to be released – reached a record high in Scotland in October, with the lack of social care packages seen as a key contributor in clogging hospital wards.

“Let’s think about this outwith an institutional approach,” Swinney said.

“What does the National Care Service mean?

“It means that you eliminate variation in standard, it means that you have high standards across the whole country, it means that you have a system where people’s rights are respected in every part of the country.

“Now those are my objectives, that’s what I want to get to, because that will assure us that we are delivering against the legitimate human rights expectations of members of the public.

“There are different ways to go about getting that and the question we’ve got to resolve is: what’s the most effective way of doing that?”

The First Minister added: “Part of what I’m trying to say to you is that there are different ways of defining what a National Care Service could be and we shouldn’t just think of it as an illustration of institutional architecture.

“You can create a National Care Service in different ways as a consequence.”

Swinney said he was trying to achieve the “elimination of the variation of the standard of care in different parts of the country” and had deployed substantial resources to do so.

“You do that by improving poor performers, you don’t do it by reducing the effectiveness of good performers,” he said.

“That’s the bit that worries me the most about social care just now, that there’s such variation around the country.

“We’ve got some areas that deliver very good performance and other areas that don’t and we need to improve those who don’t.

“So for some time, I’ve had a team of some of my senior and most effective officials working with partnership at a local level, directly intervening to try to improve performance.

“We’ve seen some really important strides forward, real improvements in performance as a consequence of what we have done, so we need to essentially make sure that’s embedded in the system.”