 Welcome to the 32nd meeting of the health, social care and sport committee in 2022. I've received apologies from David Torrance for today's meeting and he's going to be substituted by James Donan who joins us online. The first item on our agenda is to decide whether to take item 3 in private today. Are members agreed? We agree, thank you. And the next item on our agenda is further consideration of the national care service Scotland bill with two evidence sessions, both panels will focus on the bill as it relates to workforce, employment, training and development and contractual arrangements. The first panel comprises representatives from several professional bodies and regulators representing sections of the health, social care and social workforce. So I welcome those attending in person. At first we've got Mary Allison, the acting chief executive of the Triple SE. Alison Bavidge, the national director of the Scottish Association of Social Work, Kay McVey, the head of personal services at South Lanarkshire Council, an SPDS portfolio lead for workforce planning for the Society of Personnel and Development Scotland. We've got Colin Pullman, the director of the Royal College of Nursing for Scotland and, joining us online, we've got Sharon Weiner Ogilvie, the deputy chair of the Allied Health Professions Federation Scotland. So good morning to you all and welcome. I think I'm going to start off by asking your views and I will walk around all of you initially just to get your views to start us off. My colleagues joining in with other questions will probably direct their questions to each of you, but if you want to chime in, you've got something to add and you just have to catch my eye or raise a finger and I'll come to you. It would be lovely to think that every question we could round the whole panel, but we would just run out of time very quickly if we did that. And for Sharon online, if you use the chat box to let me know when you want to come in, so I'm going to ask about the co-design idea and process because one of the things that we are finding when we're doing our scrutiny of this bill and we're speaking to various stakeholders is the idea of a framework bill which sets out effectively there's going to be a national care service and there's going to be some quite high level things put in statute about that, but the co-design process is going to happen after that and inform secondary legislation. That's quite different from how legislation normally works. I suppose the nearest example would be the social security bill. I want to know from each of you this expectation that a lot of the details are going to be created through this process of collaboration and co-design. Do you support this approach or do you have any concerns about it? Marie? I think that for the SSSC as the professional regulator of social work, social care and early years workforce, when we look at the bill currently it's not clear exactly how professional regulation of the existing workforce would be affected but Scottish Government have established an independent review looking specifically at inspection scrutiny and regulation and that review has started and there is a lot of engagement and doing that work of going out and speaking to people, understanding their perspectives on what is good and perhaps what's not so good about regulation at the moment. I think that process of really focusing on how regulation keeps up with the evolving landscape and changes in the workforce and how it will fit in with the NCS is happening in quite a specific way for professional regulation and it's due to report next June. I don't know if it's quite extensive the work that that review is carrying out with stakeholders. Effectively, that co-design is already started and it's a case of the legislators like ourselves are looking at the framework bill but a lot of this co-design is under way, well under way. Yes, that's right and our expectation is that the review will make the recommendations next summer and then Scottish Government will decide what to do on the back of those recommendations. That's very helpful, thank you Alison. I suppose the first thing that our members would say is that they're really keen to see change, we really need to see change. We're really keen to be involved in that change and the commitment to co-design is in principle a really good thing. However, there are some ambivalences and our members say that they can't wholeheartedly support the bill at the moment because they can't see the detail that will affect their work and how affected they're going to be. So, you know, for example, Schedule 3 sets out all the legislation that is likely to be amended or removed and changed, most of which is actually the underpinning duties and powers of social work. So, there's a bit of a, on the one hand, co-design is definitely where we want to be and involved in, but at the moment we can't really see the detail and where, for example, the duties, say, of a duty, a general duty of welfare, where that may be. Keen to see a more national approach to improvement, implementation and the experiences of people being able to move their support across local authority boundaries, all of that is really good. One of the things that we are finding perhaps across the co-design arena is that there are perhaps some that social work is not well understood as a profession and that social work, as it is practised now, is not the holistic relationship-based profession that people go into it to do and we may get on to some of the impact that that has on the workforce later today. But so there is an issue there in terms of what real co-design looks like because it requires people to have a full understanding and commitment to all the elements within it and all the workforces within it. So your participation in that co-design process is absolutely vital? Absolutely vital. But there's a lot of work to be done. I suppose that the programme is a large programme and we need to ensure that the nature of social work, not just the statutory protection work, but the early support, the intervention support for families and community strengthening is understood and built in there so that we have a stronger social net in Scotland. I think that in terms of co-design it's important that all the moving parts are involved in that and they've got the time and the space to do so. So when I think about the workforce element of that at this point in time, they are struggling for the resource to get involved in co-design in social care. We all know the kind of recruitment retention difficulties that there are. And if people are not involved in the co-design process, everybody does want to create improvement. To create improvement you have to have space, you have to have space to think and to imagine what the future might look like. But in terms of where we're at at this point in time and maybe the reaction that some of the workforce has had generally across the piece to the bill is that the lack of detail does give them a concern, as you were talking about. And inevitably change can be concerning for people and you want to involve them in the conversation so they feel confident about their place in the future. In terms of this particular element of it, I think because there's a lack of detail there's certainly a lot of questions from the workforce and because the questions are not being answered they do feel a little negative towards the proposal. Is there a recognition that there's a hope that it's going to be built from the ground up rather than top down? That's why the legislation's been done the way it is. So a grassroots up approach, you know, you want to take the workforce with you, but just now they're not feeling like that is what's happening in practice. OK. Thank you. Colin. Thank you. Much the same to be fair. I mean the issue that we have is we actually don't know what the co-design means in practice. It's quite vague and that's a difficulty for the workforce. The workforce under huge pressures as you all know at the moment and we'd question if it's the right time to be actually doing it in a lot of respect. It is hugely important that we get a consensus around about how we develop this because it's such a significant change that's coming in to the whole health and social care journey across Scotland. So from our point of view it's the lack of detail that our members are telling us that it's that bit around about. They actually don't feel there's maybe as much transparency as there should be the next time as you go forward in the development of the service. So it's something that we need to explore further and I think people would need to be reassured of what does it mean by co-design because co-design has to include everybody who receives the services as well as everybody who provides the services and that's the key thing for us. Before I go to Shannon, can I ask all of you, were any of you involved in the national care service forum in Perth the other month? So you've all had that presence and your members have been at the first of those. Yeah we were represented at that forum and I think but I still think it's far too early and it's a lack of clarity of how it's going to go forward. That's the thing that's really concerning people and it's also we're at the process that the workforce to be quite blunt are dealing with a crisis at the moment. So what's too early? The forum is too early or what's too early? I think it's the way the legislation is going to be developed. It's new for everybody if you like and I think there's real anxiety around about what that will provide in the future. Okay and I'll come to to Sharon Wiener-Ogaway online, Sharon. Yeah hello my name is Sharon and I'm representing the Allied Health Professions Federation today. As you know we are a really multiple profession organisations. I'm representing you know 12 professions including physiotherapies, stotes, dietician, podiatrist and so on. Although we're very different we have a very similar focus and our focus is very much about early interventions, supporting people at home, support for self-management and rehabilitation, so very much reducing the dependency on health and care system. So our main concern really around the bill at the moment and it's around the detail that some of our colleagues already kind of highlighted is that there's a really strong emphasis on care and we're concerned that unless HPs are really involved in the leadership within national care board that that kind of focus on rehabilitation and enablement will be lost because we'll be focused only in care provision. And I think we are kind of you know really facing unprecedented time in the health and care services at the moment so unless we maintain that focus on rehabilitation and prevention we're never going to you know resolve the high demand that we're going to have so we very much believe that HPs have a really expertise in rehabilitation prevention and self-management and we'll need to be at the core in terms of you know co-producing the approach going forward but you know to do that we really need to be at the table at national care boards we need to have voting rights so we can have the loose kind of framework that was around the public body act where it wasn't really cleared who is on iJBs and so on so we need the details to enable us really to influence that agenda and to make the real changes that are really required and our second concern around the bill is really around the commission and I'm getting into kind of the details here but obviously you know the stop you should run because obviously our my colleagues will come to the detail I was really asking about the co-design process and I think you've made it very clear that you you feel you should be very actively involved in that co-design process but you also alluded to to being being involved in the care boards as they're formed I'm going to move on to my colleagues but don't worry there will be ample opportunity for you to come back Paul O'Kane. Thank you very much convener and good morning to the panel I'm probably going to direct these questions to Alison and Colin just because I think they're relevant to some of your submission but Sazman their submission said as it stands the bill is unlikely to deliver improved quality and consistency of social work services and Colin you said that without the Scottish Government first tackling the workforce crisis across health and social care the bill will not achieve its purpose and I think from the the answer to the convener's question about perhaps the process can I maybe just first get your sense of does it seem back to front to you do you feel that there should have been more input into the framework legislation in order to put things on the face of the bill that could actually affect the things that you spoke about in your submission and then look at how we go forward from there yes that I mean there are several things that we would like to have seen on the face of the bill and I think that one of the things that we need to be in mind and I think one thing that makes social workers kind of nervous is the amount of trust if you like that we're being asked to put for the bill which is fairly structural very framework and that it will you know that we will then move towards a situation where we can look at the quality and the consistency um so um I'm sorry could you ask the question again for sure yeah so I just quoted back at you your concerns I think about delivering quality and consistency and I was asking that would you rather have seen more detail in the bill and you said something there about the face of the bill but maybe in particular what could have made the difference absolutely um the role of social work isn't mentioned um and the role in quality and consistency of roles um leadership roles such as a chief social work officer um there's um the national social work agency we would like to see in that on the face of the bill we think that's particularly important if we're talking about national quality and consistency in giving some overarching support and direction for um positive and effective implementation of policy rather than having lots of um as we have at the moment we have the two local authorities and more who do um take policy and implement it in their in their own in their own ways um what we don't want however is is to have a um a top-down approach we understand the need for structures that enable quality and consistency to happen um however having the um the ability to for local people and local governance to flex and be responsive um is also really really important go on thank you Paul I mean we've been quite clear I mean the the intentions behind the creation and national care service are laudable absolutely laudable and I think every single one of us would agree that we need to change there's difficulties there's there's a crisis but for us yet yes if you're going forward with the legislation that we would like to have seen more on the bill in the face of the bill um as I alluded to but there's a the recognition of the join between health and social care in the current crisis um structural overhaul just at this present time is not what's required what's required is that we actually start to deal with the workforce crisis that we have because as much as we go forward the bill if we don't have the right workforce in the future to be able to deliver the services that we want to do we actually believe if you spent a bit more time around about looking at the current crisis and dealing with it the difficulties in maintaining a sustainable workforce you could have probably been more ambitious as you go forward in the future and Alison wants to come back in Paul um in terms of social work we know that there's work going on to look at whether justice social work and um children family social work should come in um that of course leaves social work pressure in it um the potentially feeling disjointed and not sure of the direction of the future of the profession and potentially bringing very significant changes in terms of how we work with communities and families so that brings a very significant level of anxiety to the profession at the moment. Thanks for those responses Alison in your opening contribution when the convener asked the initial question you spoke about the ambivalence being felt towards the bill to some extent and I suppose people's concerns about um the secondary leaving things to secondary legislation and I suppose the changes that will impact on existing legislation particularly in the social work space I mean are you concerned that secondary legislation narrows the scrutiny in terms of what can be um you know a debate in the whole parliament you know everyone having they're saying it are you nervous about that okay um so in in terms of scrutiny it's it's the not being able to see the pieces as they're coming together I think that is proving difficult for people the trans the power to transfer staff is a huge power I mean there are very significant powers in this bill which are needed at some point if we are going to get to a a much better integrated health social work and social care system however I think it's perfectly reasonable that people are concerned and anxious about direction of travel because we just can't see the detail yet thanks thanks thanks it's just to pick up on paul's point he said there's ambivalence towards the bill what I see is it's flat out negativity against the bill do you not think or do you think that part of the issue is people are normally used to seeing detail in legislation but this is a framework bill and so what comes after with this legislation will be bite size pieces of legislation that will be able to be scrutinised and interpreted and then agreed on or amended and then delivered you know I'm really interested in hearing what you have to say Alison and and maybe Marie as well in that you know the people on the ground are asking for this bill um I just read something about um an action group from Falkirk that basically said the national care service will have equality dignity and human rights at its heart it will empower people to make the choices that are right for them one of my constituents has had eight social workers in eight months so this legislation aims to I'll slim out some of the bureaucracy make it easier make it a choice for the people on the ground to choose self directed support or whatever they want so I'm interested in that aspect of maybe people need to hear more about what is a framework bill and then what comes after that so I suppose Alison first and there's something absolutely something in that I think we got very many pieces of legislation that impact on social work and so there is a kind of a cognitive difficulty in terms of understanding how those bite size pieces will end jigsaw together because occasionally you know that occasionally things rub up completely understand the fact that somebody's had eight social workers in eight months you know in a relation in a profession that has to really understand people understand their individual situations and needs and preferences their family and you know out into community their employment and their hopes and aspirations that's absolutely not the place we should be at and I think that that actually illustrates perfectly the the the crisis that again you know its health and social work and social care all of these professions and professions within them are facing in terms of how we then I guess it's going to be communicate communicate communicate the fact that there are several things not on the face of the bill I think has made people feel that it risks a top-down approach rather than actually the building up approach which is actually what I think everybody in in this room would be hoping to see so there's a bit of dissonance in terms of what's in the bill but yet what we actually are saying we want to deliver absolutely as I said right at the beginning things things have to change we have to get to a point and I speak specifically for social work whereas where we have professions that are sustainable that people can go go into where they can have a career where they don't burn out where they're able to support people and deliver our our aims for things like self-directed support and support for for parents so that we can deliver the promise effectively you know we want all of that it's just that this this bill is not clear at the moment about how we get from here to there and there is the risk that in transition there's a gap you know we need to be working on some of this stuff right now and then we must move on to a question from Sandesh Gohan we have to pick up the pace colleagues a little bit we've only got an hour and a half just from our perspective the same issues I think the lack of details in terms of you know what's in and what's out is creating a lot of certainties and certainties among staff I mean we're very much dependent our work very much depending on the interface between an acute primary community services and social care so you know to move you know the kind of the the bill alluded that might be staff can have been able to move from a health service into the national care service that does create a uncertainty because there's no clarity which you know which staff members were talking about and there is a potential for that actually to create less effective kind of a working arrangement and in terms of a in terms of the national care service kind of reducing bureaucracy and you know streamlining thing absolutely welcome that but it's all depends on the implementation and if you're still suffering significant workforce issues then actually just changing the structure it's not going to deliver what you you want to achieve so so that's our main concern thank you question from Sandesh and then I'll move on to our next theme thank you I have to I think we're used to seeing details in bills because detail and delivery is where a bill will fail and as I say I don't get into my car and drive without knowing my destination and where I'm going and so my question is going to be focused around the co-design process and I want to know what your understanding is because my question is what exactly is co-design and Colin you've alluded to that as well what about people missing say people who have part of care needs who feeds into it and at what level and how does the Scottish Government reach out who makes the decisions what's the transparency of the final design is there a board that makes these final decisions and do all voices hold equal sway so for example Colin the the Royal College of nurses versus one person that speaks so there's a lot of questions there but basically the question is what do you understand by the co-design process and is it clear to Colin first please thank you I think I've been quite clear I think that that is that's the problem we don't know it's not clear it's absolutely not clear how the co-design process is going to work going forward and I think that that's led to the anxieties not only well it has led to anxieties within the workforce because that thing around about everybody agrees there needs to be change there needs to be we need to think around about new and innovative ways of tackling the difficulties that we have and not just in social care it's joined up and we we sometimes can parallel it mentalise it's the whole care journey that's why our hospitals are are full at the moment because we don't have the journey and we don't have the staff in the right place so it's for me it's around about much more clarity of how co-design was going to work I think the issue is everybody should have a voice at the table everybody should have a contribution and that's important and ultimately we're not clear around about how that will all be brought to the end where and that's what I've said this is a new way of of delivering legislation we all need to be taken on that journey and I think that's why we need to be careful not to rush into that things on because the effectively co-design has been discussed quite extensively and I'm going to comparisons between NHS and social care Paul you have questions on this thank you chair you know I think there's been a lot of discussion in the process leading up to the bill and indeed in our scrutiny thus far about the importance of parity of esteem or parity between NHS and social care and I wonder maybe just as an opener do you think there is sufficient clarity in terms of what that parity might look like and I suppose this is really a question I think that again perhaps to Alison and Colin but I appreciate perhaps Sharon might want to have a contribution to that as well of course all panels I'm sure we've been able to answer but maybe if I can start with Alison is that okay thanks Paul yes the parity of steam I think is a really interesting one because it's a phrase it's really easy to say but in terms of what we mean it's perhaps a bit more tricky in terms of parity steam for social workers my constituency what that means is social workers being able to work as autonomous professionals where their judgments are viewed as being sound where their assessments are taken with the kind of seriousness that they should be where there is not a constant battle for each piece of support that somebody may need for for budget okay it means being around the table with our colleagues in health and in social care with our third sector colleagues in terms of delivering smooth transitions between life stages and between services it means for example having terms and conditions that are in some way equitable at the moment of course in integrated joint boards integration joint boards we have two sets of at least two cents of terms and conditions so you know some of you will know that mileage is a project for us but if you're employed by the NHS you get 61 per mile but somebody who's employed by a local authority he might sit next to me we'll get 45 per mile okay so I think there are a lot of levels to parity but treating social work you know social work is trained for four years many have masters many have PhDs and beyond it's you know it's it's something that takes time to train to do and I think we would like to see that properly recognised thank you in respect of nursing in particular and if we look at the bill and the look of the contribution of nursing within social care I don't think it's as recognised as it should be we're changing it care's changing and the delivery of care more complex care in homely situations i in people's homes or in care homes needs to be concentrated and developed and I think nursing is a unique contribution to that so I think we need to make sure wherever that is whether that be care boards or whatever that the nursing like every profession wants to have a voice but nursing has a key voice we think going forward the issue of parity of esteem is hugely important when it comes to not only the the voice at the the governance tables but also that recognition when people are within the workforce wherever they work and clearly you're not going to expect me not to mention the issue around about fair work pay terms and conditions is a key issue across health and social care and that is one of the issues that is leading to the crisis and you're all aware where we are in relation to the health service social care pay and the pay in there is frankly upsetting when you look at what some colleagues are paid in relation to and it's there's no surprise that we have a crisis in social care workforce as well as we do in the health workforce currently thank you for calling about that aspect of parity around things like terms and conditions but there is another aspect around regulation in that the social care workforce is more fully regulated than the health workforce and so support workers in social care are regulated bringing that protection for service users and also driving up the qualification of that workforce I think approximately 40% of adult social care workers are qualified through regulation whereas in the healthcare arena the equivalent support worker role is unregulated so one of the questions from our perspective about the NCS is how do you bring is it appropriate to bring regulation across a wider workforce within the NCS and the independent review is looking at how there is scrutiny of all aspects of the NCS so I think that that is another area of parity that is important thank you thanks convener I wonder if I can ask Kay perhaps coming from that personnel and that development background what is your sense of what the bill needs to do so we had a conversation there about what's not in the bill I suppose I'm just you know regardless of that process what are the key actions do you think in terms of driving that parity particularly from a local authority point of view yeah it was it was interesting Alison you mentioned that it's easy to say but hard to do and I sit on the fair work groups in the the national work for strategic forums I kind of get a sense of what's going on both within a local authority perspective but also in the kind of wider wider context so I was calling a lot of what you were saying was chiming with me in in terms of the workforce in terms of terms and conditions it is a difficult thing because there are so many employers involved in this and you've got employment law it is part of one of the when the difficult things that we need to overcome so there does need to be a fair bit of I think further discussion around about how you can make changes you know the 61 pence versus the 45 pence the occupational therapist who works under local government conditions versus the ot that works in health paid two different things you've got huge structures behind that in terms of job evaluation pay models these are not easy things to change and actually there's not much opportunity within what we've got just now to have a good conversation around about it but I suppose it's not just about pay and it's not just about the mileage rates it's probably a broader thing round about modernising terms and conditions of employment but more fundamentally at this point in time I would concur what what colleagues are saying about we're in crisis so actually we need to be doing something right now not waiting for for the bill to answer the problems yes continue on the improvement journey for the future but I see from a workforce planning perspective a really poor position that is deteriorating quite rapidly and I'm sure Colin you'll see the same in your own area can I bring in the shaman yeah just around the workforce that I agree it's a dark issue with parity around terms and conditions but it's not just around the pay it's also around support supervision training career pathways where there's no parity between local authorities and health and we're already kind of seeing parallel services happening between you know the health service and local authority because of those differences absolutely important to support the workforce not just in terms of paying conditions but also training development and career pathways thank you and we move on to talk about the national social work agency and questions led by Evelyn tweed Evelyn thanks convener good morning panel the policy memorandum states that a national social work agency would be expected to provide national leadership oversight investment and support to the profession what function should it perform that aren't covered by other bodies or agencies and I'd like to ask Alison first thanks and I think I've already mentioned support for implementation and I suppose consistency of the the profession across Scotland and I think that people in Scotland have it's perfectly reasonable that they should expect a some sort of consistency in the way that we we approach the social work tasks and the role that we perform in identifying need and unmet need in the way that we support commissioning colleagues to develop services that are going to meet the individual and community needs in particular areas so I think implementation is is going to be a really key thing there I think in terms of supporting I suppose knowledge about what works in terms of integrating research quickly and effectively into the practice of social work and the decisions that are made as you'll know times and cultures and knowledge change very quickly and instead of having a lot of different people across the country doing that work it would be really helpful to have to have a single agency that is and I think this is one of the things that we're keen on is that a level of independence from government is is required and that's one of the reasons that we were sort of disappointed not to see it on the face of the bill given that it is is a role that we would hope would not be dependent on the current nature of administrations shall we say and and also to be frank quite often social work needs to be critical of its its governments so we want to be further independent we expect it to offer a home I suppose for the excellent work going on around the strategic approaches to getting social work students placements in terms of supporting newly qualified social workers in terms of there's already work going on about advanced practice framework which is about different career pathways and so giving a place I suppose for a social work career that is in some ways equivalent to the the macron agreements for teachers or agenda for change for nurses in the in the health system so we'd see all of that as as really important in terms of getting appropriate levels of consistency and support for for social workers over the years with austerity the support for social workers in local authorities perhaps has diminished somewhat in terms of training development opportunities does anyone else want to come on that yeah I suppose just to um I think Alison's articulated quite well what what the hope is that the national social work agency would bring from our perspective as the regulator for us understanding and working with government on how we will work with the national social work agency in continuing to set standards and quality assure the education of social workers and the continuous professional learning is something that I think is really important that is fleshed out in due course everyone have you got any more questions or we'll move on to your colleagues I've got one more question and I understand the triple sce support the creation of the new agency but what do you foresee as your future if it comes on to being well we of course are the regulator of social work social care and early years and our understanding is that we will still retain that professional regulation role which is about registering that workforce ensuring that they're working to the standards in our code of practice and promoting and regulating the qualifications and ensuring the qualifications and meeting those standards so we don't see those core functions that we carry out changing specifically in relation to social work okay thank you Paul and perhaps briefly just following on from that do you feel that there should have been a broader discussion in the bill and should there be a broader discussion after the bill about I suppose the role of triple sce and spectrum where that sits and how that interacts and then I suppose the dotted line almost that might exist to a national social work agency I mean do you think there's enough detail on that or do we need to do more thinking that review comes in and all of those questions will be captured I expect in the work that the review carries out and I know Dame Subrusa chairs it has already issued her call for evidence and set out the themes that she's asking people to to respond to around that so I think those questions should hopefully be flushed out through that process if I can just briefly follow up but do you think there is a danger that we are legislating for a national care service here before we have the detail of that review you know is that again something that should have been in the bill in the first place I think it's certainly complicated and from for the independent review that they will be looking at they've been asked to look at how to scrutinise all aspects of the national care service and yet the the extent of national care service itself hasn't been been fully decided so I think it certainly is complicated thank you move on to a discussion around MDTs and Stephanie you're leading on that thank you very much convener and thanks for being here this morning yesterday we we paid a visit to Granite care consortium in Aberdeen and it's a range of time providers but also people from health and social care partnership there as well and they talk quite a lot about moving away from timing task model to an outcome based delivery system so they're doing some of that work just now and how that's bringing the capacity to the table for them shown it from the health and social care partnership also described it as the providers are like a spider's web over the top of the city that are pulling everything together so I'm wondering do you see opportunities to improve multidisciplinary work by taking this approach through the national care service and tell us in first place thanks I think there's huge opportunities which have begun to be explored in the the world of integration but of course what we've created in integration is there are different integration models across the country in terms of children's services in terms of justice what's in and what's out outcomes we've been talking about outcomes in my career for 25 years um and what the stuff that seems to get in the way of outcomes is some of the bureaucracy that we we put in place the administrative tasks the administrative burden in setting the bar report I think 78 percent of social workers said that they have a very high administrative burden and they're spending 40 percent of their time on administration tasks now that clearly reduced the time a they can spend with people who need services but also the time that it takes to build and coalesce a real multidisciplinary team um I think key things for multidisciplinary teams are that we have round tables the third sector is really part of that you know not just kind of link through our commissioners um it's really important that these teams work in localities that they understand around needs and communities that they can they can be seen by that they're accessible to that then they develop trust and understanding which I think is particularly important for social work which has become um for some people a somewhere where they'd rather not set foot to be to be frank we would very much like to um kind of regain that ground um so having small enough areas um and connections with communities um so that teams can really work together and have the time to do that these things can't happen if people are running around um you know don't have the capacity um and I think this is a message that's coming to you today from everybody here is that the capacity to engage and be involved in the co-design is is is tricky but also in the in the field the um the capacity to deliver um thoughtful um relationship based and holistic approaches with with options really looked at and tailored to individuals in the whole spirit of of self-direct support is really tricky at the moment yeah thank you i mean mulled discipline teams are key to all of this within the legality within the localities the artificial barriers cause huge issues between organizations and we we need to it's interesting when you put teams together they work through it and sometimes we put structural walls up for them and we need to be very careful we don't we don't do that i've talked before about how the uniqueness of nursing and other professions have within a multi-disciplinary team and and that's the beauty of it it's about having the right people in the right place to deliver their at that right point of care and that's what integration is all about um I think that does lead me to when we're developing when we're preparing for that that's why I suppose I was disappointed that there was no reference in the in the bill to the health and care the the safe staff in legislation because that in itself would help us develop and prepare for multi-disciplinary teams in the future by having the importance of workforce planning because I think we're too insular in looking at whether it be healthcare or social care when we're looking around about um workforce planning and that's something that will make make future multi-disciplinary teams work for the people they care for fantastic I was wondering actually if sham wanted to come in on this yeah i'll be asheron yeah um I think that I think the other the other thing is really important here and in terms of making it more effective is is the issue around data sharing between health and social care and if you look at kind of the evaluation work that health improvement Scotland have done about around integration approaches for example neighbourhood care certainly do us kind of basic lack of infrastructure around a record sharing data sharing comes in a way of actually people working together and we are seeing that in our discharges from hospital it can take you know two hours for a nurse to fill in you know all the information in order to discharge someone into the community so the burden of bureaucracy is huge and no kind of change in structure would make that more effective unless we kind of you know streamline some of those of those bureaucratic needs that exist in the moment and until we kind of get kind of data sharing agreements better so I think these are you know these are the key things that we need to work on thanks thanks very much that's really interesting actually because um one of the points they made yesterday was that last winter they had one of the most delayed discharge rates across scotland and they felt that this was a huge part of it there um and that was really helpful calling as well um looking at you know what else we could put in the bill so i'm wondering from the rest of you there is there anything else that you would like to see in the bill to help multidisciplinary working be more effective in particular around ill intervention and preventative care too thanks i don't know anything specifically i would add on that um i think in terms of i mean early intervention um and early support um is incredibly important and if we want to you know reduce the kind of individual crises and the the impact on public services and improve people's independence that's absolutely where we need to be in terms of data um uh we we could share it so much more more effectively and efficiently personally my career i've worked on data collection since about 2005 done some some kind of big projects it's it's never as easy as we think it's going to be um and i would say in the last few years we still have issues um with um assumptions about GDPR um i personally have a have an example i'll tell you very quickly which is where um there were two nurses in the same NHS board one working in hospital one in the prisons and they wouldn't they felt they couldn't share information or one of them felt they couldn't share information okay so it there's a lot of work to be done in terms of um how we get better with the data that we've already got how we share it and um um how we enable professionals and individuals to make the most of it okay thank you yeah so so it has indeed a viewing and using that effectively to deliver outcomes this isn't new new stuff this is things that we've been i think been struggling with for for a while the technology are we going for a system you know there's antiquated systems they don't talk to each other it just makes life more difficult than it needs to be in an integrated world but i want to maybe just touch a little on culture and trust because it's been mentioned a couple of times here and i'm going to be radical and say sometimes structures don't really matter if you've got people in a room who feel they're empowered to go and just do stuff and and that's what we're lacking a little bit you know that your your social worker example one not feeling like she could share and the other one could and what did they think was going to happen if he did share so it's about you kind of allowing that space and as Colin said kind of people people together working for for an outcome um overall there are there are some i think projects on the go that may help on the the data sharing side the kind of microsoft federation don't ask me any questions on that i just know it's a thing but you know the practical aspects of this that turn up in in teams you know they can maybe just can't organise meetings between each other because they're not on the same outlook calendar and these are things that could be simpler but fundamentally people will find a way if you give them permission to do it in the culture's right that says they can just get on with it yeah sharon let's come in yeah so for for us i think we very much uh i think that we need a hp leadership um you know at the centre around kind of strategic planning and commissioning to really ensure that this prevention and rehabilitation agenda is maintained um so and and really to kind of change some of the planning and commissioning practices so there are focus on outcomes and we have seen some areas where hp's have not been involved this kind of focus on on outcomes has been removed and it's all around activity and outputs and opposite so so for us it's about the details about hp's being really right at the centre there having a leadership role within those care boards to be able to influence this rehabilitation and preventing prevention agenda thank you Emma thanks convener just back to the issues of multidisciplinary team working you know i used an example earlier of one person i'd hate social workers so but but i've also heard examples of a support worker that would assess or would be able to go and look after somebody and then see a deterioration that would require a step up in care but currently that requires then referral back for further assessment which then takes time when it's obvious to the support worker that an additional care might be required so as part of multidisciplinary team working would it be better if this kind of direct engagement would again flatten the bureaucracy so that faster response times could be delivered for somebody that's needing their care escalated i see Collins nodding about that absolutely it's we need to empower teams to be able to deliver care and we do put bureaucracy in their way and that's where they joined up working if you like doesn't work because this issue that so for example somebody maybe needs stepped up care it could mean that they need district nursing support for example that then needs a referral to go through that referral goes that slows everything down for the patient the patient's not getting the care we're actually if they're all in an integrated team it's very very quick they they have a direct communication we rely on each other's professional judgment we make a decision and then very very quickly the care can be provided by the right person and that's what we all need to be looking at is how do we get the right person to deliver that right point of care and and that's why we're saying a lot of the time we put artificial barriers in place and we've all spoke about the bureaucracy and the systems that don't speak to each other which put just barriers in place not only for the staff which are frustrated but ultimately for the patient who received the care so absolutely good it's exactly what we heard of yesterday from a Granite Care consortium and they said to us that what they've got is almost a model for how care boards should work that that ideal so it can be done so that was really interesting to hear you framing it that way and your response because that's exactly those of us who were in Aberdeen yesterday heard that in action in Aberdeen so very interesting thank you Emma Gillian you the question before I move on thank you just actually to build on what Collins just said obviously there's been concerns that community health care is not defined in the bill and you've alluded to some of the services and professions that should be able to speak to each other and work together easily in your opinion what services and professions do you think should be under this heading of community health care? I think clearly I can speak much more with confidence about nursing nursing needs to be a key part of it it's not part of the face of the bill and it's not some of our colleagues would say that they're not fully don't feel fully recognised so for me it has to be everybody within the journey needs to be included they need to be recognised and it is that link between health and social care we are not good at that linkages and we're at that point where look at the minute delayed discharges we have in our hospitals today and that is a result of not having good communication and teams and actually the other thing is you're not going to this is not going to be any surprise that I'm going to raise this it's a lack of workforce within the community to be able to deliver the care we have not supported a development of the workforce that's required to meet the increase in care needs thank you james james donan do you want to come in yes if you don't mind thank you we've just heard from mr pulman there that about the sort of barriers that are put in place between the workers from working closely together i was on the chcp 12 11 years ago in Glasgow and i saw the same problem was not between the workers but between those who help power who found it much more difficult to trust the workforce to work together how do you see you not think that maybe the care act might the care service might help that might smooth over some of the problems that still exist i know it's got better since then but but it still exists between the two organizations and that's directed to Colin i think that the issues at the moment is is there not more things that we could be doing currently with the current services in relation to how we get people to be able to have that empowerment to be able to work with our colleagues you've talked about your experience in the granite city that shows you it can work it can work now why we're not learning from systems that are currently in place and removing these artificial barriers where they exist so i mean it's an internal frustration for colleagues that the issue around about care is blocked because of these artificial barriers that put in place and i think that the point that mr donald makes around about the it's that empowering point of people and people who are in positions of decisions to empower staff to be able to if you like and take this the right way just get on with it because that's what they want to do but at the same time the the people at granite care consortium said to us that best practice that they've got they'd like to see replicated in a national care service in care boards across scotland and that was a vehicle and they actually said that to us get on with the national care service so that that can happen so that's an interesting i think it's that interesting if you've had a positive experience you may have more confidence in moving towards a care service whereas a lot of people are not having that positive experience at the moment and the lack of detail is causing anxiety and they're worried that we get too thrown into we've all been involved in large structural straight shake-ups over a number of years and people lose focus it becomes about the structures and not about the people we care for okay thank you um we're bringing allison and i must i must move on to our colleagues allison and i suppose we're mentioning this but slightly skirting around and we've talked about wanting you know teams that work together to do that they need to understand and have control of budget we've heard mr donald they're talking about you know how sometimes the kind of senior management perhaps hasn't come together a lot of this is around how budgets work and how resources work and i think we need to be kind of quite clear that if we if we can get to a point where to be blunt we need more more resource in the system but also that where local teams can have access to it easily and decide where it is best spent then i think we'll be able to realise some of the benefits that we're all looking for okay thank you um Emma Harper workforce pressures has already been talked about so if you want to be fill in the gaps in your questioning and then thanks convener i will be really quick i'm just thinking about the bill and the fact that we've got recruitment and retention issues across social care health and social care you know valuing people getting them into the workforce i know dimfries and galloway college have got care courses that really look to career development for instance you know i was a clinical educator i was a nurse who taught nurses how to provide care in various things at home central cleaners access things like that so i'm interested in what you think the extent of the bill will help address recruitment retention especially if a standardised approach to career development is part of the proposals in the bill i don't know if Kate key is looking directly at me so yeah i think i'm not certain the bill will help in recruitment and retention we are where we are at this point in time and quite quite frankly we just don't have enough available workforce in scotland to fill all the rules that we've got whether it's health and social care or many other places where we're struggling to recruit i have got a real concern about retention because i can see retention is a growing issue so health colleagues will certainly are seeing the same impact that we're seeing at this point in time which is the pandemic's had its impact people are leaving earlier staff are looking for an easier easier role i'm not sure there's hope in the in the bill that will change that rapidly but we could do something right at this time so in terms of career pathways in terms of standardising approach to training etc those are things we could be doing right now and you know that worked well i think in the expansion of early years we had a good programme round about that and we saw a good structured activity in terms of bringing people in who weren't there previously but we've not quite got the same programme there around about health and social care okay and then Colin here we certainly be welcome the emphasis that there is in the in the bill on investing in training for the social care workforce because there is a requirement once registered with us to obtain the qualification but a really mixed bag in terms of where the funding for that training comes from some employers will fund some won't so access to training is a challenge and the concept that the national care service may assist with that is certainly something we welcome and just to pick up on what you said there okay we're seeing our register for people working in early years increasing as we're seeing the roll out of the funded hours and a really high level of qualification in that workforce and so I think 73% are fully qualified so seeing that absolutely has been successful thank you Colin yeah training development is key to the development of services at all levels of levels of practice that's both entry and advanced practice but what we'd say looking at the bill itself in section 24 we would say it needs to be strengthened around about training as it at the moment it says it says that case but keyboards may provide training we think it should go further than that and it should be compulsory that they should be mandated to provide training yeah thank you Emma do you have a follow-up work can i move on just a quickie follow-up it just i'm sure Colin that you would welcome the fact that the bill does basically say the Scottish ministers and keyboards may provide training because that hasn't been the case before and we know the importance of teaching people moving and handling and infection control and prevention measures especially that we've seen during the pandemic so i take on board that you think that that it might need to go further but just a quickie question i suppose you welcome the fact that it's in there in the bill in the first place welcome that it's there but as i say we'd like to see it strengthened and so it's mandated that it has to be delivered not me okay thank you um Paul you have questions around transfer functions on staff yeah thank you convener um we've heard quite a lot of evidence about this area and i suppose the known unknowns if you like um around this in the bill so i think really just to ask um what your view is in terms of the approach being taken by government to seek um to kind of so within the bill there is a power so i suppose the question is one what what does i say to staff in terms of morale and secondly what are the main concerns of staff and i might start with k if that's possible convener so probably the first thing i heard from colleagues was there's a bit of inequality there you're talking about local government staff for example potentially being caught with chupy but but health staff definitely not caught by chupy so that's probably the first thing that really gave the workforce a bit of a concern but the minute you talk about those kind of changes people want to know what does that mean for me and chupy is complicated you know inevitably if i if i cast my mind back we've got local government reorganisation and people moved in that took a few years to try and harmonise terms and conditions and it was very unsettling for people because you're you're bringing different cultures together and that can be an issue in itself probably more recently was the creation of the single fraud investigation service which took years to roll out and that was a very small number of employees within a local authority environment joining that that kind of national service but it does worry people and this is where you kind of need to keep the communication with the workforce up you know they'll ask questions what does this mean for my pension for example which which isn't something you know people have misconceptions about what chupy will and will not cover so it might be it might be like for like or it may not or you may feel that you're you're not getting access to the the same benefits that you previously had but when you bring in this level of uncertainty it's maybe a level of uncertainty that is just one step too far for individuals and so that is perhaps what's you know that level of uncertainty the thought round about chupy is perhaps what's driving some of the workforce reaction you need more clarity on that from from the minister because that's helpful for us to know so it's very personal so you know that you've got a multitude of people with different terms and conditions so they want to know what it means for them you know and it's not a it's not an easy answer to give it does need a lot of work behind it and do you think it would have been better to do this on the face of the bill to give people certainty or not at all that's the cause i think yeah so i think the minute you say chupy people get worried they think about i'm going to be transferring employers what does that mean for me you know what what protection does it give me you get the you'll get the individuals and also their representatives the trade unions asking the same questions and actually you don't know enough detail at this point in time to know what the answers are so it's hard to put that on the on the face of your your bill i suppose the the single fraud investigation service used a a different vehicle for moving staff from from councils to that that national body it's much of a muchness it's just a different vehicle but but it still had that level of concern and it took a considerable period of time to work through i've got a brief follow-up on your cost i mean there's been a lot of discussion in recent weeks about cost in this committee and in other committees that are scrutinising this legislation i mean are you concerned in terms of the the cost to set up new services and in terms of doing that transfer of staff i mean is that a worry for local authorities the change in structure is is a worry in itself so if you if you don't know what the future is going to look like then it's difficult to cost you know what it's going to entail but but if you think about those experiences that were in place you know you've then have to think about harmonising terms and conditions it's an easy thing to say but it's a costly process to go through and actually it's quite contentious and i think at this point in time we've got no idea really what the cost may be in the longer term because we don't know what the shape or form that we're aiming for might might look like just really really briefly to pick up on a viewpoint you made there a bit about staff feeling you know they don't know what's going to happen they don't know where they're going to be about their terms and conditions just for clarity i thought to pay meant that you had to have terms and conditions that were at least as good as those that you had previously that's a lot of work for employment lawyers but you can you'll transfer over with what you're at you might not necessarily be able to stay in the same pension scheme that you're in right okay which is a big concern in amongst the professions that are covered within that that bill because they're all very different so for example i'm in a local government pension scheme i've been in it long enough that i have some protections in that that i wouldn't have in a new scheme and actually helpful to know thanks i just like to make kind of a couple of observations on the transfer of functions and staff because of course what we're really talking about here is adult services staff and if you read through the policy memo and kind of think about who that's likely to be at the moment it actually i think is referring most directly to social workers the power professionals the commissioners and their support staff who are currently in local authorities who are in who are most likely to be the the the group that will be looking at their futures if you like most directly in that care services may may stay as regulated care services and providers so it's just to kind of point out that at the moment that is a particular issue for social work and the the connectors the other problem for us is what happens if social work staff don't move into the national care service which would likely mean that there would be a separation of the workforce from the duties and the powers that will be in the legislation so if the care boards have the duties and the powers right but that social workers remain with local authorities i'm using social workers that's our profession but then what we have is a disconnect potentially with the how and who delivers on those duties and powers and risks of perhaps commission services which is not something that our members would support okay thank you and move on to training research sandish thank you i'd like to start okay if i may so does the bill as laid out guarantee robust training for all staff that are being transferred i think as we've heard earlier on it talks about me provide i think in terms of robust training and support for staff i'm not sure you can see that in the bill as it stands just now you certainly would have to have much more detail around about that so with the recruitment and retention issue and certainly i've heard allison say before that the average social work is six years in post we lose 25 percent of really qualified social workers in the first six years of practice so so with recruitment and retention issues there is a pressure on staff in my experience in the NHS one of the first things to go is training and research so how could this bill protect staff when it comes to research and training it starts off with additional resource because as we stand just now so if i think about the teaching world for example there is very protected time in the teaching world for those kind of training and development type activities and a whole structure around about research and bringing that research back into practice there's not an equivalent in the social work environment for example i'm looking at you allison because you just happened to be sitting next to me but and i'm not sure in the bill as it stands just now you can you can see that that will be something an output from the bill but you need the resource to do it in the first place thank you collin you want to very quickly to add to what i've said i mean i think you need strength and not the me it must provide training i think that would be a key thing and you're absolutely right it is the first thing it goes it's the first thing that people look at to save money is the training development and actually it's the key thing that you shouldn't move i think the other thing is just to point out that it also needs to align and i've said this before is the workforce planning and that's why the link to the health the safe staff and legislation is key for me because it covers around about the workforce planning and that includes the workforce development as you go forward sorry just very quickly as my last question we always focus on training and if we know training is is vital to everything including your just well-being as you as you go through your profession but what about research how can we ensure that there is research done by people who want to do research and i was going to lead on to questions from gillian about data but there should be rich data so how can we ensure that people who want to do research from social work from from other areas get to do that if i could ask Allison um i suppose again it's making a culture where this happens um case talked about having time so if we want to enable um you know people who are working to undertake pieces of research that help we need to make time and make structures that enable that to happen we have um you know a a social work academia in scotland that um is is producing um lots of research um but how do we connect all of that in to um the the and turn it into good practice um and reflect on it and review it and learn new things from it so again there are something about the positives of having national structures like a national social work agency that that enable the the feel like the the collation of that but also learning about the knowledge of the gaps um areas that are not being researched that maybe are not popular and then we can seek out um individuals or um you know other other university departments who have specialist expertise in those areas can i bring you in sravan for questions about how we can ensure the researchers uh as uh integral part of what people do so if you look at the career development framework for example the nest develop the very much talks about the clinical training leadership and research elements of the work of hps and nurses i think what we're trying to do in the NHS at the moment is really to make sure that staff have a proper work plan depending on their grade and their level of working that would enable them to do that they've been able to them to dedicate time to research if those staff however have moved into the national care system where there is maybe different thinking different culture there's not those framework exist then you know there is danger that that will not be maintained thank you and sandesh i can move on Emma thanks convener just to pick up on the issue of research and training right miss clinical nurse educator that was my my career for many years but the the very fact that research and training is in the bill and the research part says that uh that the Scottish ministers and care boards may do any of the following in relation to research relevant to the services but it's assist others in conducting research and give financial assistance to in relation to it so this would enable further legislation to basically say absolutely we value research we value training training leads to quality quality care improvements and then allows for career progression as well so just back to this framework bill will enable further research and training to be enabled as we move forward with this national care service not sure if if it's a really a question or just a comment allison anyone want to respond again i think what you're talking about is really important career pathways and options we need people who will go into academia we need people who to be practitioners we need people to go into leadership and senior management positions you know and within practitioners we need people to keep honing their skills um we they may become more specialist they may um develop particular sets of sets of skills what we need again i think i've mentioned agenda for change before is some kind of framework and we have the the advanced practice framework that's being worked on um by the officer to choose social work um advisor at the moment so we need to pursue that but i think we need to think about it not only you know so we've got teachers we've got some of it in health we should be working towards it from social work and we think we need to replicate that across the professions and we also then need to make sure that the professions can find it easy to perhaps to move professions at particular points in their professional lives you know we want people to come into this very very broad sector and have healthy thriving professional lives where they're feeling that they're able to do what they came in to the professions to do but also to move around and experiment and develop that skill set okay Colin want you to come in yeah i agree with all of that but i think the thing for me is around about is that funding being available for it and it being absolutely ring fenced if you like and i think the issues around about the within social care is looking at multi professional research and i think it's around about how we look at opportunities to do that it's not about just about uni professional research it's around about that multi professional element of it and that it's actually to the integration that we've been talking about and just a final point is we have national education for Scotland so nes and health improvements scotland we've now got public health scotland these are bodies that you know national health service workforce look to for advice and that so this again could enable our national care service workforce to tap into expertise in nes his and public health scotland would that would be something that we could reasonably assume as a potential body that would help support education and research in this national care service is that correct mithie we already work closely with nes and i know that they certainly see that integrated approach across health and social care is being okay thanks okay thank you right as as build data and julian mckay thanks convener um despite the fact that we know there are significant gaps in social care data there is no requirement for care boards to collect data or report on performance included in the bill what data does the panel believe should be collected to inform social care reform and development of a national care service i know that is how long is a piece of string style question um but thoughts on that would be greatly received k i think i'll come to you first i'll i'll take a strand of that and hopefully callers can fill in some other areas so i suppose for me if i think about data collection which is always problematic in the health and social care world we don't necessarily talk the same language and that makes things tricky so i might talk about turnover and somebody somebody in health will have a different terminology for it but in the social care world what always makes me a little irritated is people talk about your vacancy rates and what how many vacancies are there in social care and and they don't at the same time talk about unmet need because you know in terms of vacancy rates it's a bit of how long's a piece of string it actually depends on you know what is required to be delivered and and in the social care world also about the state of your providers in the area and who's able to do what so it'd be good to get a common approach to language and maybe something that makes data gathering a bit more straightforward so we can share data in a more effective way and just understanding what the data is all for so in workforce planning terms for example you can gather a lot of data but are you looking at it and are you interrogating it in a way that is meaningful in order to get the right outcomes? Colin? Yeah i agree with that it's around about having that shared understanding and the shared data we lack a lot of data that's not available in the social care well it is available we just don't gather it and the other thing is around about systems to gather data especially with the raft of employers who are involved we need to make it easy for employers to be able to input that data so that we can use it and interrogate it to make sure that we're developing services that meet the needs of the individuals we're providing care but also the workforce and that data is well it's missing as we speak. Milly? Yeah we are a national statistics provider and our workforce data reports which we have been publishing for I think over 10 years now are cited regularly in all of the documentation surrounding the creation of the national care service so there is data there about the workforce but I think that point about what's missing going back to what you were saying Kate linking it to outcomes I think can be very difficult and certainly work needs to be done around thinking about how you do that. Alison? I think we need to decide what's importance and what we're going to measure and why we're going to measure it that then leads to kind of data sets and standard ways of doing that remembering that data drives what we do you know we know what happens or the issues that can happen should we say with waiting lists times and you know it really drives how we manage what we do so we need to be careful. We've mentioned a couple of times collecting unmet need I mean this is an area in social work at the moment that simply isn't collected if somebody presents but is nowhere near what we would say the eligibility thresholds are at the moment we effectively we might sign post but effectively we say go away until you're worse okay come back when you're worse so there's something about and and there will be no main note made of that there is no data and systems that collect that might collect that there's been an interaction but we're not collating that that kind of level of need and of course when resources have been scarce and eligibility's been going higher so when the first things actually a national social work service needs to do is really understand the the the early support that people need and the the level of preventative early services that we we should be aiming to get in and if if as a society we decide we can't afford that you know we need to look at resources absolutely let's not be naive but that then that becomes a political and social decision um but that we know what we're dealing with and that I think that's the the the tricky bit at the moment. Gillian thanks um obviously we have anticipatory care planning to a to a certain extent in in places and we heard at Granite City Care they're moving towards an outcome focused they're using an outcome focused model rather than collecting data for when people clock out and people clock in and out because that's very binary and doesn't actually give a flavour of the of the service that's being delivered. How how do you see anticipatory social care planning as well as anticipatory healthcare planning feeding into an outcomes focus model I'm assuming the panel would like to see a move towards more outcomes focus models rather than the sort of the sort of timing task but if I'm incorrect on that you can you can correct me there maybe go to Alison first. You're very correct and as I've said before I think um you know outcomes um trying to get to outcomes is is not a new thing we have been trying we have been aiming for this for a long time but I think again it's it's some of the the structures that we have that stop us working perhaps as full um into the temporary teams um maybe uh we're not working perhaps as locally as we could do we're not as accessible to people so that that um and and and that it has not you know people don't come and chat on the social work department's door anymore you know um and there are many different doors perhaps that one has to chat on to find to find the right door so the notion of a kind of a single point single points of contact are really important but also making those local where you know begin to know people's faces you know where um the integrated teams are in your local community where they can be found and that there is a level of trust that those teams are working for the for the community to strengthen and build and and and catch people um who may fall through gaps good thank you the question on this thank you very much convener back again um I think you're absolutely spot on Alison and we all know that data drives what we do so the data we collect is is hugely hugely hugely hugely important there um interested as well to um um when we're looking at outcomes quite often it's the voices of professionals that are right up there um and I'm quite interested as well in any comments that you have about how we can make sure that we also keep the the voices of those that are receiving care and receiving services because sometimes their their view of the situation can be a wee bit different there so about having that parity any comments around that absolutely happy happy to um comment on that um I think I think that there's a few points there certainly what social workers go into social work to do and be trained to do their essence is around human dignity human rights social justice hearing people who are not otherwise heard that is that is our very our very essence however what happens when we get out into practice is that um there are mechanisms that then either don't enable options to be fully um explored or fully delivered or resource issues that mean um that there are problems um very I mean it's always concerning to hear that the voice of somebody using services may not be heard um we would view ourselves as an advocacy um profession very much wanting to stand alongside people who need services um and um I think again what we need to do moving towards national care services is ensure that frontline professionals are empowered to to do that advocacy properly and that goes back to some of the things that we've talked about which is about um professional parity um which is about not having assessments kind of rigid because um then it will reach certain that a lower resourcing requirement or you know some of the things that happen I think we need to be honest um um one of the other things that can happen and certainly that social workers I suppose it's part of our bread and butter is where the views of people and their carers and their family may be different and that there is a role for us in um how we support people to work that through negotiate that and how we we we seek a way through um the human rights issues that appear because we are creatures who live in families and communities um so we you know we're we're not islands um and so our human rights impact on those around us and that um I think what we need to always ensure that we're doing is being having clarity about um where those rights rub up against each other um in in families but also and where there are there are protection issues child protection and adult support protection issues there are there are often times where it it does bottom line is it does feel to people that their views may not be taken fully on board but also the profession of social work is about trying to enable people to work through that and have the the least damaging experience of sometimes what is very crisis driven um um work Colin? Very quickly. It's it's making sure that the voice is heard at every level so that's from commissioning but it's also around about that when the the carer and intervention has been planned that individuals are involved in it but as importantly is one care has been delivered that we actually get the reflection from the individual who's received the care and that's recorded and it's fed back and it comes back to this data if you actually started to take these responses you can then build how effective your services are. Thank you and that good note to end on so I want to thank all our panellists this morning for the time and what they've told us I'm going to spend the meeting for 10 minutes till I change over on panel. We now move on to our second evidence session which comprises representatives from trade unions and they which represent the social care workforce and a welcome to the committee Mary Alexander deputy regional secretary for unite Tracey Dallan the regional secretary for unison scotland ross foyer the general secretary for the stuc and Cara steamson the organiser for the women's campaign unit of gmb scotland welcome to you all thank you for coming along to speak to us about the national care service and we take things back to the the review Derek feely's review and the recommendations that were made in that review do you see this framework bill as being the spring board to realising the recommendations of the the so-called feely review and I'll maybe go around everyone first of all to get your your views on that before I allow colleagues to come in so if maybe go to Cara first of all thank you I think that looking at reforming the social care sector following off the back of the feely review you know is welcomed and I think that you know great things could be done with social care if it's done properly however right now the bill is not it's not prescriptive enough to give reassurances to the social care workforce social care staff right now are being asked to take a leap of faith into what the Scottish Government are trying to do around about the national care service they need to be given more information you know that there has to be more through the bill that gives that gives the workforce faith that this is going to work so you don't agree with it the idea of a co-design process it's going to inform the secondary legislation that's going to provide that detail is that something you would rather that the bill had was completely prescriptive of everything and do away with the co-design process or do you agree that maybe this way of doing things actually means a bottom-up approach rather than the top-down one no definitely we agree with a co-design process and you know we welcome that we think it's really important that people with lived experience and the workforce are involved in that however you know when questions have been asked at present everything seems to be answered with it's subject to co-design and trying to get the workforce the workforce on board with that when there's not a lot of information to go on you know we're struggling to get the workforce involved when everything that they're asking is what does this mean for my future what does it mean for my career am I going to be able to feed my kids is my employer going to change and every answer to that question right now is it's subject to co-design so we're asking them to take a leap of faith into co-designing something that there's no a lot answers around just now and that's where that's where we're having issues there has to be there has to be more in the bill yes we welcome co-design you know for the intricate details but you know it's a very very wide framework so when you say there has to be more in the bill specifically what do you want to see in the framework bill that wouldn't be part of the co-design that would be in statute already without that co-design I think really you know for instance you know collective bargaining is a big thing for us to ensure that the workforce are represented we don't think that you know there would have to be a kind of a co-design around that the workforce should be represented there's fair work and we wouldn't see the workforce you know saying they don't want that and so there's lots of things that could enhance social care now rather than it being co-designed with a bill something that trade unions have been bringing to the forefront of you know the issues that staff have at present things could be changed now Mary Alexander freely does the bill the framework bill provides you don't have to press your microphone we done for you and does the the aspirations and recommendations of the freely report the framework does it at least provide a springboard for them as it's written I think the freely review has our report has a you know a number of very positive elements in it and there was wide-ranging consultation with freely however you know we are disappointed from the point of view that it retains mixed provision of care services and our position as a union is that the national care service should be publicly owned and run and universal and free at the point of need and that's our position and the you know there are a number of recommendations in freely such as adopting the fair work and social care group inquiry recommendations which is very positive however there is a lot of frustration as Cara has indicated among the workforce about the amount of talking that's been done around you know what needs to change in care what is the position of the workers because there was quite an extensive inquiry the fair work convention under two now that started in 19 in 2017 it's not 1917 and feels kind of like it but you know so and we're coming up for five years the reports recommendations came out in February 2019 and then Feely in 2021 said Luke let's let's adopt these and that echoes a lot of what we're saying around sectoral bargaining you know having a minimum terms and conditions changing the you know commission and procurement process and so it's very frustrating to you know we seem to have there's a lot of talking going on and has been going on over the last five years and from the our members point of view they're just you know frustrated beyond you know beyond belief about nothing concrete happening that that's changing you know what's happening in their day-to-day job role so there's issues you know for example Edinburgh there's a 20 percentage shortage of staffing there and you know we regularly get calls into our office from people saying you know I've had enough I can't cope anymore you know it's really difficult we're not getting the you know the support and supervision that we need and we're not getting the training that's necessary to deal with people for example with mental health health problems or learning issues for for example so there's an awful lot of frustration out there the mileage issue is a really a big problem and because people are now saying Luke we can't afford to take our cars to work you know it's not cost effective why is it that NHS staff there's a temporary arrangement an increase in mileage rates applied to them but it doesn't happen to us and you know they are really feeling extremely undervalued and given everything that they've done during the pandemic you know to keep vulnerable people safe they're just very disheartened and they want immediate action which is what's you know highlighted with the briefing that the STUC have produced those immediate demands because we absolutely need them there is a huge crisis and you know if you look at for example places like Aldi that are paying 10 pound 50 an hour you know a lot of people are leaving because frankly it's not so emotionally draining it's it's a better job you don't have to worry about what happens when you leave you know the vulnerable service user and you haven't got enough time to deal with it okay my colleagues will probably dig into some of the detail of that and we do want to keep it to this scrutiny of the bill and and these issues are very important and obviously in the form what the national care service is hoping to achieve but we do have to keep bringing it back and I will keep on bringing you back to the bill that's in front of us because that's where we've got to make our recommendations informed by yourselves Tracy can I ask you about my initial question about feely well the focus of the fair work in social care inquiry had a a large chunk of it about improving the quality of the work in contracted social care and I don't think the bill sets out how it's going to improve the quality of work in contracted out social care and poor quality jobs leave you with poor quality care would be would be my summary of that and as much as the bill talks about ethical commissioning but like the point that Cara was making the very warm words very welcome words but I've absolutely no idea what it's going to mean in practice so your answer to your question is do you want us to be prescriptive or do you want a framework it's probably somewhere in between ideally would want you to be prescriptive about all the things we want and perhaps more of a framework for perhaps some of the others but the real core of this is about the ethical commissioning if you're going to create these boards and they're going to commission services what does that mean for the staff and at the moment that means that the staff could be contracted out hired out on a contract by contract basis moved from one employer to another never in a stable environment at all I'm quite sure you'll probably want to speak to your local government colleagues about the workforce issues that we've given evidence to there about retaining a quality trained workforce under the fair work principles and that's where the prescription needs to be because all of those those fair work principles that we've worked so hard to achieve jointly need to be embedded into this bill but that contractual aspect you just talked about that's a question presumably that you have around this because it's not explicit in the bill but still questions around that or huge questions around it I mean we would say don't do it um we don't think you need to under embark upon huge structural reform in order to get some improvements around fair work and the workforce engagement I mean if we take the um the sick pay issues that existed throughout Covid the Scottish Government intervened and put in place a really robust system to look after the health of workers so they could take time out when they were ill and then return to the workforce you did all of that without creating a bill there are there are lots of things you can do but there was emergency legislation in place for that so I mean my understanding is that with having ministerial responsibility that's when the Scottish Government could step in for example when there's a situation where there's a provider that fails or standards fail and I've had this explanation before from one of you colleagues around that if all you need to do when there's systemic failures is intervene you can do that without creating care boards and everything else that goes with it you've done it before you'll do it again happened in my local area where there was failures with the home care provision and the council stepped in at huge cost and we've had the examples in some of our rural communities where it's cost a huge amount of money to buy a care facility off a private contract so you don't believe that the Scottish Government should have should be stepping in I do believe you will have to step in at times where there is some kind of failure what I don't believe is that you need to create the national care service in its in this framework in order to do that you as a government will always step in when you feel that there is a need to whether have been crisis as you've done it before without any of this so I'm not sure what the step change is if it's for emergency because the inference is it's not for an emergency but let me take you back to the pandemic where there were failures for example in some of the standards that were being deployed in care homes and the government had to have the Covid legislation to step in at the moment we don't have the government doesn't have the ability to step in as you suggested you said that local authorities have stepped in but the government that's part of my understanding of some of the provisions in the bill is to give ministers the ability the national care service to step in okay on an emergency basis that's fine but that's just one component part of this entire bill and the rest of it just leads to a huge range of questions. That was a bit that I wanted to focus on that's fine can I come to to to Ross Foyer? Yep he asked whether we think this bill will meet the the requirements of Feely yeah Feely talked about if we want a different set of results we need a different system and the short answer to your question is no this bill doesn't deliver the changes that that are really required if we really want a truly transformative national care service which is you know something that all of us here support do we think this bill is the right vehicle to deliver that I'm afraid not what we feel is that this bill could end up costing an awful lot of money for the Scottish Government at a time when that money could be better used to deal with a system that is in crisis in a much more immediate way and we we would like to see that the grave concerns that we have around areas that are missing in this bill because it does co-design is a great concept but you do need some key driving principles that we feel are missing from the bill so there is no mention of collective bargaining and what that process would look like and how we take that forward we've been waiting years now to see that taken forward appropriately we need to see the profiteering aspects there's nothing done to transform the fact that we still have profiteering happening in our care system and if you're serious about setting up a national care service that's going to change things we have to address the fact that up to almost 30% of fees paid into care in some of our more profitable care homes are going out the door not getting used on the service if you look at not-for-profit parts of care services compared to privatised parts of care services that's closer to 3% that's not spent on delivery of the service itself so that's a huge leakage of funding that in the state our economy is in we can ill afford not to address that issue and also we need to address the issue of local accountability it doesn't work at the moment through the joint integrated boards and the way that those are set up at the moment there is a democratic deficit in how we're delivering care we need to make it better and our fear is that actually with the sort of commissioning system that's being set up it won't address in a way that gives us any surety the fair work issues and the collective bargaining issues or take that forward it won't address the fact that we still have profiteers sucking profits out of our care system and it won't address that local accountability so those are a number of issues that you think should be in this framework bill straight off informed by the work of the fair work absolutely for this bill to be fit for purpose and worth spending the money on we need to see that we're actually getting something out of it because there are far too many immediate issues that need to be addressed with workforce and provision out there really critical issues for us to be justifying going down this path right now we want to see the bill withdrawn in its current form Emma, and then I'll come to Sandesh. Thanks, convener. It's still good morning. Just to pick up Ross on the point about collective bargaining, I'm reading a document in front of me, February 21, from the Scottish Government that says that the Scottish Government has made a clear commitment to promote collective bargaining through the inclusion of an employee voice indicator measured by collective bargaining coverage within the national performance framework and will work in partnership with the STUC to achieve increased coverage. There is already the intention to do that. It's part of what's been moved forward. So if that's already taking place elsewhere within the Government's processes, I'm interested you think that the actual language needs to be in the bill rather than using a co-designed approach in statutory legislation down the line to basically embed that as the Government has actually looked like already taken it forward? The Government has made a commitment to widen and out collective bargaining more generally and I would actually like to give my colleagues an opportunity to answer some of the detail in this because they've been in the room representing their members in some of these discussions but what we're saying is yes we absolutely would like to see more explicit reference to a sectoral bargaining framework within this bill, a very explicit commitment to that being there. I don't think that what you read out to me goes far enough frankly. It commits the Government to the principle of extending collective bargaining but it doesn't clearly say that it's part of a national care service. We will have national pain conditions bargaining, we'll have a collective bargaining framework in there and that's the sort of surety we need but I would prefer to let my colleagues answer because we are the umbrella body, they actually represent the members on the ground and they've been in the room involved in these talks. A lot of employee law is reserved still to Westminster so there's not certain aspects of employee law that can't be achieved in Scotland but we have to look at what is doable in legislation in Scotland. This is not about employee law, this is about leverage. At the end of the day the Scottish Government contracts care, you spend an awful lot of money in contracting care services and you have every legal right to lay out that collective bargaining should be part of the process that you would expect contractors delivering care to uphold certain collective bargaining principles. That, I believe, has now been tested actually through the construction inquiry and that adherence to collective bargaining is something that the Scottish Government could and should require as part of their contracting process. Can I move on to questions from Sandesh Gohani? Thank you. I have to say that I was a little surprised by the convener's remarks around Covid because in previous committee meetings we heard that this bill would make no difference to what happened in Covid and I believe that care homes closed themselves before the Scottish Government told them to because the patients were still trying to be pushed in. I would like to ask you a little bit more about that and to elaborate on what you were saying. I would also like to know from Tracey and Ros, both of your unions are calling for the bill to be stopped and for the crisis right now to be addressed and I would like to hear a little bit more about your reasoning for that. So you want to go to Cada first of all Sandesh? Tracey first. Tracey, sorry you mentioned Cada's name. Sorry Tracey, when you were speaking about just a little bit earlier you were talking about how the emergency framework is one part of it and I'd like to just know a bit more. I obviously have no insight or knowledge into what organisations have said one thing or another. What I would say in recognition to the work the Scottish Government did was that during Covid when things were at their deepest darkest worst for many aspects of the workforce there were measures put in place whether through emergency legislation or otherwise. So yes they made a huge difference to people. I mean very basic premise of if you're off sick with a dreadful virus that could kill you. The financial distress of not knowing if you can feed your family because you're not able to access sick pay or worse you come back to work and therefore infect other people with it was alleviated somewhat through that process and it's for me exemplar behaviour by a Scottish Government that is able to do these kind of things. I don't think you need necessarily a huge structural reform in the context of a national care service in which to do that. Can I ask Kara about the questions that I had about how both unions are looking at wanting to stop things right now and concentrate on the crisis that we have? Yeah thanks for that. I think just to bring this into the point as well I was actually a home carer and my local authority and worked all the way through the pandemic so the feelings I've got and the connection I've got with the workforce right now is something that I'm really keen to bring to the table to let everybody know. Obviously at the moment we feel that the bill is not fit for purpose I'll now go back over that I explained that at the very very beginning and the reason for that is we are dealing with a workforce and I will try not get emotional when I'm speaking about this they are broken they're exhausted and the spotlight is now of them. The spotlight was on them at one point you know the care are doing great they're out there standing a doorstep and clap now we're giving them a national care service bill it doesn't give them any sort of job security any sort of value and any sort of feeling of worth after the nightmare that they have just been through for the last two years so we want reform we want to make social care better but we feel that what they've been offered right now is not good enough. Thank you convener as I have a couple of questions I wonder if I can return as to the way that the bill has come about we've heard a lot about co-design after the the frameworks passed we've heard a lot about it being done through secondary regulations my sense across the all of the contributions here today and more widely is that there are things that could be dealt with right now using existing powers about pay terms and conditions the recommendations and fairly and the fair work commission and that actually it might have been better to sit down and co-design something in a meaningful way before we got to the legislative process would it be fair to say that's the position of trade union members and that's why there is this call now for a pause to the bill that actually it would have been better to do the co-design up front to actually have a meaningful discussion about you know what this is going to look like. Maybe so in there and yeah I think that's you know that that's a fair reflection of of you know how we feel there is a lot of discussion going on and but as I said earlier that is causing an awful lot of frustration among you know our members because of how long we've been talking about sectoral bargaining for example we've had numerous meetings that are probably hundreds of meetings about about sectoral bargaining and the point was raised earlier on regarding collective bargaining and that was in the national performance framework but you know the fair work and social care group recommendations are quite clear about you know the problems there is within social care and staffing and recruitment and retention issues and it does call for a sector level body and that was in 2019 so there's a lot of talking being done and it would be you know something needs to happen now with it for people to feel more confident about you know the bill because they just see there's not much detail around anything for example you know the care boards that the proposed setting up of the care boards has just caused a lot of uncertainty divisiveness worry about what's going to happen to my job what if we get transferred what about the pension what about the sectoral bargaining arrangements that there is and so there's huge uncertainty with the workforce and that's on top of as Cara said you know people suffering zero our contracts and you know working long hours and not getting paid for it not getting breaks etc Tracy yeah can I just add to that that it's like buying a house but without ever having seen it um we don't even know many rooms are in it or where it's located in many respects so you're absolutely right I think some of this the pressure if you like around doing this doing it now doing it in this way has come from that start at an earlier stage in that level of engagement and the fundamental for us is about the ethical commissioning it's about 75,000 jobs going out of councils to somewhere um whether that's in the same house or it's in a house next door and in a state up the road we don't know we just don't know and in such a critical area of of the lives that we lead to have our social care workforce uncertain about who they work for where they're going to be um I just think is is has all the hallmarks of of this being a bit of a disaster at this stage and we would absolutely say to you if you won't withdraw the bill please pause it please engage at that much earlier stage because that whole co-design needed to have had to involve us even from a workforce issue um at a much much earlier stage we genuinely do not know what the future looks like for around 75,000 and that's council staff and then all of the social care staff that work for private contractors and what the future looks like for them. Thanks very much, convener, and thanks for those responses. I wonder if I can just come to something that Rose said. Rose, you spoke about democratic deficit. I think that it exists in the current system in the way it's set up. I mean do you have concerns that the transfer of that decision making, that power up to more of a national level, will it kind of increase and exacerbate that democratic deficit and is it your kind of view that in democratising either IJBs or care boards you know there should be voting reps that come from trade union side or carers or patients with lived experience? Thank you sir. Eddie, ballad questions. What we do know is we're not happy with the current system because it seems to fall between a rock and a hard place and you know there isn't the accountability that we would like to see currently. We don't want to see any further dilution of that. It's not necessarily a bad thing to have a set of national standards as part of a national care service but it's also very important to have that local accountability and local democracy in terms of how these things are implemented in order to suit local areas. Just to say I think your previous question kind of links into that because what we need here is a bit of time to get this right. I actually think that you're absolutely right. The co-design needs to happen now before we're expected to back a bill that we don't understand what it's actually going to deliver. It's all jammed tomorrow and that's very difficult for workers who are involved in delivering a service that's in crisis today where they need immediate action. We get a bit sick of the co-design thing because we've been talking about this for years. Workers have been at meeting after meeting making it clear where the failures are. Ultimately there needs to be more investment in the front line and that's why particularly at this time where we've got huge workforce crisis, we've got a crisis coming this winter, we actually wrote to the minister last week to say look could we put this bill aside and not be putting budget money towards these huge structural changes now. Let's take more time to get it right but right now let's look at collective sectoral bargaining. Let's look at £15 an hour for qualified care workers. Let's look at sick pay. Let's look at getting a set of national standards in and a number of other asks because these are the immediate things that are actually going to make a difference on the ground and create a workforce that are well trained and high quality and that's exactly what we need to be able to deliver this service sustainably. It's not that we don't support a national care service. Nothing could be further from the truth but we want to get the opportunity to get it right. Can I bring any questions from Tess White? Tess. Thank you and I'm sorry for missing the first part. Just one question. So one of the things we were in Aberdeen yesterday, Aberdeen City, one of the things that hit me this morning was this huge disparity if you think about 61 PM versus 45 PM and I know when you're looking at aligning terms and conditions you've got huge issues on pensions, on sick pay, on all that sort of thing which can be huge costs if you're aligning but even something small people will move because they can't afford to move around for 45 PM mile but if they were paid 61 PM mile so just a comment on that which is tiny but it's huge. You're absolutely right and for some of our members there's a difference between whether they can go to work or not, whether they can afford to pay, to fill up the, whoa, cheese, I've just ticked coffee everywhere, whether or not they can afford to go to work or not and sorry Mary, I didn't do it deliberately. Thank you. So yes but I think it's broader than that. If we look at the construct of this as it stands there's a huge propensity for people to be contracted out and the minute you do that you see the terms, there's empirical evidence around this, you see the terms and conditions start to drop so the pay rates go down, the mileage rates go down and there's then this internal market and people will jump around so there's no security around any of that for the future but worse than that I think in relation to this bill there's an equality impact assessment there about some of the service users experiences in terms of the equality impact but there's nothing there in terms of workforce so gender, race and disability we know absolutely tend to be those areas where there are equality dimensions to this. We've seen it in Glasgow in equal pay it's cost the council hundreds of millions of pounds by contracting people out and then having to bring them back in and the contrast with other workers in other areas so I think there needs to be a full equality impact assessment done on this it's linked to sectoral bargaining and some security and some levelling out that will exist there but all of it needs to be invested there's no way that this could be done within the current cost envelope in terms of bringing all that together so I mean even the setup costs are eye watering if you add in some of the dimensions around that if this starts to decline and we think it will by people going out to contract us about how we bring them back up because sure as fate that won't work it will have to come back in the examples are there. Thank you. Thank you. Can I bring in James Darnan? James? Can we just unmute James' microphone broadcasting? That would be super. Okay. Okay, that's true. Usually people are trying to silence a microphone and it's supposed to turn on when I'm on. I'd like to come back to Tracy the analogy about the house. Do you not think that this is more like an opportunity to purchase something and then design what it is when you're there, when you see the space, when you see what the opportunities are and give you the opportunity to do things like the issue that was just talked about about a 45, 61 pence per mile. Surely a national care service gives you an opportunity to work closer together and try and resolve some of the issues because I completely agree with you. I don't think that people are doing the same job in the same area should be getting different terms and conditions. I think there's got to be a long term aim to make sure that there's an equality of that. Now, it might not be there just now, but surely the opportunity when you're co-designing and the social security bill is maybe a good example of that. The co-designed after the bill has worked in that case and why can't it work in this case? That was to Tracy. You wouldn't buy a house without a survey, would you? What if it's structurally? That's not what's happening here. You either want to ask me a question or you don't, but my answer is that I think that you wouldn't buy a house that you hadn't had surveyed and could have all sorts of structural faults and then you need to trust the developer that comes in and the problem we've got at the moment is there's such insufficient detail within this bill. How can we trust what this is going to look like in the longer term? We genuinely don't know. It leaves all sorts of chasms open. Now, while we would agree on the outputs in terms of people being paid the same and the quality of care being broadly, certainly what people need but broadly consistent and those providers being scrupulous, ethical and commissioned properly, I think we might disagree about the means in which to get there because you've heard from all of us repeatedly, we don't think this bill is the way to do it. Mary wants to come in? Yeah, what I would say around talking about the mileage and other inconsistencies in terms of terms and conditions and the point you made about let's do the co-design now, we've had the fair working social care group which met for 18 to 22 months I think and took evidence from all parts of the social care workforce including the employer so we've got that evidence, we've also got the Fili report and the wide range of consultations that was done then so what I would say is that we knew what the problems were, we identified those problems and so we've had all this time in between to look at a sector level body which is the recommendation for the fair working social care group and that hasn't happened so co-design is then going over a lot of the stuff that we've already sat in numerous meetings and gone through all the challenges and the issues. On the procurement piece that Tracy mentions I've recently co-chaired a construction inquiry and you know there's a number of recommendations that the Scottish Government can make that you know Westminster can't interfere with basically so for example they could require in-commissioning procurement and adherence to collective bargaining rates already the Scottish Government require anybody that gets public funding has to pay the living wage so there's precedence there and that we can you know work with and move on. Thank you. I just want to go back to Mary, if you don't mind, just to clarify that point about sexual collective bargaining. We know what the steps are to put that in place are and so if we wanted to embed it in the bill you know we want to get it done before then but get it embedded in the bill that would help us to progress the national care service you know in a better way with the staff you know is that what you're saying? Yes I mean if you look at some of the demands that that we've made in the STUC briefing and indeed the union demands if you have sectoral bargaining you know number one as a priority you know a lot of the other things like mileage payments and 15 pound an hour and things would fall into place because you've got you've got those sectoral bargaining arrangements there. Okay thank you. We are now moving on to questions from Emma Harper about the workforce. Yes, thanks convener. So we've heard a lot already about I suppose there's real challenges right now we know that there's some issues around recruitment and retention. One of the things that I've raised is about having a national approach to standards of training and education. Do you think that that will help support basically saying that you know this is worthwhile as a career it's a great way to help you know obviously look after people we know that predominantly it's women that are the carers and often they are caring for other people at the same time so do you think what's set out in the bill as far as training and standardisation of an approach is some is a way that we should move forward in order to support recruitment and retention. Tracy. It's a regulated workforce all of those if you like dimensions are built into their registration that they are required to be educated to a particular standard have continuing professional development so all of that is there I don't think that necessarily needs to be the main focus the big issue is that a lot of workers have to pay their own registration fees so there's then a further financial burden it's something that's just changed as part of the local government pay settlement that the councils are going to pick the tab up on that our fear would be if they find themselves being moved employer that they might lose the ability to have those fees paid but the fundamentals are around basic rates of pay it's just the ceiling is unachievable and they're all stuck at rock bottom for many many many of them competitor type employment in local areas most carers you're right working women they live and work in their communities it's the type of work they want to do in their communities and for the most part they're happy to do it until a supermarket builds something new along the street and then the money is better and they just have to move they have to move for where the money is and we need to do something about that we firmly believe that sexual bargaining is the key to that because it's not just about the basic pay it's also about the mileage rates that you spoke about pension schemes we're seriously worried about what NCS means for pensions in terms of transferring out large swathes of the workforce and then perhaps the scheme being diminished for those that remain within it but we have to put together a an attractive package of employment measures to make sure that we're the employer of choice for what is some of the most basic human rights and dignities that a lot of our members of our community deserve to have delivered in their own homes in some cases um by people who really care about the work and are fully trained and engaged and registered to the appropriate standard but that bit if i if you think i've been critical about a lot of this that bit's not bad in relation to the the professional development side of things i think the focus needs to be on frankly hard cash i wanted to come in Emma can i bring Carlyne yep yeah so thanks for that um professionalisation is you know a big key ask for us um around about this bill because care workers are professionals right now they're not treated as such and we welcome the change to for that to you know care workers to feel that they are valued and they are professional um you know a consistent training and development programme again would be welcome because you know from an equality point of view it won't matter what area you're in you know what kind of workplace you're in you will be having access to the same training as everybody else doing the same job so that is definitely something that you know we would welcome again though the triple s e you know as you to be trained to a certain standard and we would expect it that the fees would be covered by by employers um i think is well one of the big things is is it we have to move care on professionally so society still have a perception of care workers getting in dusting the fireplace and sitting down having a cup of tea and speaking to somebody care has evolved so much from that but society's perception is no evolved with it and i think we often training and making this career a professional career um we would have a great opportunity to you know explain to society that that's how that's the route we're going down this is a professional career we want to recruit we want to retain and we want people to be proud that they work in social care. Ross wants to come in the Emma before i come back to you. Yeah just one final thing you know in that package of measures that we're asking for that makes the employment worthwhile that's important is is also just the the care package the timings of it and and the cuts that have taken place to care packages for care at home that's something we've asked to be addressed urgently because that's about the job experience so you know we've got people who are trained to a professional standard but they don't feel they're able to exercise their role to an appropriate standard given the resource constraints that they're working within and i think that has to be understood is also part of the you know part of it is about money and the job the work being sustainable and not having to pay to work as some of our members do find themselves having to do at the moment but part of it is also feeling that you can actually do a job for the people that you're trying to do a job for and some of these care packages have been cut back to the bone and that is not a satisfying job experience for our members when they don't feel that they're able to give the appropriate level of care that they should be given so i think that that needs to be seen you know that's also been one of our asks to the minister as well as the paying conditions side of it they actually need to be funded to an appropriate level to be able to do a decent job for the people they care for okay Emma back to you thanks thanks convener thanks for your answers um my understanding is of 1200 different care providers in scotland so this bill would propose to have them basically meeting a criteria for providing whether it's salary whether it's education career pathways that whole approach so that you could work in the freezing alleyway or the scottish borders because your i suppose your career pathway training that you have achieved would be then transferable no matter where you go so my understanding is that the bill does propose to include the provision of training and even fund it as well so is that not a good thing to have the 1200 care providers you know meet certain criteria that's then equivalent and measurable so that then we know that the value of the care the care that's being provided in the carers is valued i think yes it's the enforcement of that and i think some of the contracts for the work and therefore the staff that will populate that need to be crystal clear that it's based on fair work it's one of the things that the that's come out of of the feely inquiry is this that that fair work should be the the hallmark of an exemplar employer and i'm i am on a very safe ground in saying that of those 1200 they are not all exemplar employers in fact many of them i wouldn't you send to the shot with a list to be honest um far less provide care in a local area so i think if there's going to be ministerial oversight of this i think there is currently local oversight within councils and certainly within the the i gibs that that has to be at the very very heart of this that is one thing saying what you're going to do and it's one thing being monitored to ensure that you do and that there are consequences if you don't so if you don't pay the Scottish loving wage you should not be in a position to to you know bid for a contract and have that awarded to you it just should be out the question you are out of the market as such so i think we need to be very very careful going forward particularly if we do end up with a very much a commissioning and procurement environment around care that we don't see further erosions of the of the provisions within the contracts mary alexander wants to come in ever mary yeah i i i think um going back to your question yes it is positive that you know there there will be you know it's training standards across the piece um because that's one thing that you know our our members tell us is sadly lacking at the moment with the staffing shortages they're missing out um quite a bit on training and it does need to be better um from a fair work point of view um the problem that um you know we have is always the evidencing of those standards and i think there's a lot to be done in the fair work space around um you know if someone's bidding for a contract then they need to provide you know the evidence that they are a fair work employer what does that look like you know do they have union recognition um there's monitoring as well which frequently doesn't happen which really needs to happen so you know are these providers matching up to what they say you know that they're doing and are they complying and if they're not then there should be consequences as as tracy said and we should be you know putting in place that evidence that monitoring that compliance as part of the commissioning and procurement process so that if they're you know not good then they shouldn't be in the game they should be removed um and that is is something that's sadly lacking at the moment generally in in procurement. Can I come to Cara and then I'll bring in Roz? Just um wanted to add on that I agree with my colleagues you know as I've already stated as well training development totally welcome um there does have to be regulation around that to ensure that everybody is receiving the same standard and consequences if they are not um I think one of one of the big issues that's that's happening in social care right now which is something that we believe should be put in the bill as well is obviously around agency staff um so there's you know 1200 employers but there's also agency staff which a lot of our workforce are actually leaving to go and work for it at the moment because they're getting £10 50 an hour working in a care home or they're getting £20 an hour if they go and work for an agency it's a no-brainer and a cost 11 crisis but they have to be brought into that kind of a training and regulation as well because the staff the permanent staff that are on the ground when they have five agency staff shown up to help them with one shift they have to be trained to that standard as well so it doesn't fall back on the permanent staff to pick up the kind of a more complex needs. I was just going to say you talk about the number of different providers and the standards and is that is that not a good thing of course it's a good thing but that's where we still have grave concerns about the profit element being still part of this framework in this bill because when we did our STUC research earlier in the year profiting from care our report showed that staff and resources are 20% worse in private sector providers in older people's care homes compared to not for profit older people's care homes and that's a stark difference in the level of resource and service being provided so we have to look at those things but I think we also have to address the fact that it's not a surprising difference given that we're talking about some organisations who are taking and making profits and devetting them out from the service so you know standards need to cover levels of resource that are actually being put into the care and the quality as well as things like training standards pay conditions. Emma, I see you doing this. We short one directed at somebody and then I have to move on to Gillian. I'm doing my teacher's there again. On the face of the bill it says that the national care service is to be an exemplar in its approach to fair work for the people who work for it and on its behalf ensuring that they are recognised and valued for the critically important work they do so that's on the face of the bill so that's what we can build on again this is a framework bill and I'm saying do you agree that it's actually really a good idea to have fair work this approach right on the face of the bill and I'm going to go to Ross because Ross is nodding. Absolutely agree that fair work has to be at the absolute heart of the delivery of this service. The trouble with terms like fair work, the wellbeing economy, just transition as they sound great, what we have to do is we have to drill right down and start to define much more clearly what we mean by fair work because sadly fair work even when we look at different public sector commissioning bodies means a different thing to one government department or body than it does to another and that can make a huge difference to workers on the ground. We really need to be much clearer in how are we implementing fair work and how are we evaluating it and how are we enforcing it and there is much further that Scottish Government can now go as has been proven in recent fair work convention inquiries in their commissioning process to really batten down some very clear benchmarks that we require when we talk about fair work but yes it has to be at the heart of it. I think we need more assurance of what do we mean by that because it all sounds lovely. I want to see what it's actually going to look like. Thank you. Gillianne? Thanks, convener. I want to come back to something that had been touched on by I think both Tracey and Mary earlier on. We obviously know that adherents to fair work principles by employers should be monitored as social care employers don't always up the responsibilities to their staff. In your opinions how could the bill be strengthened with regards to oversight and regulation and what if any specific provisions would you like to see included in the bill either in terms of strengthening oversight or in terms of those consequences for employers who don't up hold their end of the bargain. I'll maybe come to Tracey first when he's started with this. I mean the whole principle about fair work cascades through ministerial duties, standards for commissioning and procurement so I think number one I'm just going to play it back to you in that ministers will have a specific duty to ensure that their exemplars of fair work if you've got sign off on commissioning and procurement and unfair work persists it's been authorised by Scottish ministers so there's a responsibility on all of us I think around that. The monitoring and the reporting on employment practices has got to be key to this exactly who is doing what and where and when and why. Number of years ago when Scottish living wage was part of the the pay bargaining Scottish Government funded it and a social care employer in the area that I lived that just refused to pay it I mean they were getting the money from elsewhere. Now the council stepped in and took the contract off them it's an example I think of what you were talking about earlier. Now we need more of that when we identify that whether it is on a on a local level or it's you know it's endemic throughout then I think that there needs to be some steps and some scrutiny and I've already mentioned it I think there needs to be some penalties here that frankly if you breach the ethical commissioning and tendering and procurement process you should never be allowed to darken the social care door again unless you can go away and I don't know rehabilitate yourself and come back and show that you can do it fairly and squarely that there's no place for some of these practices in care they have a huge impact on the workforce and therefore have a huge impact on the on the recipients of the care so I think that's what needs to happen. Ethical commissioning strategies within the care board strategic plans absolutely need to to be as robust and transparent as possible. Thank you very much. I think in the initial questions we've started to touch on many of these issues about transfer of staff and the concerns I think trade unions have around that 75,000 number and the potential knock-on so I think what I will do is just trying to focus if I can maybe on your involvement in understanding that process particularly around TUPI for example so I wonder if I can just start by asking when were trade unions consulted on the sense that there would be a transfer and that might involve a TUPI process by the government in terms of the bill. Well just now Paul if that's an invitation because until now no it's very difficult to start that consultation process when you don't know what the final destination is going to be so we know that if the tendering process results in I don't know adult social care residential homes in the Lothians is going to be run by another employer on a particular date we can start that process but we've no idea at this stage exactly what the implications are. Our fear is 75,000 staff will end up working for care boards. 75,000 staff may also be contracted on a hired out basis to deliver social care for that care boards potentially to other employers and we'll see one TUPI transfer leading to another TUPI transfer leading to another and at no point do you take your pension with you. TUPI doesn't cover pensions so it's just your bare terms and conditions that we will see eroded over time but there has been no formal consultation with us over the transfer of 75,000 staff to ACAIR board. As Tracy said there hasn't been a formal consultation and it has been suggested that that might not happen it may or may not happen however you know that's a huge uncertainty for our members and I think there has been discussions with COSLA and you will have seen that we the unions put a press release out with COSLA called for the reversal of that provision for all the reasons that Tracy's outlined you know the fears that staff have you know the potential bounce from you know care board to you know somewhere else and then back again and the pension provision is is lost because it's not covered as Tracy says by TUPI so it's huge for us and the number of people that's affected by it and we really think that you know the money that has been spent on the national care service should just now go into local authorities and try and sort out some of the crisis that we've got in that sector rather than proceed with this uncertainty which we don't really know that much about. Cara, I wanted to come in before I come back to you Paul. Yep so basically the same as all my colleagues here we've been told there's kind of a no formal we've not been told anything formal as yet what we have been says is by the minister is there is no intention of doing this in this bill but of course it could be subject to co-design when we get there and therefore again it just kind of reiterates the point of the bill that you know when there's nothing solid people then start making their own assumptions and actually you know a good example that was actually on a meeting yesterday where a civil servant who had mentioned something about our briefing paper and how we were going down the route of you know assuming that there would be two pay from local authorities and he says that was a bit you know presumptuous of us to assume that and that's not what the bill says and our answer at that point was that the bill doesn't say either so this is where those concerns come where you've got a framework people start making up their own minds about what that framework means when there's no guarantees and no outcomes of co-design as yet. Thanks for those responses because the policy memorandum does speak about you know workforce employment and contractual arrangements being subject to that secondary legislation process and that includes the transfer of staff from local authorities potentially so would it be fair to say that at no point the government came to you and said there's a potential within this bill for 75,000 staff to transfer and that that might involve a Tupi process. I think that's fair but it was immediately obvious on the first reading of it but nobody came to us in advance of the publication of the bill and said there is a risk or there is a likelihood or there is a certainty and none of the above applied we could read it for ourselves when it was published. I just find it extraordinary that nobody came to the Trees unions and said potentially this is a process. I wonder if I can then just talk about the finance of all of that because obviously that involves you know the requirement for you know if you're doing a massive structural change like that that brings with it a financial burden and there's been a lot of commentary in this committee and in other committees about the financial memorandum that accompanies the bill so you know we've heard it referred to perhaps as a blank check and I just keen to get your sense of what that could mean in terms of the finances for local authorities. Because if you're going to bring all these 1200 employers under one umbrella and pay them all the same rate and we level everybody up fantastic because that's what you're going to need is a blank check it's hugely hugely expensive it's hugely hugely time consuming bringing everybody together and harmonising all of their terms and conditions and 32 different social workers in Scotland working within the local authorities will all be paid at different rates they will have different conditions attached to it they would need to be harmonisation and it needs to be fully funded so there's not a blank check we're not you know not expecting there to be there never has been a deal with multiple different harmonisations we were I was in the local government committee before I came in here talking to some old timers a bit like me who remember local government reorganisation back in 1996 and how much money that took to create the 32 unitary councils and harmonise all the conditions it took years it was painful we still remember it and it was it's expensive it would be an absolute ideal it would be utopia for us if everybody was on the top line everybody was on the higher rates but we recognised that that's perhaps not realistic. Okay moving on to finances in more detail, Sandesh you have some questions? Thank you thank you convener. We're hearing that the cost to set up the NCS could be up to 1.5 billion do you think this expensive restructuring is the best way to improve social care delivering Tracy if I could start with you? No and I think you've heard from us as to why I mean the conservative estimate is half a million we've actually half a million half a billion we've actually no idea what the actual cost will be but we understand fully that these things are never quite as they first appear often costs will escalate and it is entirely their own time to be spending upwards to 1.5 billion pounds putting in structural change when we are facing the most inordinate pressures on our everyday NHS services and on our social care services so just the answers no. So when you say conservative it's not the conservative pasties? No with a small C. Tracy can I just stay with you because what and I want you to be clear I don't want to put words into your mouth but what I'm hearing and this is why my question is do you trust that all the things on this bill are going to be delivered at this cost and do you believe that staff will be looked after? No. Could you explain why? I think trust takes some time to develop I don't think it's an inherent lack of trust in the Scottish government you've heard me describe some good examples of that in the past but no it's back to this I suppose discussion about buying something off plan I need some more guarantees I need some more detail I would not be spending that amount of money I rarely spend a huge amount of money on anything without being clear about what I was getting for my money and where the value would be and there's insufficient details on so many fronts in here for me to say that I have confidence that if we just take the feely side of things the sectoral bargaining will all work out the way we would like it to I worry that we will lose even more of the workforces it becomes the least attractive place to work and that ends up costing more money even just simply recruiting staff cost money placing the ad cost money never mind training them developing them and retaining them so there's really nothing in this that fills me full of confidence at this stage. Thank you and my final question so Mary did you want to come in on that? Yeah just just to say that you know we firmly believe that the money that is being spent on it is better spent addressing the issues the immediate issues that there are in that sector just now given the cost of living crisis given the fact that you know the the survey that we done of members which was over 500 they can't get to the end of the month without running out of money and borrowing from financial institutions or family and friends so you know there's there's very serious issues that we've discussed and you know that money is better spent now given the you know where we are in this country with the financial crisis and the economy is better spent on addressing those immediate issues and then pausing listening to some of the challenges and the issues that we're highlighting and looking at solutions and trying to get some actions lined up on those like deliverance sector or bargaining. Ross wanted to come in. Yeah just to back that up I think that we would like to see that money that's that's clearly been put aside for this being used to address the cost of living crisis the First Minister said that we're facing an emergency humanitarian emergency situation and so for us part of the the resolution to that is diverting money in our in our budget to those who need it the most that means putting money into low paid workers pockets now it means giving people what they need to get through this crisis situation and we could use that time instead to get the provisions in this bill right over the next couple of years and make sure that we actually do you know it's buying off plan without a plan at the moment we you know we could develop and co-design a plan that we can all see and get these issues out in the open and then take it forward and in the meantime use some of the money that's been earmarked for this to deal with the crisis that's right under our nose and that's about putting money in workers pockets. I'm going to bring in Carol Mocken. I'm really interested to explore the key of a profit and social care that has been mentioned at the start. I'm very impressed with the report from the STC and I would suggest that everybody on the committee reads it I'm hoping it as in as part of our evidence. I wonder if Roz and in fact all the panel members might be able to just give us some key aspects from that that we should be considering because I know most of the trade unions did to contribute to that work. Who would like to go first? I think I've covered quite a bit of it but obviously as mentioned we have a real concern about the level of when people are paying fees for care the amount of those fees that are being diverted and sucked out before it gets to being used for service provision so we found that you were talking up to 30 per cent for some of the big private sector providers as opposed to more like 3 per cent for not-for-profit providers now that is a huge difference and that is money that could be retained to deliver front line services if we took a different approach to how we design a national care service profits should have no place in the delivery of social care and at the moment sadly they do and that's part of the model as a commercial model in far too many parts of the sector. We also found that public sector provision the workers are paid on average £1.60 an hour more than care workers to work in the private sector and as I said staffing levels in elder people care homes that are private sector are 20 per cent less than non-private sector institutions so these are big big differences that I don't believe we can ignore when we're looking at how we take forward and design a national care service that's fit for purpose for the future. Money is tight so why are we allowing that money to go to profiteers when it could be used for front line services? We move on to final questions from Emma Harper and then Stephanie Calhann. My understanding about the financial issue is that the costs that have been projected for the bill are estimates that are already being used for health and social care so this isn't like 1.5 million of money that's just coming from somewhere else it's already part of the the care delivery that's already happening on the ground that's my understanding anyway I suppose which might be worth picking up in additional and then my questions were about training and research again but I think we've covered a lot of the issues around the necessity for like training being standardised that could be part of a national approach to help support the staff because on the ground this is about what the people who are in receipt of care wanted they want a national care service the folk that are being cared for but also carers providing the care they can see what can be fixed they they know what works we know that self-directed support works really well in some places but doesn't it in others so this creation of this national care services bill is about helping to support people on the ground because that's what people wanted so that's something that I'm interested in and then the training that around that that will help deliver what the folk on the ground are asking for I think I would make an initial response to what you're saying and then pass to my colleagues but so do we we want a national care service but there's no point in having something that's called a national care service when really all we're talking about is a national commissioning service so you know let's have a transformative national care service and let's take the time to do it properly and do the name justice in terms of what we deliver and that means bringing the workforce with you and and really working to get it right and listening to the concerns that workers are are raising on the financial part of the issue that's not my understanding but if what you're saying is right then that gives me even more cause for concern that that is completely and utterly unrealistic to expect that it would be done from effectively within existing budget. I know there will be additional money that will be added to it but the complexities of the whole financing of care and care delivery with the 1200 providers with people doing care at home and care in residential homes the whole thing is really complicated so trying to iron out the whole the whole approach is something that this bill looks looks to be doing I mean the fundamental is that if we're going to get the sort of care service that our citizens require and deserve then we're going to need significant front line investment and that means new additional funding that isn't there at the moment to deliver in terms of pain conditions but also in terms of resources so that that care abusers can get a decent level of service and you know we can call things whatever we want we can organise them whatever way we want but we need that additional funding to be put in and that needs to be realistically accounted for. Mary wanted to come in and then I'll go to Stephanie for the final question. Yeah just quickly I obviously echo what Ross has said and you know I know that there has been other bodies like the Audit Commission that has queried the finance you know and then the provision that's been made as you know I wouldn't say unrealistic I don't think that's the word they use but it was it was querying that those were sensible projections to deliver you know the national care service and you know as Ross says that you know the whole point about the national care services about driving up standards quality of care addressing workforce issues and you can't do that within you know the cost envelope that you know has been set out there has got to be more resource put in to this and a greater understanding of the issues and the pro that the solutions to those issues and those costed. Thank you. Final question to our panel Stephanie and then we must round up. Thanks very much convener. I'll direct my question to Cara please. You spoke earlier on Cara and obviously you were really passionate about it and quite emotional about the fact that you know care workers are just at breaking point that they've been faced with an incredibly incredibly difficult time and I know certainly we've got other we've got nurses et cetera as well who've faced an equally tough time too but they have this image in the public you know of you know people appreciate that nursing is a real vacation but it's very very skilled that there's a huge amount of appreciation which perhaps social care workers don't always get so I'm really interested in what you think might be the benefits and what might be the risks as well of a prerequisite for respect of social care staff to have qualifications and also in how we might look to attract young people into that workforce and show them that it could be a job that can be really worthwhile and really enjoyable. Thanks. Yeah I think that obviously all the things that we've spoke about today you know our key asks on how to make social care more attractive you know that it's a starting point there. The problem that you have with Cara is that even new people coming in and younger people they're being met way you know align a staff that's so exhausted, so tired and so undervalued that that rubs off on them right away which is why we want you know we want a reform of social care to start you know having them as professional workers making sure that they're training and their qualifications are up today making sure that we're paying them a professional wage you know minimum 15 pounds an hour but also we want we want people to have pride at the work in care we need to bring the workers along with us because right now on the ground the workforce feel like it's full of empty promises again just kind of like going back to Covid you know when we were talking about you know provisions of PPE and stuff like that you know they were told they didn't need certain provisions to do their job they were told that you know that that's fine you don't need that nurses do need that and the result in that was a lot of care workers died that's that's just the bottom line of it so we're now asking people to put trust in building the care sector again which again has already been mentioned my colleague that does take time and it's going to take a lot of hard work and this doesn't just come down to money it comes down to putting the time and the resources and to making these workers feel valued and that they're part of something thank you we must round up today i want to thank our four panel members for the time that they've taken this morning to take us through their views on the national care service our next meeting and the committee will continue our scrutiny of the national care service with a further two evidence sessions but that does conclude our public session of the meeting today thank you