 Good morning and welcome to the 28th meeting of education children and young people committee in 2022. The first item on our agenda today is our second session on the National Care Service Scotland bill. We will hear from two panels of witnesses today. Our first panel, I would like to welcome Louise Bussell, chief officer of Highland community, NHS Highland. Nicky Connor, chief officer and director for health and social care at Fife council. Fiona Duncan, chief executive officer, health and social care, chief social work officer at Highland council. Vicki Irons, chief officer, Dundee health and social care partnership. Ross McGuffey, chief officer, North Lanarkshire health and social care partnership. All of our witnesses are joining us remotely today. The members will generally direct a question to a particular witness to get us started. However, should you wish to respond as well, can you please put a capital R in the chat box? The clerks will be monitoring the chat box as will I and will bring you in when I can. Please do not feel obligated to respond to every question. If you do not feel that you have anything additional to state to what has already been said, that is absolutely fine. Also, if you are asked a question and do not have the information to hand again, please just say so and you can send it on to us in writing after the meeting. We have a lot of questions to go round and ground to cover today, so we will move straight to members' questions. Can I turn to my vice-conviner, Co-Cab Stewart, please? Thank you. Good morning and welcome everyone. The Public Body's Joint Working Scotland Act of 2014 aimed to better integrate the health and social care systems in Scotland through integration authorities. My first question is, how does integration currently work in your local area? What are some of the advantages and disadvantages of the model that is adopted in your area? I am aware that there are two different models. It probably includes an answer from everybody here. I would like to start with Ross Ross, the chief officer at North Lanarkshire Health. Good morning. In North Lanarkshire, we have an integration joint board, and I suppose that integration journey has been quite an interesting one. We started with children and families as part of the integration board set-up in 2018 that moved back into the local authority. What we reflect is that, through that integration journey, we had an integrated set-up pre-integration and pre-public bodies act in North Lanarkshire, so we already had an integrated planning arrangement between the council and health board for community health and social care services. I suppose that the Public Body's Act in some regards put us back a little bit in that journey. I think that there was quite a lot of introspection when the act came in. It probably took two or three years to come out of that and we started to move back forward again. We probably got the ground rules sorted between all the partners and the new ways of working in place in the governance arrangements correct as part of that. I think that the key part for me in terms of the success of the integration approach in North Lanarkshire is really about the whole system collaboration. I think that it is trying best to, in some regards, lose what belongs to IGB, what belongs to council, what belongs to NHS board and really try best to focus on what matters for the people of North Lanarkshire and how we best deliver that in the matter of where it sits within that system. I think that we've got a strong collaborative system now in North Lanarkshire. The whole local partners are fully involved. We've got a range of different integrated structures in place that support that working. I suppose that my main focus on that would be the fact that I don't think that it's necessarily structures that lead to it. I think that it's actually more about the leadership locally, the culture, the ethos that we have built up locally that really makes the difference. I think that even pre-integration, we had quite a number of integrated services already in place, where integrated planning structures are already in place as well. We can deliver those things in respect of structure. I think that we can show that the progress that has been made in North Lanarkshire over a long period of time in terms of shifting the balance of care and really coming up with a more integrated offer for the people of North Lanarkshire. Before the other panellists come in, can I just add on the next bit of my question, which was about how much money does your individual area currently spend on children's services? How has this changed over the last decade? If I can get a comparison between the change in outcomes for young people, I'm looking at that impact of how much money has been spent and what the impact has been on the outcomes as well. Let's have a look. Is there somebody indicating, or I could go to Louise. Sorry, can you hear me okay? In relation to our services in Highland, we do have a significantly different model from elsewhere, which is really why we're here to present that different model. We have a lead in Highland. Can you hear me okay? Yes, we can hear you. It's a bit intermittent, but we can hear you. We're getting fine, so carry on. Okay, thank you. We have a lead agency model in Highland, which means that we're not an IJB, we're the only area that isn't an IJB. We have more adult services sits with the health board and lead agency for children services sits with the local authority. We have a system where we have a small number of services that sit out with that of our CAMHS service, but the primary care element of that sits within the council. There are crossovers within the model. It was set up in 2012 and the background was that it came from research from across the country and visits to other services, including an area in North Yorkshire integration in a similar way. There was a feeling that this would significantly help in terms of bringing services together. The challenges have been that for a long period we didn't necessarily have the governance that supported the model sufficiently, because only in the last 18 months have we had an integration agreement in place that we're all signed up to and we're committed to. We're working on the back foot a little bit in terms of how we get to the right place. The opportunities are that we have a lot of our services wrapped around education, so there is a strong focus on how do we make the best use of health and social care for that education. The challenges are that if we've got part of the pathway in the board and part in local authority, how do we ensure that governance is an oversight and crossover working. The reality is that whatever system you have, it is how we bring things together wherever the organisation has its focus. Do you have any figures, Louise, about how much is being spent and how that relates to the outcomes? I haven't got the specific figures in front of me, but I'm happy to get those and send them across. I don't know whether Fiona Duncan's got some of those because certainly the children's services sit primarily within the local authority. She may have them to hand, but I don't want to put her on the spot just in case she has them. That's great. I'm happy to have them. Vicky Irons is keen to come in. Thank you and good morning. I just wanted to build on the information that Ross has shared in terms of the earlier stages of establishing the integration authorities. Again, the circumstances in Dundee do differ slightly from Ross's contribution and indeed the lead agency model in Highland. At the outset, I was general manager in Fife, but I subsequently moved to be the chief officer for Angus IGB and more lately of Dundee IGB. There was a decision taken by the authorities at that time that they would not be delegating children's services on part of the authority that sits with the IGB. I currently am an accountable officer for adult services across health and social care. If I can give you a very brief reflection on how that has worked in terms of developing care services and our strategies for adults and older people, we have certainly seen huge benefits across the partnership in terms of integration. We need to remind ourselves that integration was also aiming to not just integrate the provision of health and social care in communities but also to integrate people's journeys of care across the acute sector and the communities. We have benefited greatly from many of the specialist consultants that we have available in the acute sector in Ninewells and Tayside becoming part of the integration authority. We are working hand in hand with our primary care teams so that the journeys that are available and the pathways of care that we now provide for older people and adults are robust and integrated and do as much as they can to provide as much as they can. As I mentioned before, there was a decision that children's services would not be delegated into the IGBs across three local authorities that form part of Tayside. Many of the reasons for that are not dissimilar to what Ross has described to you. There was a fair amount of fear around the possible changes ahead and most people were more wedded to the authorities because they had grown up with their professional careers. We bit dubious about forming part of a new organisation. We will see the same again as we move towards building a national care service. Many people will wish to stick with the arrangements that they have experienced so far. It means that the integration across children's services and adults becomes slightly more difficult, but I would have to agree with Ross that that is only difficult if you do not have robust partnerships present locally. I think that I am very lucky from a done-de-perspective that because the chief officers are also executive directors of council and executive directors of the NHS board, we are obviously very close to our colleagues who have the authority to manage children's services. As a result, we work really hard to make sure that partnership works. We do not form part of the same organisation, so it requires a lot of effort. It also requires a lot of effort, particularly in the transitions between children who are receiving care and support in their earlier years and when they move into adult services. Those are areas in which we have worked in an integrated way for decades now. The introduction of the integration authorities might have interrupted that slightly with providing new boundaries for us to work through, but we are all pretty much used to working with boundaries at some aspect. We have tried to do that as successfully as possible. I have Nicky, who would like to come in and then I will go back to Louise, because I think that you want to come back in. The experience in Fife is that we are also a body corporate model within Fife. One of the key differences is that we are coterminous. There is only one IGB, one health board and one council in relation to how we would work together when many of my colleagues across Scotland work with multiple IGBs in a health board area. Going back to the beginning of integration, there is a large level of services delegated within Fife. I think that that brings huge advantage in terms of the opportunity to support that common vision, common purpose for the people who need to work together to deliver outcomes for people to be a team together. Within children's services, in the shadow year of integration authorities, there was an opportunity offered staff engagement to place regarding whether children's services within the council should be delegated or not. For the reasons that Nicky had said, a decision was taken to remain within council services for the children's services and for criminal justice services. Within the health services, though children's services were delegated, they make up key areas around our child health surveillance teams, our children and young people community nursing teams. That includes areas of integration such as residential care, home care, supporting out-of-hours nursing for children with additional needs. It also includes our school nursing services, health visiting, family nurse partnership, child protection, our children and young people occupational therapy services, breastfeeding and infant mental health services. What we have in addition to that within children's services is that mental health services and primary care services are part of the areas that are delegated. There is also a key focus within those services as well around the mental health and wellbeing of children. In terms of some of the strengths, I think that there is a strength in being coterminous. I think that opportunity to be working together and, as Vicki has described, being able to sit within the executive team of the health board and the executive team of the council enables those shared discussions. One of the areas that we have done within the health and social care partnership in Fife is a recent restructure. That was to bring a key focus of the services that are required to work together. Our children's services now sit as part of prevention and primary and preventative care services, supporting and further supporting that integration with other health services. We have a really robust community planning arrangements within Fife that focuses on having a joint children's services plan that joins up with local authority. In terms of outcomes, we have been the first health and social care partnership in Scotland to be inspected under the joint inspection programme with the care inspectorate and health improvement Scotland. What was drawn out within that is the strength of focus on organisational development and culture and also the restructure and bringing services together has been highlighted as a strength. I want to focus on that spirit, which we would call Team Fife, where we work together, regardless of organisation, to wrap the best outcomes around the needs of children. In relation to the size and scale of the health and social care partnership in Fife, our budget is roughly £630 million, approximately 6,000 staff. The only data that I have just now is that the budget for our managed child health services is £15 million, but in addition to that, we will have CAMHS services and other services that are wrapped around children that I do not have the figures for today. Thank you very much for that very detailed response, Nicky. Louise, would you like to come back in? I want to point out that NHS Highland has a second area, which is Argyll and Bute, and Argyll and Bute is an IJB. Argyll and Bute have a significantly different model to Highland North, but there is also an interest in data mentioning in their scheme of delegation that it has all of children's services. Speaking to the chief officer for that area, she feels that that works quite well for them. I have that very good governance that is similar to what Niki said in terms of the way we bring people together. She chairs a children's oversight arrangement, which brings in education all of the partnership, as does the independent sector, et cetera. It is much more about how we do things, rather than necessarily exactly where they second. There are all kinds of functions and challenges in whichever direction you go but it is is this useful to share that we have those two different models running concurrently? Thank you, Scottish Government. I'm sure that we'll get into some of those complexities later on in the line of questioning from colleagues, but can we continue on this theme, with some questions from Ruth Maguire, please? Thank you, convener. Good morning panel. I'd like to ask about your integration joint board, lead agency models, and the difference that they can make in terms of accountability uwch, lle'w iaim Rydw i'n have wedi stwff iet��l yn sorted艺wysed. I'm interested in how your model supports local accountability, flexibility and more joined up services, but I'd like to hear some examples from the perspective of children and families in Highland, how that's working. As I mentioned earlier it very much supports how we work very closely with education, health continued health and social care at that level. The challenge is that at times some of our services sit within health, and we've got to make sure that the pathway is clear. I will say that some people have a really good experience of... I'm sorry. Shouldn't you say, sorry to interrupt and it's quite awkward when we are doing the remote. I am very keen to hear about specifically how it helps a family. So you're still talking a little bit about the organisation, rather than children and families. Sorry, that I was just given an oversight of that before being more specific. From a phob slice family point of view, I think the fact that they are able to have an experience that has all of the services in one area and one remit is helpful. They are not having to go to multiple sources, but we do still have that challenge with some pathways. I think that, for example, our mental health pathway just doesn't feel robust as it should do ac ydy'n nhw'n cael gallu y rhanio'r lleffwyr yn gweithio. Mae angengwyd yn mynd i ddamnol, sgwrdd ym mwy fywch. Mae'n hynny o'n credu y cyfnodd rhaid i ddaeth hy'n ddweud cyfryd gan ymgylcheg yng Nghymru ond i ddaeth y Gymhreid yn ddweud yn taethol. Ond mae'r grannau sydd yn perthynas yng Nghymru, mae'n darparu gael yr hynny yn gyrthwyr yn drwy cadd, ac mae'n ddweud yn ddweud mai llun o'r ond Felly nid y gallu'r ffianc yma yn ei ddweud. Mae'n rhan i gael i'r ddweud. Mae'n rhan i'r ddweud. Mae Gwyl drwsfa'n wirionedd, rwy'n ddweud i'r ddweud, ond, iffyrdd gyda'r ddweud, Ffionna Duncan yw'r ddweud mae'r ddweud i'r ddweud i'r ddweud, ond, rwy'n ddweud i'r ddweud. Rwy'n ddweud i'r ddweud i'r ddweud i'r ddweud i'r ffionnau i'n ddweud i'r ddweud It's a deal? Good morning. I'll clarify that. that is in my remit. On the forage which is taking place, I think that it is a real advantage that we are having children's social work together with child's health so that it can help people to target things such as parenting classes and mums to be Colد, they are linked to social workers, they are morphed into the family teams, o'r heil staff a'r social workers work alongside. The whole point of that is trying to get more towards the early intervention and prevention side of things, rather than waiting until it enters the statutory side, child protection et cetera. That is very much on the ground enabling that to happen. An example that you might want, which is going to happen, which we have just been funded from in terms of the Scottish Government whole family fund, is that we will be targeting the Lochaber area that has been agreed, and that is a multi-agency ask, and that is about ensuring that what we do have in that area is working effectively, efficiently and flexibly because, although there is some good working with families, we could probably argue that we are targeting children, but perhaps to the detriment of not supporting adults alongside that. Some of the work that has come out is that we need to do both in order to maximise opportunities. We are doing quite effective work with children, we are in the schools, we are in the communities, however we also need to bring the adults on board with that and offer them the support that they need. That is an active one for us just now. Thank you Fiona. How long has your system of integration been in place? That has been since 2012. That is when that came on. Unfortunately, both me and Louise are newcomers to Highlands, so we did not experience the previous system or being here at the start of that. We are very much the here and now and understand what we are trying to achieve. Ten years feels like quite a long time for a system to be in. Do you think that it is established now? Do you think that you need more time? I think that it is a really interesting one for me because you have a number of different aspects of it. If the way that has been divided out and delegated enables, within my directorate, to make complete links with education, housing, homelessness, et cetera, welfare, that part of it. The bit that me and Louise's chief officer are trying to do is ensure areas such as transitions are actively being addressed. One of the areas that is within NHS Highland just now is CAMHS. That, without doubt, is an area that is not working as well as it should be getting access to services. We are actively focused on that just now. I suppose that, if I was going to be gently provocative, I might say that ten years feels like quite a long time to get to the point where you understand that you need to support families as well as children. Am I picking you up unfairly? What would your response be to that? Louise, do you want to contribute to that first before we go back to Fiona? I know that Ross Ross is also looking to come in, but I want you to pick up that thread. I think that one of the challenges has been that we have not had an integration agreement between the two organisations, so services have not worked sufficiently well enough across the pathway, as they should have done. We completely acknowledge that, from our perspective, it has not been as positive for the last seven or eight years as it should have been. Fiona and I are very much saying, okay, we need to fix this. Who is responsible for an integration agreement between the two organisations? Why has that not happened? Louise? That has related to the fact that the two organisations were not able to come to sufficient agreement in the past around what that integration agreement should involve. It related to finance, it related to a number of factors. Again, the challenges that Fiona and I have come to this since that time, and when we were already there when it was being more positively looked at, but there has been relationship challenges in the past between the local authority and the NHS, those are, I would like to say, very much in the past and we are in a different space, but I think that that is why it feels like that 10 years has not necessarily got us to where we should have been because it hasn't been in a good relationship. I think that that probably shows the need for us all to reflect on children and families rather than organisations. It would be good to hear from some of the others. Ross has come to, from North Lanarkshire. Ross, yes, over. Yes, so again, I mean, sort of mark my previous response. I think that we had some integrated children's services ban arrangements in place for many years and predating that public bodies act. I think that, I suppose, on the ground what that brings is that we have got a really integrated approach and system up to try to best wrap around care around an individual and family. I agree that there are still, without doubt, elements where we still need to see development. Transitions is still an area that we have still got to try our best to develop in, but we can start to see some of the changes in that area coming as well. Even things like the national spec around the CAMH services being expanded to day 24 is another area of where we can start to see a bit of our shift in that pattern around how we can support those transitions and how we can expand that time period where we can support a longer-term transition towards adult services. I think that there is something here around the fact that it takes time to make really significant change. We look at our journey around self-directed support in North Lanarkshire. We talk about the fact that it has taken 10, 15 years to get to where we are now. It is not something that can be done quickly. When you are looking at transformative change, it does take a bit of time. Sometimes we end up getting to the next restructure before that the structure that we are currently in has had a chance to really get to where it needs to get to. I suppose that some of the crux of that is that there are some brilliant pieces in the fully-reviewed and important aspects that we can absolutely get behind and go and try best to take forward. The question for me is whether that needs to be driven by a structure change or whether we can actually forget structures and that so that we can do more by just trying best to get the right leadership and the right approaches in place within the existing. Nicky Connor, from Fife, wanting to come in on that as well. Thank you very much. If I were to offer an example, I could draw on something within our children's services plan that we have been working strongly on. It relates to graphic in relation to children being nurtured and it relates to emotional wellbeing. Work that we have done in Fife is together to develop a framework called our minds matters. That has been strongly influenced by the voice of children and families to hear what mattered to them in terms of shaping this framework. What that has meant around joining up services for children and families is more a universal level for families. What we have in place is a directory of shared services to enable families to be able to access information at the point of needing that. We have also implemented our refreshed child wellbeing pathway, which supports the identification of vulnerability and mental health services earlier and having that as a multi-agency pathway so that we are able to, I guess, the principle is no wrong door and be able to support families at the point of when they access services. Then looking at when people need more intensive services regarding how we can support that, including access to primary mental health workers, the role of health visitors, the role of school nurses and also how they can be accessed to calm services. Our minds matters framework has been supported and driven by the voice of children and young people and their needs and the services working together to offer integrated pathways. I hope that that offers an example of common purpose around a need for a child. Thank you. It gives an example of the work that you are doing. I suppose that I am trying to get at it and I will probably start sounding like a broken record. What does that mean for if I am a mother of a child who has difficulties? Do I pick up your directory phone, whichever service I think suits them and I am plugged right into it? Is that what is happening on the ground in five? What we are doing is we are working together around what is the need, what is the best agency and the best level to meet somebody's needs. We have pathways to support direct referrals. I was involved in a discussion this week where there was a referral that had came into CAMHS. CAMHS was not the appropriate service to be referred, but school nursing could have supported. What happened then is a direct referral between services to support that family to get access to what they needed. Rather than being told that this is not the right service for you, refer yourself somewhere else. I think that it shows an example of how we are aiming to join up our services around the needs of individuals. I hope that will help. Thank you. Do you have questions on this theme, Stephanie? You are okay. Can we move on to the next question now from Stephen Kerr, please, on the general views of the Bill. What I am hearing is that change is quite difficult to manage in your organisations in terms of integration and working together. I am referring specifically to some of the evidence that you have already submitted in writing. For example, North Lanarkshire talks about concern about the impact that the bill would have on a significant change programme that could cause partner bodies to look inwards for a period to address organisational concerns. Similarly, Dundee talks about changes that would create greater complexity and would cause disruption in the working relationships that you have already established. Am I interpreting that correctly? Can you help me? I would like to come first. We will go to Vicky first. She has got her hand up. I am sorry for broadcasting, I confused you there. If we can go to Vicky Irons first, please. Thank you. Sorry, my arm was not working in the chat, so I used the visual hand. Apologies for that. Some of those comments come from our experience to date. Although we are focusing primarily today on the last set of reforms and the forthcoming developments that are outlined in the framework for the national care service, many of us have been in similar roles for a good couple of decades now and have lived through reforms in Scotland in this area twice before. The thing that we have learnt from that is that there tends to be a huge focus on structures and organisational change. Usually, that process can detract from the real outcomes that you are trying to achieve and the outcomes that are envisaged and which underpin the spirit of integrated services. Many of us are cautious when it comes to further change, but we are mindful that, if there is an opportunity to reform and develop further, we would like that to recognise some of the constraints that restrict our progress at the moment. For many of us, the fact that we have to deal with two different employing authorities, the fact that we have to deal with two very different cultures and structures and integrate our teams in that can often get in the way. Some of the other issues that we have obviously fed back through formal submissions and given evidence in other parliamentary committees include the fact that, because we are an integration authority that sits in between two public authorities, we do not have control over our own budgets. We have a cycle each year where we have to go through quite significant negotiations and planning mechanisms to be able to set our budgets and then deploy our resources appropriately. From my own perspective as a chief officer and having been someone who has worked in this area for a great deal of my career, we would just hope that we can learn from the previous reforms that we have travelled through, that we have experienced and not necessarily repeat those. I think that, when it came to establishing the IGBs originally in 2014-15, we were very conscious that the public authorities that make up the IGBs were reasonably cautious of change. I will not say that they are resistant to change, because I do not think that that is appropriate and that it is a fair reflection of the partnerships that were in place. I guess that what we are looking for this time around is that people embrace the possibility for reform and change and get behind it and make it work. That is certainly the perspective from myself having worked across a number of areas to date. Can we hear from Ross and we have also got Louise wanting to come in, Stephen Kerr. Ross, first, please. Thank you. From an authoritative perspective, I would say that I think that the learning from the Public Bodies Act coming in North Ireland was probably quite challenging. As much as that is the fact, we had already gone down quite a significant integration journey beforehand. I think that there is an admittability when you go through a major system change that takes some considerable time to get everything in place. The governance arrangements around integration have been particularly complex to get our heads around and get in place effectively. Any resistance coming through in terms of the North Lanarkshire IGB submission is the fact that we have a really strong system working locally in North Lanarkshire, so we work incredibly closely between the two chief executives and the council. The NHS board has very strong relationships with our South Lanarkshire colleagues. We see ourselves as five organisations between the council's NHS board and the two IGBs working together on this and again with our wider public partners. There has been a huge amount of work done around pulling together all the partners together in the Lanarkshire context to create what we feel is quite a strong system just now. The reticence and concern has gone around any unintended consequences of changing and impacting on that. I think that the key focus here has to be on local leadership, local culture, local ethos and how we go beyond boundaries to work together collectively for the needs of local population. It is a place-based approach for me that adds value. I think that there is a lot within the Filiad report that really focuses on those elements. It is how we try best to maximise those within our local systems and we suppose that the crux of what whether we succeed or fail. Louise, do you want to come in now, please? Yes, thank you. The challenge that you are hearing is that organisations have made work whatever they have got at the moment. Selling a good reason for change to people is always tricky. That messaging around why we are doing something has to be really, really clear with our staff, with our communities and so on, so that we can make a successful transition to wherever we go. I think that some of the things that we have found historically has been challenges around what sounds simple but IT. How do organisations work across IT systems? How do we move the report in terms of workforce? Again, we have staff that took it from the Highland Council into the NHS and vice versa. That, again, often sounds simple but it is often more complex. Whatever we do, it is about making sure that we have a lot of preparation and planning and clear communication with people and really understand the reason for the journey. I do not think that none of those things are ever unsurmountable but I think that preparation is key. Stephen, can I get the witnesses to think that we are here representing perhaps the inclusion of children's services? It would be really interesting if we can have our—when you are commenting and answering the questions, if you can have it through that lens, it would be really helpful. If you want to broaden it, please feel free. No, I do not want to broaden it. I want to do exactly what you suggested, convener. If I can turn to Nicky Connor, who is in Fife, your evidence stated that there is no evidence to including children's services in national care service and the disruption that structural reform would cause would be a benefit to children and young people. That is a very stark comment to make. Would you like to elaborate? Is my microphone off? Yes, it is. In Fife, what we would reflect is our strong partnership arrangements that we have around children and young people. I have described that through us having a joined up children's services plan. What we would need to give consideration to is what matters is the ability for that to have that partnership regardless of whether there is structural change or not that would take place. It is crucial that we are able to work in partnership now and it would be crucial following the national care service that we can work in partnership then again. That probably refers a little bit to Vicky's point about the changes that come with structural reform and the disruption that that can cause. My view is that the more we can integrate services, the better that is and the more joined up that is for children and for families. There are areas where we could strengthen transitions, so if we look at children transitioning from children into adult services as an example, we would be an area whereby having our services across children and wider services joined together could help. That is not what the Northern Alliance said and their evidence said that the main risk of locating children's social work and social care in the national care service is that they will become a very small component of a large complex organisation that has a predominantly adult focus. That is diametrically the opposite of what you have just said. Our journey of travel towards the national health and wellbeing outcomes is towards prevention and early intervention. The work that we do around children and around families has been absolutely crucial to the work that we do around integration. Can I have some comment from other members of the panel on what I have just said? Quoting the Northern Alliance evidence that children's services will be swallowed up and lost within the context of adult services. Vicky Irons, do you wish to come in? Thank you. That is not the experience of the health and social care partnerships that we have in Scotland that have delegated functions and completely integrated services across children's and adult's care. A couple of my colleagues have mentioned some really important points today about transitions in care. I would also agree with Nicci's comments that I believe that the best infrastructure that you can create is one where you have a completely integrated health and social care service that is across the entire life spectrum. That is because, even if we are providing care that is focused on adults as we are within the Dundee partnership, you cannot provide the care for an adult whilst not being aware of their wider family circumstances and the needs of their children and other relatives. The same goes if you are trying to provide adequate care for children. You would benefit from a working knowledge of the dynamics and the needs of the wider family and the parents. Although there will be a legitimate concern that the scale of children's services would feel like it would be lost, that is certainly not the experience of my fellow chief officers who have that as part of their delegated authority presently. For all the reasons that Nicci has mentioned, one of our main reasons for being established was to ensure that we were doing more work upstream, working on prevention, working with the nation's public health in mind. We can only do that if we can take a whole population approach. Is that an argument for including children's services in the NCS, or is that an argument for the status quo? For me, it is an argument for it to be all-inclusive, so that would include children's services in a national care service. It is well known that I am also mindful that, in creating a national care service, we have to make sure that that does not run as a parallel process and arrangement to the national health service, so my preference would be for a completely integrated national health and care service. Let me just ask you, stick with you, Vicki Arns, for my last question, and I realise that I have probably taken enough time. Do you have Fiona, the wanting to constitute as well on your last point? Let me just ask this question and then go to Fiona. In terms of the bill, so the bill itself is an enabling bill. It is very little in the bill in terms of the detail of what a national care service would look like. Basically, we are being told that the powers will be transferred to the ministers and then, at some future point, we will find out the detail of what the national care service will actually look like in terms of its design and structures and so forth. Is that a sensible way, from your point of view, to make the kind of change that you have just advocated for, in part? Certainly, as far as we are aware from the framework that we have seen, the next steps would be to open up quite a consultative process in, if you like, the design, the model for moving forward, and we would very much welcome that. Do you think that it is sensible to do it that way round? Do you think that it is sensible to do it the way round that the ministers are doing it, as opposed to understanding what the implications are of a national care service during the process of the passage of this bill? I do not really feel able to comment on that, so I would probably refer not to. Okay, Fiona Duncan is keen to come in again. She is from Highland Council, Fiona Duncan. Thank you for that. I think that the national care service proposal is not a panacea, and, obviously, internally we have been having significant conversations regarding what would the advantages be of bringing children's services in. The information that we are aware of is not very much at the moment, and we very much prefer not to bring in children's services in. I think that some of the reasons for that is that we have well established and informed systems already within children's services, working with children and families. Probably, our biggest link is with education. Education, early years, etc. That has taken many, many years to get where we are. If you look at attainment, etc., they are all starting to improve. Being pulled into a national care service, education will not be, so therefore they will be outside. There is very much for me the social aspect of children and families, whether it be education. We know that poverty, discrimination, etc. and disadvantage are very much at the heart of some of the problems that we have, so we need to target those. That is where the early intervention and prevention comes in, with education, welfare, housing, access to employment, etc. For me, they are all the crucial elements that we have in working with children and families moving forward. I hope that that is helpful. Yes, it is. It is kind of the opposite of what we just heard from Dundee. Will there be any questions that you would like to come in with, please? We got a bit to the number of the issue about what the real barriers are to progress. Everybody accepts, although they probably do not want, apart from Vicky, children's services to be included in the national care service, that there are problems. The problems that Vicky identified were with regard to employers, two different systems, two different cultures. I would quite like to know from Vicky how that manifests itself. What does that mean for, as Ruth Cymru, identifying the recipients of the services? Secondly, from Highlands, as to whether you have overcome that problem of two different employers with the way that you have organised your services. First of all, Vicky, and then Fiona, after that, please. Yes, thank you. It does not make integration impossible, it just makes it difficult, I guess, is the perspective that I would come from. So where you have a completely integrated team that both operate together and based on the same base of providing care to the same people, it is just very difficult when you are working with two different sets of terms and conditions, sometimes two different policies from whoever the parent body is, whether that is the local authority or the NHS board. You also have to go through obviously two different sets of negotiations when it comes to agreeing the resources and the annual budget that is delegated to the IGB. Vicky could interrupt. So it makes no difference to those who receive the service? I guess it makes our system clonkier. So I couldn't have a heart set, it makes no difference whatsoever. It takes longer for us to plan and redevelop our services because we have several processes to go through. But the ultimate aim of establishing the IGBs was to make sure that, at the point of delivery, our services are integrated. So I would hope that behind the scenes we have worked through all those administrative barriers and that the individual is now receiving much more integrated care. Hyland Fiona, do you want to kick off? Certainly. There are probably two areas to this. On the one hand, it has worked very well. We have staff within NHS Hyland, social work staff who work there on NHS terms and conditions, et cetera, and NHS staff within my directorate within Highland Council delivering child's health. That working well is not an issue. Where an emerging issue has started to arise is through salary scales. We have different terms and conditions. What we now have is NHS Hyland staff on higher salaries than what we do in the council. What we are starting to see is people jump ship, basically, moving over. That is an issue that we are looking at very clearly. The other part is an achieved social work officer, which means that it has statutory responsibilities for certain duties but also social work staff. I meet regularly with social work staff in NHS Hyland. We make sure that the professional links remain the same within NHS staff that work under my directorate. They need links to the clinical nursing director. You can establish those links very well, and it is not to the detriment of anything. You can have both, but we have an issue moving forward in terms of salaries. Okay. Would any of those problems be solved by including children's services in the national care service? I think that Vicky agrees that it does, but does anybody else think that those problems would be solved? Nicky Connor looks like she is moving towards her screen. Thank you. Apologies for that. I think that the advantage, potentially, is a national approach to how we do things, rather than the variation of 31 different IGBs and local authorities, as well as the different numbers of health boards. Nicky, that is not what I am asking. Would those problems that have just been identified by Hyland and Dundee be solved by including children's services in the national care service? I know that there are other potential benefits, but that is not what I am asking. Would the problems that have been identified this morning be solved by this? Apologies if I am not understanding. I am not meaning to be. I guess that it depends on what the national care service consists of in terms of how that is going to be implemented and delivered. Depending on what that brings in relation to the roles that are being an employer and other things, some of the issues that have been described there are part of what may or may not be the future. That makes sense. We do not really know what the national care service is going to really look like, because the framework model of doing this has not really worked up the co-design stuff. What I am puzzled by is that not every part of children's services would be transferred, as Michael was identifying in the previous week's evidence, that we are still going to have bits of the service provided by other bodies, other than the national care service. Surely we are just changing the line rather than solving the problem, if it was to be the case that you were to include, if you were to put it all under one employer. Surely we will still have the same problems, it will just be different people in different places. That makes sense. I think that, within Fife, not having all of social work delegated and having children and families within Fife council and having adult social work within health and social care, there is one chief social work officer. We work very closely and we work well, and that is down to relationships and ways of working locally, but they are within the council. So there is something there about what does a national care service consist of in relation to some of those roles and that professional leadership, and to have all of social work together, in my view, brings advantage. Vicky and Ross want to come in to Willie Rennie's question. If we go to Vicky first, please. Thank you. I am very briefly. Again, I think that, certainly, what was intimated through the Derek Feeley report is that there are definite benefits from having a completely integrated service. I guess that the question that you have asked there, though, is the national care service, as it is described in its current form, going to make any difference to some of the challenges that we have had to date? The answer to that is no, not in its current form, because, in actual fact, what lies behind the framework that we have seen today is a series of suggestions that, even within a national care service, the employing arrangements will still be separate. It makes it very clear that the services that are delegated to the national care service from a NHS point of view will remain under the employment of the NHS. It infers that there may be the employing rights of the new health and social care boards of social care staff and other staff, but, again, that still creates a division. I would certainly agree with my comments at the moment that one of the things that is really interrupting the efficacy of our working arrangements are the difference in terms of conditions and the differences in terms of professional bodies and what they are trying to achieve through their pay awards, which are also showing a difference as well. If the national care service framework that is created can provide one completely integrated organisation that has all of the people working within it on the same terms and conditions as part of one public body, it stands great chances of achieving something really significant. If it does not, if it has a hybrid model of existing arrangements, then we will suffer some of the same constraints in terms of making things work. I am a bit confused because you have provided a very coherent explanation as to why, under its current set-up proposal, we should reject including children's services. Earlier on you said that you were in favour of including children's services. No, it is not necessarily about children's services. This is about the efficacy of a national care service and the health and social care boards that have described which form the foundation of the local organisations within that. What I am suggesting is that, unless there is consideration of it being a body that can plan and commission services and also be an employing authority of all of its staff, whether that is across adult services or children's services, we are still going to witness some of the constraints that are present in the system. I guess that I am talking about the current framework that will have its disadvantages for adults as well as for children. It is not necessarily about whether it is a good idea to include children. I think that it absolutely is. The issue for us is under what conditions, and if the conditions do not change from what we are operating within in the moment, there is a question mark for me as to why we are going for another series of reforms, unless we are going to genuinely work through the barriers that were highlighted in the original Derek Feeley review. Thank you for clearing that up. We have got Ross, who would like to comment and also back to Louise, please. Ross, over to you. Thanks a minute. I think that you were picked up earlier and I know that it has been covered in previous sessions as well. I think that the key to success around children's services is the collaboration and integrated working across a whole range of different organisations and sectors. No matter where we draw the boundaries, they are not all going to be in, so we are always going to have to continue to work in the way that we currently do to go beyond boundaries to support that. Whether that be housing, education, the third sector, police, universal special services, et cetera, they all have to come together to work in an integrated fashion to wrap around services around the family and children and young people. No matter where we draw those boundaries, we still need to have that same focus on a local setting that would bring our local partners together to work as intensively and co-operatively as possible. I think that Ross has pretty much said what I was going to say anyway, which is that I will not repeat it, but I would add to that that, from an organisational point of view, the simpler we can make this the better, whichever way we go, whether we go with children's within the national care service or not, we just have to simplify the way that organisations can and do work together to streamline and facilitate things working well rather than put up additional barriers to it. I have a question, as I was picking up on when we were talking about some of the issues with staff. Do you think that your members of staff—well, they are not your members of staff, are they, in the IGB? The people working and delivering the services commissioned by the IGB, do you think that they are aware of the pending workforce changes that are ahead of them as they are moving to perhaps change their employers? What sort of challenges can you foresee when you are transferring property and liabilities from local authorities to the care boards? Who would like to go first on that one? Can I ask Nicky to go first, just because you have got that one board, one council approach, if that is possible? In fact, this morning, we are discussing at our local partnership forum with trade unions, the national care service and the process, and we have been doing a range of communications with staff to support that early discussion and engagement that we will continue with in relation to moving forward. I guess that feedback from staff is a bit mixed. There is some concern. We have just come through the pandemic. There has been a lot of change and challenge that we have been experiencing. With others that think that there would be real advantage and opportunity to bring things together. I guess that there is a mixed feedback in relation to staff. I think that there is a lot of complexity around how we move forward, regardless of whether we are coterminous or perhaps the challenges around their not being. The future, as I understand it, is that there will be less health and care boards as there are IGBs, so there will be a lot of change that will take place. From what you have asked the negotiations in relation to what happens to other assets that are not currently in, there is a level of complexity of working that through. It is not something I fully understand just now as to how we would approach that, because it has not been a discussion as yet as to how that would be approached. I can imagine that some of the negotiations on the liabilities might take quite some time as well. Can I just leave that there? There is no-one else indicating that they want to come in on that. We will move on to questions from Michael Marra. My area has been touched on a fair bit already, but I am keen to dig in a little bit more of that. It comes to the nub of my concerns and queries. It is really about the range of work undertaken by social work and children's services and whether the national care service would focus predominantly or too much on the care issue. Fiona Duncan, you mentioned some of that already. Can you be illustrate for us the breadth of areas that your social work colleagues would be dealing with beyond and including the issues of care, if you could? Certainly. One of our key tasks is protection. In the bill and the report, there is hardly any mention of protection. That is one of our concerns that we have raised on several occasions. Child protection is obviously linked to all partners in relation to that. There are national processes in place, national guidance in place, etc. There is that part. There is also peer looked after child, so that can be everything from kinship, fostering and adoption through to residential care, so residential children's homes. You then have your early intervention and prevention protection. That is working, trying to work with children and families earlier before they actually hit the statutory side of things. That is the area that we want to promote. Within our family teams, we are all mixed in together, so we have child's health in there, so that is your school nurses, etc. The links—huge links—are with education, as I mentioned earlier. We have staff, social work and school nurses in the schools, working alongside our education colleagues as well. That is very much a part of our day job. Sometimes families get in touch with us, sometimes it is about signposting, etc. We are making sure that they can access the support that they need. The key role of that is about keeping children and families safe, first and foremost, and then encouraging, enhancing and supporting them to achieve what they would like to achieve in their lives. For my own clarity on that, the individuals who have employed the social workers, I know that some of them will have particular roles, maybe through care and after care, some may be specific to it. However, you will also have social workers who cover a wide range of those issues, people who are involved. It is not a case of those social workers who deal with care issues and do not deal with those other issues. Is that correct? That is correct. You will have some people who—the case loads are mixed, so you have to have a mixture of child protection, as well as other things. The one area that you probably do is that we have a team for that, and the same with fostering and adoption, we have a team that looks at fostering and adoption as well. However, everything is linked, nothing stands alone, and I think that that is really key. That is really useful. Vicky Irons, can I come to you on the same issue? How would you envisage those people who have mixed portfolios, which is key to how a social worker is trained, how they learn their professions and how they are qualified? How would you see all of those functions landing within a national care service? I do not envisage that being a significant issue at all, because all those functions are also present across adult services in terms of public protection. Ross may have indicated earlier that, even if you have accountability for a health and social care partnership that has had delegated authority for adult services, it does not mean to say that we do not have an intrinsic role in the issues that relate children and young people in our area of accountability. I work very closely with children's services, with schools and education, particularly around the public protection agenda. We are more than well aware that, if we have a public protection issue coming through children and young people services, that often is related to the circumstances that are present in adult services and families. I cannot foresee that being a difficult issue. I do not think that there is a suggestion that we would be, if you like, drawing a boundary around children's social care services in the way. The list includes issues of fostering, whole family support, kinship care relating to children, early intervention work through education services and partnering. Those are not things that you currently do, are they? No, but I cannot see that being an issue if they formed part of an integrated health and social care board locally, because although those are areas that I do not have direct accountability for presently, they are still areas where we all work with a considerable amount of partnership across the existing partners that exist in my local authority area. I think that Ross mentioned something earlier. There always has been a degree of lines being drawn in terms of boundaries and in terms of organisational boundaries, but the role of a chief officer and an integrated authority is really to work in partnership across those boundaries. I cannot envisage a situation where we would not still be capable of working across the whole remit that has just been articulated. You would recognise in that that your colleagues in Dundee City Council are completely and resolutely opposed to that change. The chief social workers, all the people who do that work, think that it is completely untenable. I understand that there are reservations from most local authorities in terms of the integration of children's services into the new proposals around the national care service, so I am very much aware of that. From my own perspective, irrespective of what ends up forming part of the new bill and the new organisational structure, I am confident in terms of our relationships that we have. We all sit around the same corporate team, we can still make the arrangements work and work well for the people who actually need it most. I suppose that if I were to reflect on some of the frustrations that you have already given, then as a Dundonian, I would certainly observe them, where the City Council puts money into the IGB and then takes it out to plug its own black hole and you cannot plan for services and there are problems with the money. I think that you have expressed that really well in terms of the challenge. I suppose that the model that you have postulated around would not be looking at just replicating some of that perhaps with a third agency involved. If you were looking at bringing children's services in and there was to be a whole other budget that was put to that, is your suggesting that we just pull all that together? Also, would you not think that the logical conclusion of your model is to bring education into the picture as well? Quite a lot in that, if you bear with me. I guess that there is absolutely a danger that if there isn't complete clarity and rationalisation in terms of the make-up of the new proposed health and social care boards, we are in danger of cluttering the landscape more than we have presently. I think that some of the views that I have shared personally as a chief officer but we have also shared from the current perspective of the health and social care partnership is that ideally we would be moving forward not necessarily with three public authorities that are present within the local landscape but that we could move further and actually create a completely integrated health and social care authority. I am agreeing with you that there stands a potential risk that the landscape could become more complicated. Chief officers collectively have fed back that we are worried that a set of sharing a national care service as a parallel authority to the national health service may draw up new lines that we would have to work through in terms of integrating our services. The issue here is what comes out the other end. I would advocate and support a system in which we are quite bold in terms of our aspirations for integration but we make that clear and we reduce the amount of complexity that is present at the moment. Thank you very much. Can we move on to questions now from Graham Day to be followed by Bob Doris? Thank you convener. I listened to the views that were expressed earlier and very much thank you for your candor. One couldn't help but conclude that this is a sector that isn't great at change either culturally or practically, that after 10 years of the existence of IJBs, we are still not there yet, at least in some localities. Isn't that an indictment of the existing approach, at least in some parts of the country, and a reason to make the proposed changes because they are the only way of delivering a system that is consistent for young people wherever they live in Scotland in a specific way? On the subject of transition, if we are going to get better co-ordination, planning and co-operation, can that only be achieved with an approach like the one that is being proposed? Doesn't it offer also the best chance of better integration of whole family support? I would ask you to respond to those questions to reflect not only your own local experience but the situation as you know it to be in other parts of the country, because I am trying to get a feel for the overall picture. I appreciate your experience as your locality, but you also experience people who will know what the position is across the rest of the country. Can we start with Vicky Irons, please? I agree that there is scope. There is definitely opportunity if we explore the full potential of having a completely integrated national care service. I feel that although we have described a number of the disadvantages and some of the obstacles that sit within the way as part of the discussion today, we have worked really, really hard over the past 10 years to try and overcome those and still to deliver the outcomes that people need. I genuinely feel that there have been significant successes across health and social care partnerships, not necessarily just in Dundee or Tayside but elsewhere in that respect. Given the opportunity, we would love to have a landscape that enabled us to overcome some of the barriers that were articulated in the Feeley report and to have accountability and responsibility for planning and deploying the resources for entire families and the populations that we represent. I feel that there is opportunity there. The proof is in the detail for me. If we recreate something that makes the landscape even more complex in terms of accountability, employment rights and everything else, I am not necessarily confident that we will have learnt from the previous series of reforms in that respect. Can we also hear from Ross McAfee if he is able to respond? I think that we have made reasonably significant progress through integration over a period of six years. Particularly with the pandemic through the middle of it, it has not really helped in terms of some of that and in some regards it has supported it as well. I think that there has been, in my mind, a strengthened and integrated practice through the pandemic learning across Scotland. I think that we are probably in a better position now where three or four years ago across the country. It is difficult to answer the question without the full level of detail in terms of exactly what NCS is going to look like. Particularly around whether we will see what health services will be transferred across, where they will be managed, etc., and exactly where the boundaries would sit between. I come back to the fact that we are in a journey where we need to get to much more individualised care, whether that be for children or adults. To get much more the ability to have conversations with individuals to be able to have trauma-informed practice, much more personalised self-directed care and more proactive support around individuals. That picks up some of the key elements around transition as well. To do that, we are going to have to make significant changes to the way that we deliver health and social care services. I do not think that it is necessarily structured the way that we do that. We need to try best to have a look at different models and how we can try best to make that work locally. A quick example, we had a session with chief officers and his a couple of weeks ago around human learning systems. I think that there is a whole load of the work around human learning systems that picks up a range of the key themes around feeling. The sort of academics that we are saying to us is that we cannot structurally implement that, so we do not bother with structure. What we need to do is go out there and start to change the way that our staff are working, in small tests of change and build up there and on a local setting. As we identify the structural challenges, we can start to make some change. To try best to make those changes through a structural focus is going to be nine on possible. That, for me, is tied in with some great stuff in the report. We need to get that real focus on personalised care, providing staff the opportunity to have much deeper conversations about those professional relationships coming together to support people and wrap support around them so that we can try best to come up with the right answers to the issues that individuals are focusing on and are facing. That complexity that every individual has around them, we need to be able to get into that way of working with everybody, and that means going across boundaries the way in which we set the boundaries. Unless we come up with one single public service, those boundaries will still exist. Thank you. That was more charitable than it was to my original question. Let's come at this from a different direction. There's a sense from a number of things that have been said today, a recognition on all your parts, that we can do this better. If, within the proposals for our children's services and our national care service, there was a role for people like yourself to bring your experience of the past 10 years to bear to look at what has worked well, what hasn't worked well, what the cultural changes that require to be made, the barriers that you've identified earlier to be overcome. If there was an opportunity for front-line professionals like yourself to bring what you have to the table and to develop a national system that reflected that lived experience, do you think that that presents an opportunity to make genuine and worthwhile improvement? Ross, are you happy to carry on as we left from yourself and then... I certainly think that bringing in the experience of those in the system together makes absolute sense in terms of that. I suppose that there's a slight year at the back of my head that, by taking forward national care service developments around adult services with children coming on afterwards, if a national care service were to be formed and then this to be coming in as an add-on, I think that there are real worries in my head there that we would end up with a governance structure that had been created specifically around adult services and would then have to try best to shoehorn in something different. There is an element here in my mind of we need to finalise what the decision is and exactly how we're taking this forward, but I would rather see that done once rather than in separate bites, because I think that there is a risk there that we end up creating something that is absolutely focused around adult services. I know from the previous questions around how staff felt. I know that, with the experience of children and young people and children families, social work has been in both the integration board and outwith the integration board. In the early days of integration, there was certainly a feeling that integration was absolutely focused on adult services, all our outcomes and our outcomes indicators were all adult focused. I think that the children and families teams felt a little bit overshadowed in that landscape. By doing that in two stages, it might lead to that same feeling again. Very reflective of the question that you are asking. At the unique role and perspective that I think that we can bring as chief officers, I do not think that there is any other role that sits on both the executive team of the health board council and on the IJB. We wear different hats within our role. In our role on the integration joint board, we are chief officers supporting the strategic planning, but in our role as directors on the executive teams, we have also got the responsibility for delivery. There is something from me really important around that role, as clunky as it sounds, around that glue that helps to glue and support and join up our systems together. In terms of sharing our experience with that part of your question, I think that there is a lot to be offered. I think that there is also learning across our system of how things have been approached within whether it be children's services or adults. We have put ourselves forward to be a potential pathfinder site in relation to girthy, so getting it right for everybody. The principles and the values by which children's services would work in my experience of having some children's services delegated was a real strength in how we could approach and achieve the outcomes for adult services, too. One of the things that I would reflect on as well though is that the current legislation enables the delegation of elements of children's services, and what we have across Scotland just now is variability and how that legislation has been applied through the choice of different age areas through the integration scheme. Again, that would be reflective of the structure to make the change happen. I highlight what I said at the beginning about how, within Fife, there are really good relationships, and we work well as a team across the agencies. Regardless of what reform comes, I am not sure that I can envisage that there has been less than one health board, one health and social care board and one council in an area such as Fife, but across Scotland, I think that there is more variability and probably significant impact and change. I move to questions now from Mr Bob Dorris, please. Thanks very much, convener. It's been a really interesting evidence session. I've got questions on two themes, but both are around what the opportunities could be of a national care service. I note that there are concerns that have been raised today, but that might happen, so it's about what the opportunities might be. The first part is on the national care service charter that is contained in the bill. There are some concerns that are raised about whether the care service will focus too much on adult care and not dealing enough with children, young people, families and child protection. Does anyone want to comment about what the opportunities could be to shape that charter to set out what our ambitions and aspirations are for the wider childcare services in Scotland designed nationally, but delivered with flexibility locally? What are the opportunities? Is there any given thought to the national care service charter and what the benefits of that could be? I'm looking for someone willing to go first on that one. Perhaps I can go to Louise Bussell up in Highland, please. Yes, absolutely. Some of the opportunities are, as I mentioned earlier, the simpler we can make this, the better. If we can make something that has a seamless service for people from over cradle to grade, if you like, as we try to do with the NHS, I think it's helpful so that people really understand where they're going for services, what those services will look like and how they interrelate with other parts of the system. If we've got one model across the whole of Scotland that works in a very similar way, that helps everybody to understand exactly what we've got and how we're doing things. Having that journey, people moving from children's services to adult services would mention quite a lot today already about transitions. Having that opportunity for transition within a single system instead of hand-offs, as we often have in service lines, unless we've got that pathway right. That simplification and streamlining of how we do things. Again, as others have mentioned, we've still got to make sure that the cross-relationships are there between health, national care service, education and independent sectors. There's still a requirement to make sure that those lines are right for what we need to do. However, again, that simplification of how we're doing pathways I think would be— Can we perhaps go to Ross or Fiona? Again, I think that we've got a lot of the real building blocks already in place in Scotland. Just reflecting on some of the positives, whether it be through GERFEC or the progress around the promise, I think that we've got some real positive building blocks in place. The key to it for me is a bit of trusting belief in some of the positives that we've got in development and really trying the best to get all the efforts behind following us through. I think that in local systems, the importance for me is how we all work together collectively as local partners. As I keep saying it for me, it's about making sure that we're doing the right thing for in my area that the children and young people of North Anarchshire and the families of North Anarchshire, and I think that we can maintain that focus across all local partnerships. With the positive direction of travel, I think that we've got a lot of the building blocks already in place there to actually make some significant change over the couple of weeks. That's helpful. I asked a similar question last week, and I think that the witnesses last week have made a similar approach to witnesses this week, which is understandable, which is everyone's focussing what structural change may look like, rather than what the potential opportunities may be of this change. Just for putting on the record, the national care service charter is an opportunity to draw in the one place of some of the rights and responsibilities that all of us have within the national care service and for children and for families, so maybe not for answering today, but if any of the witnesses think that there are some opportunities in relation to that, perhaps you could pass it to the committee by email to the clerks, because that might happen and we want to make sure that those opportunities are realised. My second line of questioning was in relation to kinship care. Just to give an example, in May this year there was a national kinship care protocol brought in across all local authorities, and it was cluttered and it was complex and it was difficult. Some of the accusations that have been made about a potential new national care service that involves COSLA, Solar, Social Work Scotland, Chief Social Work Officer's working group and the National Kinship Care Collaborative were attempts to have a national co-ordination to kinship care, which is absolutely welcome, but Nicola Clynyrd spoke about that variability across Scotland for various services, and we still have a situation where kinship care allowances vary across 32 local authorities. Access to trauma informed care for young people varies across 32 local authorities, and placements in bereavement, for example, so when a kinship carer volunteers to take a child or is placed by social work, it can determine whether you get that allowance. There is significant national variability, so other opportunities within a national care service delivered locally to address that national variability, and I would quite welcome any comments in relation to children and looked after children. Given the fact that Nicola Clynyrd spoke about variability across the country, perhaps Nicola Clynyrd would be an ideal person to come in about how we could deliver better potentially with a national care service for kinship carers and looked after children and their families. There is something there about national framework and local delivery, as you have described, and the opportunity around the single governance framework to reduce the potential in relation to some variability. So long as there is the flex that we deliver locally, in terms of my responsibilities just now, it is only health services for children that are delegated, but what we have in place with some of our adult services is that we have shared lives and we have got support for adults at needs or in terms of protection and we have mechanisms in place there, which I guess go back to a letter to framework nationally around protection. In terms of some of the benefits, though, and if we look at looked after children, some of the work would be that can happen across the agencies, and I guess I would highlight it already does happen around health services assessment beginning to come together to be able to support locally the joined up across the agencies in terms of meeting the needs of those individuals. For example, just now, referrals would be into our health services, whether that be across our school nursing services, to ensure that they are concluded and informed and ensure that the voice of children are heard within the assessments that take place to best meet their needs. I think that that happens already in relation to how our services would join up with the unique contribution of each of those services. I do not have that. Can I ask you a little bit more about that, if that is okay? I apologise again because it is so difficult when it is an online session like this, so I commend the really good work that is happening locally. I suppose my point would be the work that is happening locally in Glasgow, but we differ from Gallowsheels, which we differ from Aberdeen and Aviamore, is making sure we get more natural consistency. We have been hearing for many years about benchmarking and sharing best practice, but decades later that has not necessarily happened, so can that help to address that variability? I have also got Fiona from Highland, keen to contribute, Bob Doris, sorry. I see that we have chief social work officers who have for many years asked for a national agreement in terms of fees and allowances for kinship, fostering and adoption. I know that that has been discussed for a long time. One of the reasons for that is that it can sometimes be portrayed that the child is being a bit of a pawn here in terms of what gets paid and what does not, and that should not be the case. We were expecting the fostering to come forward quite soon, but that has been delayed. I do not think that you need a national care service to come to that agreement. If you asked across the board, would we want a nationally agreed fees and allowances, that would be yes. Could we actually achieve that in another way? There is more than one way to achieve that, but a national care service may be a way, but it is not the only way. My final question, because it might be directed to Ross McGuffey, because it widens out Fiona Duncan's point. It is not just about the allowances that are paid to support kinship care children and their families, but about the access to wider services. There is quite significant variability across the country in relation to that. Ross McGuffey talked about trauma and forum care support, which he was absolutely right to do. I have a centre of excellence dealing with trauma and forum care for kinship carers based on my constituency. They get funded via commissioning bases, sometimes from integrated joint boards, sometimes from local authorities, sometimes from NHS direct across a number of local authorities. It is a mishmash of funding that makes them really struggle with sustainability. In terms of commissioning specialist services that is trauma informed for very vulnerable children and young people, could there be an advantage in relation to a national care service to delivering better in relation to that? I certainly think that there are elements in the way that we can do to try best to bring stability to services. In terms of our commissioning approaches, I have local examples, probably more focused on adult services, but we have a 10-year framework for self-directed support providers and care at home providers. The whole aim of that was to try to bring a degree of stability to the sector that had previously been two or three-year agreements that we had been able to provide. There is certainly something around sustainable commissioning that we can look at to try best to provide that sustainability. Obviously, every individual area has its own mix of providers and opportunities. Some elements will be in-house in some local authority areas and partnership areas. There are certainly elements that we can do in terms of commissioning both in terms of national frameworks and local frameworks that can make a difference on that. I think that that is an area that we can do irrespective of structure. That is an area that we can certainly continue to develop. I know that the latest report was very strong in terms of the importance of ethical commissioning. In our local partnership, as part of that development, we were visited to talk through the work that we have done locally around ethical commissioning and the impact that we are able to have in terms of that stability. I will leave it there. Thank you for being here today. If I can direct this to Vicky first of all, and of course you are all welcome to come in. We have talked a lot about consistency and quality and we have highlighted quite a lot of challenges to joint working. We have talked about the real improvements as well and partnership working that have been going on. We have heard that the Katie's success really is a collaboration that improves outcomes. Going back to Derek Feeley's recommendations, central to that was an NCS, the co-design aspect, that looks to fully involve not just social workers and health professionals but also those receiving care in the organisations that support them. Adults, children, families, third sector advocacy, disabilities. Those recommendations were in response to overwhelming public support to see that. So looking to care boards that include members with lived experience as well as social workers, health professionals, etc. Is that not an opportunity to expand on the success of joint working to include those with lived experience in the on-going design and delivery of services going forward to make sure that we are delivering the outcomes that matter most to people, not just now but in the future as well? So surely it's about that collaboration, bringing in that lived experience, actually adding to the collaboration that you've got and making things better. Who's the question director to Stephanie? I said Bicci, sorry to hear that. Yeah, thank you and I absolutely couldn't agree more that to bring in not just that lived experience but actually to co-produce and co-ordinate the care that's provided I think is a huge opportunity in terms of any reform moving forward. We do presently, within the IGBs, have engagement from carers representatives. We have actually quite an extensive network of individuals with lived experience in the families and carers of those who are experiencing our care as part of our strategic planning approach that was set out in the original bill but I think that there's a huge opportunity to take that much further forward and one of the main reasons I think that that presents us with an opportunity is I think it's becoming very very clear in terms of the sheer volume of demand for our services that we need to create the capacity to care across all of our communities. We need to start thinking about doing that through partnerships so that this isn't just about a statutory service response it is about what can be developed, what can be delivered, what can be supported within people's own communities across unpaid carers around the third sector, around our independent providers and the statutory services that would form part of the new national care service so and I think it's very clear from the Derrick Feeley report that we have to look at our services through the lens of the people that need our services and need our support so we would genuinely welcome the opportunity for that to become a driving force in the new organisations. Okay thank you on that Vicky I suppose the Derrick Feeley report gave no indication at all of the inclusion of children's services and it did come as quite a surprise for it to be here today but you spoke briefly about the co-production of services there so I'm I'm trying to ask you a bit a little bit given that the co-production is probably going to happen after the legislation might come into play can you not foresee that being a challenge and I think Ross alluded to it being bolted on earlier on can you not that sort of cart before horse aspect of this bill at the moment Vicky? Yeah I mean I agree with Ross's comments I think that will provide a huge challenge for us when it comes to adapting to change when it one of the most important jobs for people in the roles that we hold as chief officers is enabling people to change and taking people with us when it comes to moving forward and developing and if you're going to do that in a staged approach I think that that does potentially present some issues and I probably just agree with Ross's comments that from the perspective of chief officer if we're going to go for really quite radical reform that are in the interests of the people that we want to provide care for in a sustainable way it would be better from our perspective to do that once. Thank you Fiona, I want to come in on that point as well. Thank you Fiona over to you. Thank you I just feel at this point we had as you will be fully aware the promise who have reported significantly on in the first instance on our looked after children and the whole idea about the structure needs changed and that's everybody in every organisation and they after speaking to interviewing meeting thousands of young people go together the promise documents which are on going and a 10-year plan and that I think gives you a really good indication of changes required but also where it needs to go and there's things within that that nobody disputes if it's for the welfare of the child as we move forward. It's always been my understanding when we talked about the national care service is that as well it's almost as if the process outlined in the promise can or could be used within the national care services that is to progress. I know it says it's a 10-year plan but I think it articulates the intricacies that are involved in the different parts that are involved in the system and it may be helpful at some point to bring that on to the table but I think again it perhaps articulates that that is on going that is running as we speak alongside the national care service. Thank you and we heard some evidence from them last week so can I hand over now to Michael Marra please thank you Michael. Thanks convener so this is a very major change that we're being asked to pass in a framework bill you understand we're essentially approving it in principle and then the model will follow afterwards and I recognise that that's a challenging thing to then imagine what that process might look like after the event. We've just touched on the promise and the failure review can I ask what evidence what the witnesses have seen marshaled to support the change that we've been asked as a parliament to approve? What's the evidence base for the moving of children's services that you've seen can I start with Ross please? I don't know I've seen a great deal I mean I think that I've said a lesson to previous sessions in the care inspectorate it was quite clear that we've got some areas with children's services delegated to IGVs that have been positive in terms of care inspectorate report and others that have been not so positive and vice versa for those who don't have a delegated so not sure I've seen it any complete evidence but I suppose that I think the process that came out the back of that was to build that evidence base and to review that evidence base to make the decision. Okay thank you Nicky have you seen a marshaled evidence base to support this change? Thank you the apologies can you hear me? I've not seen a specific evidence base other than the discussions I've had locally regarding the advantages the evidence that I would say I have seen is that there's a strong evidence base that the more services are together the more they're integrated the more we can join up outcomes for individuals that does not relate specifically to children's services. Okay thank you. Vicky have you seen a marshaled evidence base? I mean we've just heard the feelie review it was about adults care so Vicky Irons have you seen a marshaled evidence base about the transfer of children's services? No not none in addition to those that have been referenced by my colleagues. Okay who have I yet to get to Highlands Louise? As others have said I haven't seen an evidence base other than the need for us to have things as aligned as possible wherever that ultimate outcome is but I haven't seen any evidence for this specific move. Fiona do you think we should be following evidence based policy making? Have you seen any evidence? We should be following evidence based and no we haven't seen any evidence based on this. Okay thank you very much. We have a wee bit longer if anyone wants to ask any further questions if not we can conclude the session early. I've got nodding heads. Okay can I thank the panel for your time today and for responding to our questions it was very informative. We are now going to suspend the meeting for 15 minutes is that correct 15 minutes thank you very much. Okay welcome back and we are now going to take evidence for our second panel today on the national care service Scotland bill. Can I welcome to the meeting Martin Crue who's the director of Bernardo Scotland and Jude Currie chair of the Scottish Association of Social Work. Good morning both thank you for joining us. Our session is hybrid on this panel Jude Currie is participating virtually so Jude as you won't be able to catch my eye when you want to come in can you put a capital R in the chat box when you wish to speak and the clerks will be monitoring the chat box and we'll bring you in when you can and let's move straight to members questions and can we start off this after the second session with Stephanie Callaghan please. Thank you very much convener and welcome to the committee today. I suppose a question for both of you has integration led to a more collaborative working right across the public sector and between them and third sector organisations and has that helped to improve outcomes for children and young people? I mean the brief answer is probably no it's as with a lot of implementation it varies across Scotland and in some places it's made a bit of a difference but for most of our work it's not made a great deal of difference. Jude would you like to respond now please. Yes I guess I would say the picture is very mixed and certainly I think the variety of experiences of our members which will be very broad because they will exist in very different selves we're obviously speaking on behalf of social work members today and we always will work and strive to do best practice and that has been mentioned I think by Mr Doris last week in terms of the workforce regardless of structures we will always try to work in productive multi-agency ways particularly as children and family social workers trying to harness a multi-agency grip around a child and a family but we can be better social workers and offer better social work I think if we have the enabling conditions and the environment to help us to do that work so I would say what we could speak to are the conditions that we need and the mixed conditions I think that we experience across country. Thank you and can I just ask then going back to yourself Martin then do you believe then that the national care service presents an opportunity then for third sector organisations as well as people with lived experience to actually be be right there in the centre of care boards and to be part of that co-design process to look at new policy and look at the delivery so that people are getting the outcomes that matter to them? Yeah I mean the the area that I can speak to is about the inclusion of children's services in the national care service I mean as far as I can tell the Feely report is a good report on adult care it doesn't look at children young people and I suppose you know I'm so I'm I'm not opposed to the inclusion of children's services but I think the key point is is it going to lead to better outcomes and at the moment I would say I'm not convinced and you know just the level of upheaval here I mean I know the committees looked at college reorganisation and I was on the board of Edinburgh College and its predecessor Stevenson College and just the amount of upheaval that change took which is small compared to introduction of national care service so you know almost inevitably any change of this sort takes longer costs more and is more disruptive than people thought I think on the specific here of children's services I think what what we're looking at is does it make the interfaces between different parts of the system easier and you know Bernardo's works across a whole range of different children young people support I think the the area where if you said okay well an ideal national care service would would potentially have better interfaces with health and with adult social care so how would that impact on our work I think the area where I could see potentially it could be good is particularly for older children with learning disabilities where that transition into adult care is a really difficult one so I could see that as a potential benefit but you know I know some of the previous evidence you've heard there's an awful lot of other children and young people and a national care service would either not affect those interfaces or might even make them more difficult so just just take three examples first of all you know for most children that the key interface is education for children who've been abused key interfaces are around police and children's reporter system and for care leavers the key interfaces are around housing colleges education sorry employment support so for large numbers of the children families young people we work with I can't particularly see that national care service would have a big positive impact okay so you've talked about the challenges there can I just ask you as well about we heard from rossam guffaerler on in the session today as well about those concerns that if we have adult services as part of the national care service that actually having children's services sitting out with that could create problems with the approach to whole family support I think he spoke as well about it being something that could that perhaps you would look at shoehorning and later to a system that's surely built around adult services so just wondering what your thoughts bear on that yeah I mean I think there's that there's a danger being either in or out of it but the fact that we're included as part of the framework bill I think illustrates what the position of children services is and you know as I said the it wasn't part of the Feli report we currently spend around five times more on adults social care than we do on children's social care so the reality is that children's services is the Cinderella here and you know by being on the framework and a bit of uncertainty we're we're not sure whether we're going to be invited to the bowl or not and to stretch the analogy a little bit if we do get a ticket the music will probably already be playing and it might be a waltz whereas we'd rather have a disco Martin thank you that's lovely I know I'm not shortly Jude curry I know you're keen to come in on this as well thank you Martin Jude yes I mean on where I guess children services in in particular I guess my role is practice and social worker but also represents in saswa I would say my question is not so much where exactly we sit but that what it looks like for the functions that we do so I think it's really vital for the end result of the services that we seek to provide and harness around a family holistically really depends on those functions being together and those functions being that social work needs to sit where those functions are and when I say that I mean those resources the leadership the autonomy we need to be where that is I think the further that we are fractured a distance from that I think the end result for the people that that we work with day in day out I think we heard it in the evidence session last week sometimes people with eight social workers over eight months do we know what doesn't work also we need assurance that what we are moving to has is defensible and shows some evidence that it could work and that we have as social workers often sitting in these gaps between services that are maybe unintended gaps but we sit in those difficult places often and we bring our skills to bear in that but equally you know the setting the bar report will tell you very clearly that there's so much stress in the system and distress in the system that I think we really need assurance that the functions do need it to work and be sit together and aligned we do work with whole families you know our members including myself will work with a whole family network and that will include engaging with criminal justice social work health services education housing all in the one meeting and I think for every ounce of depleted energy that we spend trying to navigate perhaps even more complicated structures because we are perhaps outside or or distanced from what we need and it just takes away from the relational energy we need to be spending to help children and families benefit and realise their rights from those services so I think that's why it's really key because it's linked to that lived experience of the support that we hope to provide so I feel like it's just that function of social work needs to be really understood on the face of this framework and the face of this this bill as well as throughout the programme and I think that point about you know there has been extensive listening to you know the experiences of those who use adult services but that question is asked in Professor Daniel's research group around how do we ensure that children young people and families get the help they need when they need it so that includes so many different partners and I think we need to have due diligence and patience to hear what the evidence from those key to delivering those services and experiencing receiving them really tells us and so I suppose we can't assume that and I think that's why I can feel it's it's quite frustrating I think when you have a framework and people are probably quite frustrated there isn't particular detail that we need but you know are we example if I can you know many members might be working with a 14 year old for example now who we know may need and that social care support within adult services by 2026 by 27 but the apprehension that we are engaging with starts now our work with that family starts now so whether we are in or out it impacts us and we need to know that our functions will work together for that family and for that end result both now and later so it's that apprehension about impending change I don't think can be underestimated. Thank you can I move to questions from Graham Day please because he's going to carry on this theme of integration thank you. Thank you can we appreciate that I'm picking up on Martin's comments earlier I attended an event in Parliament convener last night in relation to the assisted dying bill the proposed bill and the member in charge of that bill has taken an approach where he has a panel of highly experienced medical professionals who have put together a set of proposals that they believe if taken forward would ensure that the legislation worked in practice and I can't help draw a parallel between that approach and the approach that could be taken to this framework legislation except in the reservations you have about it because if I don't think it's in anyone's interest to have some sort of bolt-on further than the line to a national care system if we're going to do this then there is a logic to having young people services included but if in that period of research and the period of consultation there was a very full and genuine engagement with the sector listening to people who could highlight what's worked well hasn't worked what are the barriers if you had a blank sheet of paper how would you design a care system is there not on that basis merit in this proposal I think there could be but it would probably take more time and we wouldn't necessarily be starting from where we are I mean that there's I know there's been talk already in the evidence about sort of co-design and what that looks like and I think somebody earlier said you know it's been rather overused but I think if I could briefly say about how we've done a piece of work in Renfrewshire working with health and social care colleagues and I think one of the important points there was we started the process by having a discussion at senior manager level about were we all committed to making changes as necessary and really the determination was to improve mental health services for children families we then went into a consultative process and we held sort of three facilitated focus groups the first one was with children families the second one was with frontline workers and the last one was with managers and from all of that what we got was a hugely complex picture and out of that you know we were then trying to draw solutions and I think that's that's the point in these processes you have to embrace the complexity and you have to listen really carefully first and you then come to okay so this might make improvements I think the problem is here that we've we've almost jumped to a solution and no matter how well done the co-design work now is you can't go to children families and say do you think a national care service is a good idea or not you know that that's not there lived reality but then with respect there lived reality in too many places as a locally delivered and designed and constructed whatever you want to frame it a system doesn't work for them and there will be good examples I fully accept that but what we have at the moment doesn't work for everyone isn't the only real chance here because we heard earlier about 10 years of effort and still know we're near being where we would all want to be isn't this the the one opportunity we have however your reservations about the approach but if this is taken forward in the way I've articulated from here isn't that the best chance we have to get this right for children and young people going forward I think I think one of the big problems that I see is the landscape in which we are trying to introduce a national care service and as is often the case with major reforms you know you're not you can't choose the moment that you are implementing but I think just you know just briefly to you know go out go back to the reality of the world for children and young people at the moment you know we've got quarter of children in poverty across scotland we've got many families who were just coping being pushed over the edge now into the cost of living crisis we've got existing services that are stretched and the thresholds of support to families are far higher than the early intervention that we would all like to see we've got the prospect of further austerity and public service cuts we've got a retention and recruitment crisis within social care staff and on top of all of that we're trying to introduce the promise and you put all of that together and you say okay well will the national care service address and improve things it you know it it doesn't really scratch the surface of a lot of those issues so I think it would be a huge leap of faith to say this is the moment where the national care service will make a huge difference but then if you'll get this from the other side do you have confidence that as structured and given the approach that's deployed in multiple locations what's in place will address those issues well I think what you have to you know from my perspective I've been working in children's social care in scotland for over 25 years now and I think we have to remind ourselves that there are good examples of things that work and you know the committee will be familiar with violence reduction unit with the decrease in the number of young people in custody is a fantastic achievement you know Pullman is a quarter four compared to where it was there's good examples of public social partnerships and we're doing a number of specific really good pieces of work which are working now which some of which you'll be familiar with I know committee members visited our services in Inverclyde there's also work we're doing in Dundee and Renfrewshire and that can work under the current system and I think you know that what I would say is that there's from my experience I'd say that there's four things that make it work first of all a genuine determination to make things better and to deliver change where it's needed secondly that you embrace that whole system complexity thirdly you put children young people at the centre of all of your considerations and fourthly you build that mutual trust and respect and I think we can look at structures but again in my experience when it works it's not what agency you come from it's what you bring to the table that really makes a difference but wouldn't a change of structure or isn't a strange change of structure so I'll get my words out required to facilitate that cultural change that's needed in some places and to ensure that that highest standard of those best examples become the norm I think as I said earlier you know one one one the issues here is is that health and social care are you know really important to children and families and I'm doubt about that but there's there's an awful lot of other players in the system and it just briefly you know the the alliance work that we're doing in Dundee at the moment started with education and social work and the third sector coming together to to work on improving outcomes and we very rapidly said okay who else do we need to involve we need to involve health but then it's also about housing it's about police it's about criminal justice and the children's hearing systems it's about employment support it's about transport and planning and and the private sector has a role as well so I think you know we could be putting a lot of effort into one part of that system and saying okay well you know we we can get a better alignment here perhaps between health and social care but there's an awful lot of other parts that either are going to be unaffected or potentially disrupted by those changes thank you now Jude you've been waiting patiently there I know you've been wanting to come in so over to you now thank you I think I would probably echo that point about you know the key key partners that we really do need to make sure that we that won't be disrupted with whatever happens I don't I don't believe that the structure in and of itself creates the conditions of what we need I think it's the assurance that the relationships that are the heart of what we do will be safeguarded within a national care service and that just doesn't come by by structures alone I think we need defensible incorporation of what we know works and that there won't be additional disruption barriers so you know some of our members will have fears about a potential loss of connection with key council services whether that's education or hiding for example our third sector commissioned colleagues as well but equally we do see the opportunities as well I think that's where it's difficult because we just need the assurances I think there is the will and you know certainly speaking on behalf of of sasa we want to be part of a constructive conversation about this I guess it's just when the lived reality on the ground is that we already have to navigate complex systems and complex needs within a family setting and we're already having to have conversations within a multi-agency meeting about oh sorry what is the parenting task and which of that adults needs is a social care need you we try to take and understand those holistically but our systems and processes ask us to unpick those and direct them down different paths now social workers we try to draw those strands together again and there is so much intent and good intent on the ground to do that but if it's if we're not given the assurance that what happens next makes that easier then I think the natural fear is that that will make it more difficult thank you very much and Stephen Kerr can we move to some questions from yourself now yeah so that's an interesting point that jude has just made I mean at the end of the and I was very struck with what Martin said about those four issues that you highlighted those four characteristics I mean does anything in this bill do anything for any of those issues that you've highlighted well I mean my my concern I think you've very much had this from the the promise as well is that if we concentrate too much on structure we miss an awful lot of other things and I think I just mentioned the you know the experience around getting it right for every child and you know about 10 years ago I was chairing the Scottish Government's GoFec programme board to implement getting it right for every child and we didn't get everything right but some bits of that went quite well and I think that was because what we were trying to achieve was a cultural change and what we had was an agreement on the the principles and goals across all these different agencies we worked very hard on a common language you know people will be familiar with the Shinari language which is now you know absolutely in all of the agencies and I think the third point was we came from the child's perspective you know GoFec's about wellbeing it's not about what services are delivered to families so I think if you if you put that together I mean when we were doing GoFec we we didn't particularly look at structures and we weren't particularly bothered about getting a consistent picture across Scotland so we got reports back from each of the the 32 areas but what we tended to do was share good practice and encourage people to learn from each other and I think one of the drivers in the national care service and in the failure report is a feeling that there should be more consistency and I think that's a really difficult thing to change. But it's not dependent on structural change is it? I mean the way you were describing it earlier it's about people it's about leadership it's about people who take an initiative who bring other people together and then work on improving the delivery of a service. Yeah and you know to my earlier point it can be done under current circumstances but I think you know it's having that determination and sometimes it's also about resources. So things can be improved yeah there's no denying that and you're making that very clear but you've also raised the spectre I think a red flag actually about the way that the public sector particularly often struggles with change and the delivery of change yeah do you want to comment on that? Yeah I mean I think we I'd go right back to Four Scotland's children which you know was a report in 2001 and we've had over 20 years of pretty consistent policy which you know I think people feel we have we have good policy around children young people in Scotland and and that's been consistent and we've had it for a long time. What everybody acknowledges is there's an implementation gap and that is the frustration that we have all of these aspirations and good intentions but what actually happens on the ground is not always what was intended and I think it is you know it's that lack of real drive to implement to improve and that can happen in pockets at the moment but we're not sufficiently consistent and then the other factor is the lack of resources and I think you know if you work in children and families I always think the acid test is if this was my child would this be good enough and too often it's not can we bring in jude curry please on that no thanks yeah I think that's an important test to have and I do think what you know looking at the state of our profession at the minute in terms of morale resource thing and I guess I would say a degree of weariness you know I I think we're at danger of losing sight of you know why people come into the jobs and why they work with children and families and I do I think structure can help but it can also hinder and I think social workers are no stranger to change and change agendas certainly in the 12 13 years that I've seen a lot of structural change but it is those things about culture it's about language it's about leadership and I think you know it's important that our social work leadership is understood on the face of this bill and the place of where that sits because it impacts on practice leadership and retention and recruitment for the jobs that we do but I do think that point about resourcing we can put all the structures in place but if we don't have the resources many many times we can look at a plan and you know agree I'm all dazed at the child's plan we don't have the accessibility and readiness of those supports regardless of where we might sit that won't work for families and that doesn't answer that key question of do families and children get the support when they need it so it is those ingredients and you know I was at the building families improvement conference yesterday and it was core ingredients a recipe for what families need that was from research that was stated as family community loving care and compassionate services and I don't think any of us involved in children and families wouldn't look to strive to provide that but I don't believe structures alone will get us there I think we've got so many other ingredients to that recipe that I think we crucially critically need in place and we need to make sure that the leadership and the people who have the strategic leaders deliver that for us on the front line and to enable us to sit in living room and provide confidence and hope to family who really needs to be assured I think first okay Stephen Kerr ah right so I mean so when you talk about resources and you know resources are finite and particularly money in time is it wise given the challenges that were outlined I think so eloquently by martin crow in his evidence just a few minutes ago jude curry that we take up time and money to do something that's basically structural that will be process heavy and that will create new and challenging interfaces particularly in relation to children's services which will be a small part of an overall service can we go to jude first yeah sorry that's fine thank you jude yeah so if I'm picking up your question right in terms of you know is it is it worth the time and resource when those are finite to potentially I think you're asking the key questions we'll ask of ourselves you know in terms of even the fears of what we feel might be an operational nightmare or cultural nightmare if not done well but I think the key part of that is inclusion of everyone who will be impacted by this to be fully consulted and involved and included including all the complex you know the complex functions and levers that deliver that so it doesn't have to be a waste of time resource that is finite I think it's about making sure that we are making defensible decisions about that and that it's not more change for change sake for children and families and I think that's why it's really key that we take the time to listen to the research that we need do you want to come in on that Martin you don't need to know you're fine can we move now to questions from Willie Rennie please I think jude just summed up actually quite neatly there saying change for change sake and I think both of you have expressed very clearly that there are issues change is required but structural change doesn't necessarily deliver the change that we require let me just be a wee bit devil's advocate because I agree with everything on that I think we've had several evidence sessions that I've made it clear that you know that the structure is a bit of a divergence from the real challenges that you face and I have heard about leadership and resources from jude I would like to get a better understanding about what that actually looks like and what the changes that we require to make these services better and then what do we do about it because there is a there's a day another members of the committee have not unreasonably highlighted that there was a view from some that just leave us alone and we'll get on with this and we'll deliver the change now I don't necessarily agree with that because I think everybody accepts that change is required but let me just be a wee bit devil's advocate to challenge both of you to say what do we need to change and what do politicians need to do to help that I don't do you want to go first um we would difficult question but I'll try to answer it I think um what do we need I mean I think we probably need as a profession I think we'd go a long way if we felt kind of represented and understood within this national care service programme from the face of the bill onwards and that is not for that in an end point that we just want that for that sake it's because we believe that it will deliver better social work and better conversations and relationships with all of our partners and with families about what's needed so in terms of and can you repeat the end of your question there for me again? It's probably a wee bit convoluted but what I'm really it's just wider change what wider change do we do in the system is it better leaders is it more money you know what is it that you need us to do because we're we're not getting clarity on exactly what it is you know the Parliament and Government should be doing? I think autonomy you know what we need autonomy when we're sitting and I said autonomy rather than in the sense of power I think we need to be able to sit in a living room as I said earlier and to feel like we have and you know it's not a heap so well we know that families come with huge wealth of resources of stripped of networks that they have and do some don't but we know the existing communities that we can harness wealth from so it's not just about financial resource but we need to feel that what we do have a function and statutory role to access or seek that we need to know that at the point that we are sitting in a living room having the conversation that we have the permissions to have those conversations and that we have the confidence to be able to go to you know our managers and leaders and they have confidence in their managers and leaders that there is influence there to advocate and that that is not lost in a system somewhere so I think that's why when I speak of leadership there is that strategic leadership element but certainly from where I sit and practice every day is that practice leadership and those things need to be aligned and so all these things all these sort of community planning and strategic what they need to sit together so that's what I feel you know as a practitioner on the ground I think you know that's where all balls boils down to in that good conversation we're having about then families feel they've got choice and control because if we don't feel when we're trying to resolve a difficulty with them as equals if we don't feel that there's agency there then we won't and so it is agency really so do you is that are you basically saying that you don't feel that we've got your back when you're making some of these judgments that you know politicians and government doesn't back you up when you're making difficult decisions I you know and I hope I'm being faithful to the variety of experiences of our members here and saying it's not that it's about faith and confidence about having our back I think it's understanding that the often the gaps like I said earlier that we often sit in and how we have to navigate those you know that that they happen sometimes because there are different levers and different agendas that don't align at government level at community level they just don't and we get stuck in all of those as do children and families and it's that's our fears that they get lost further in that and that we get lost with them because we sit with them and you know and that that's something I think so it's about that communication and collaboration being echoed all the way down and you know that we will be critically challenged and constructively challenged and we welcome that but equally it's that sort of hustle of you know what do we need to ask more about here you know and what needs to be understood more about how we how the role of social work fits in amongst all these different elements of the care service they may not be necessarily involved in all of them but we often are explaining them navigating them and trying to make sense of them ourselves okay Martin yeah I mean from my perspective the the single biggest thing we could do is earlier intervention um the christie report 10 years ago told us that it pointed out how much of our resources are spent on failure demand and in scotland we've we've just had what is I think a you know a fantastic review done under the auspices of the promise which has said you know we if we work together we can take far fewer children into the care system but that hinges on good early intervention services we've got the introduction of the whole family well well-being fund which is extremely welcome but needs to be much more substantial if it's going to actually lead to change and I think you know my my feeling is what we really need is is a national family support service delivered by different agencies but actually providing early family support in every community across scotland because at the moment what we tend to do is we we tend to atomise the problems and we say okay well we've we've got a problem with educational attainment therefore we need to do this in schools we we've got a problem around mental health so we need to do this to support CAM services and we've got problems with with poverty or drug addiction or whatever and so many of these services come back to if there had been better early support to families that would have made a huge difference so I think you know there isn't one answer here but the thing that I think would make a huge difference is if we actually put in place that national family support and you know the the committee's talked about you know where does children's rights fit in with this I think you know the the key point for me is we want to be able to say to families you have a right to the support that you need rather than you know you might get a service or you might not and if we're serious about having a a rights approach then we have to anticipate that more need will surface there's an awful lot of families out there at the moment who don't get the support they need so you know having a rights based service is people saying where's my service and the best way you can do that is to have community support across the country that is there without stigma and is very easily accessible with services coming to families rather than them have to go and get their specialist support from from different parts of the system so why is that voice for early intervention because we've we've debated that for years why is that voice not stronger and why is it not up to the extent that you would like it to get to what's what's stopping us I think you know and some of the the financial parts of the promise were really compelling on this but actually if you treat this as almost a capital investment rather than okay so how can we just add a bit of money into the system then you will get a return on that investment and you know there you know people in the past have said there's enough money in the system if you move it around and that may be true to an extent but the problem is if you're going to make a a big change what you have to do is double invest sometimes you have to carry on what you're doing and you have to invest new money but I think if if we invested a substantial sum into early intervention with a 10-year horizon to say okay it's not going to pay itself back immediately but if you did that and actually put in place the measures of how you're going to judge that I think what you would find is that the return on that investment would would come back thank you can we move to questions now from Michael Marra please i'm interested in this this area you've just been talking about but both Jude and Martin is the organising principle of a national care service not the provision of care but actually what you've been describing to the committee the thing this morning is about keeping young people away from care and is that not essential culture risk in terms of trying to integrate what you do with an adult national care service Martin yes the the the danger is that if you work in public services in its broadest definition which includes you know voluntary sector delivery that we we exist in service delivery land that's not where children and families are you know children and families have got their problems they've they've got their strengths they've got their supports and then there's other services that come into the family or or that get alongside the young person i i think that that is absolutely right and it you know it does go back to GoFec you know actually what makes a huge difference for you know a child might be a club or an activity which doesn't sort of feature as a care need if you like and and that's where i think the early intervention comes in you know let's try and actively have fewer children and young people coming into the system Jude do you think that's a a risk about a culture clash i think we're at risk of potentially over simplifying what we mean by care because i think and to maybe frame it as something you know obviously we want to prevent children and young people entering care but we need to appreciate the the complexity of care needs that might be within the network surrounding that child that may involve you know adult social care it may it may include a variety of different elements so i think martin's point about early intervention is really key because even though certainly you know as a social work practitioner we're often seen and perceived as crisis interventionist you know we're coming in at certain points we're certainly i wouldn't like to be coming in doing like to be but we do early intervention there too it's not a not a chronological thing always it's a tussle that we're always engaging with so i don't think it's as simple as you know care exists in this forum and you know the prevention of care is it over here i think they come often intertwined whether that's intergenerational within the family and you know or it's it's even within that stuff the complex and competing needs of that child or young person themselves but you know there might be elements of additional need that requires social care element but equally there's other other bits that there's lots of good intervention work that are being supported by universal services so that's the complexity really yeah and that that's very useful i think will it not be said to be the case that they in your members are more and more in terms of reducing resource lack of partners to refer on to that actually prevention work has become much more difficult and that your much more your members work will be taken up with permanence issues about referring to care child protection issues and you know even that idea of the permanence you know we want to look at permanency we do in terms of what is long-term care at home name and that brings in the promise in terms of well what scaffoldings have you made you know there's roots out of care not just into care you know and so yes i think we are you know that again the set in the bar report will make it very clear kind of what the challenges facing our profession are that we want to we want to move away from but certainly yeah that the early intervention profile could be could be much better and i think that you know i think it was said last week i think by Jackie Irving about you know we take risks in social work and we have to do that and those include financial risks and i think that's where the trust in what we do as a profession you know and as you know within the third sector and all the partners we need to sometimes do that because you know even when i first joined the profession as a social worker in 2009 you know scaffolding is almost like you know but we can't stay involved for too long because you know we've only got this a might of time or you know that's not a good indicator but actually sometimes by staying involved you know in a universe or a with third sector partners over multi years of funding that are invested actually financially works out far better you know and it's far better outcomes because it keeps that child at home throughout their childhoods you know so we do need to take risks in how be bold and how we view some of these challenges but i suppose what i'm getting up within that is that the i mean your members will be under pressure to close cases the regularly are your manager saying we have to reduce the case load you've got too many we have to get and they actually is there not a risk that this accelerates that process that the way that martin's describing this is kind of the Cinderella service within this process i mean we're looking at the figures if i can you know the setup costs for this organisation that are currently looking at about 1.3 billion that's not money to be spent on your services that setup costs 1.3 billion you know the sdc in trade unions yesterday calling for this whole programme to be stopped i mean that's the situation that your members dude and your service deliverers martin would be walking into i mean that feels like a big risk to what you do right now martin i mean the situation you describe is absolutely accurate you know and where you know we we work very positively with local authorities in particular and what they want is earlier intervention but a number of the the services that we we've had running for years were set up as an agreement to be a effectively quite an early intervention service for families and what we've seen over the years is that those thresholds have just got higher and higher and we're we're working with not just riskier families but families who are more mired in their troubles and are going to take a lot of help to get out of that but i think you can you can still do things which don't automatically rely on just statutory services i think you know the committee will be familiar with family group decision making and processes like that which actually identify the strengths and the resources that are available to the family which enable us to take a more a more rounded view of it and you know kinship care is you know is is a very big area of support to to children so you know that there are some alternatives within that but you know that the the the you know i'm not going to comment whether it's a good investment or not but clearly it is a huge amount of money to put into a new structure and as part of maybe to that dude in your reflection i mean do your do your members know that this is happening i mean this is you know pensions aren't included in tupi arrangements you know there's there's no clarity on that do they know that actually they could be moving employers to a completely new body with no indication of what might happen so in terms of art you know we've done a little work to try and engage as many members and social workers as we can and i would say that that is extremely difficult given when you look at how busy you know practitioners and members really are to know so you know it has been mentioned i do here you know we do here our member for we do here but probably not to the detail that i know we do provide in terms of just keeping people involved and and part of this to share their views with us but the busyness of our work you know this is where i think this inclusion and times understand and make sure that that as a profession we're fully informed and fully included because it's really like you said it's really crucial there are a lot of fears and i suppose the overarching messages across a variety of views that we have from members are that yes there's opportunities but there's also fears yes as you say about terms and conditions about pensions but there's opportunities in there too to improve conditions for the profession as well in terms of you know even the idea of of our mileage you know particularly we're all social workers driving around if we are you know looked at on par with with some of our other colleagues you know in health so we do you know we do need to to kind of look at both unbalance and i think we try to help members to do that and represent the variety but i think that's why i think understanding some of the functions and what it costs to provide them is really critical what we do is too critical i think to risk in their being less resource put into them so i think you know while for example we may keep connections with our colleagues in other departments like housing and education if we are you know feeling depleted in other ways and by this that would also be a fear there's lots lots there Mr Marra i think it just strikes me that that i can't see this government doing this to doctors saying to an entire profession we're going to change your employment rights we're going to put in place a bill that allows us to do that and pass it and but they're prepared to do it to social workers i think i think you know that's why we want to be constructive here you know because at the end of the day we do want you know that this aspiration of more accessible support being offered amongst all the other things that make up a life but you know we do need to make sure that the national investment can be really helpful for that you know it can bring that consistency but it is about accessibility too it's about you know people having that rights across the country but that also means that we need to be in communities and we need to be connected and we need to be forming relationships so that is a that's a tense line to tread and you think you're right you know i think what we just want is to feel included and you know on behalf of those that we support and so yeah i do you think the priority issue is an important one thank you thank you excuse me frog thank you very much michael and jude and martin for those can we move to questions now from ruth maguire please thank you convener good morning both i had some questions around structure i think we've probably covered that pretty well in answers both in terms of the importance of leadership and culture versus structure but also i hear jude loud and clear when she talks about her members being depleted of the structures that they have to navigate round or are taking more energy than than the job itself in terms of leadership and account in culture one thing we didn't talk about there was accountability and i suppose i would have a question for you both in terms of what risks and opportunities you would see around children's services the accountability for children's services moving from local authority to Scottish Government ministers i'll come to martin first i think with due respect to local government colleagues accountability to many of the families we're talking about is pretty low currently you can put in place you know if there was a national care service you could be more consistent about complaints procedures and all that sort of thing but i think if you said okay we have a national health service how accountable is that to the families who we're dealing with again it's it's low you know because work accountability is important but you know if you're if you're struggling to get the services and support you need you know you don't stand back and say how can i you know how can i realise my accountability here so i think i'm using politician or policy making language there does making people you know realising people's rights that's what we're going to be in the business for can you see opportunities in that that chain of accountability i can't think of another word to use for it being to Scottish Government ministers rather than to local authority i think it would have a different flavour i mean the you know i was talking somebody at police Scotland and you know bringing the all of the forces together meant that there was a a closer focus on police Scotland as an entity in in the whole but of course what that means is that the the issues and the problems that were covered by eight regional forces are now all the responsibility of one body and i think you know as we see with the NHS you know an issue has to be pretty big to you know to sort of hit the the scale on that so i think the advantage at the moment is that if you know if there's a child death inquiry or whatever you you know that is dealt with at a local level and hopefully those lessons are learned but if if we had that on a scotland scale it might sort of shift some of those thresholds okay and jude um yeah i mean i think you know we're you know we're accountable and it gets answerable to our codes of practice and the social workers aren't you know and we've got a code of ethics now we also are accountable to our statutory function but in terms of you know under law and what we do um i think accountability to the outcomes for families i do think yeah that that you know we have to hold our hands up and say you we need to be we need to do better and could do better but we need the conditions to do that and i think i do think there are advantages at times to having you know sort of national oversight that you know and i guess investment in terms of training understanding awareness governance of certain aspects but i do think you know that can't come at the the loss of local connection and local accountability and so it is that that national local and i guess sense of checks and balance and so again accessibility of complaints you know how do people voice what's going well and not and they do that within their communities and within the relationships that are around them or do they have to try harder to seek those out and those are the questions that i'd like to ask okay thank you if i could stick with jude i wonder reflecting on the change that we had with health and social care integration obviously there's there's risks in any change there's as well as being opportunities there's risks reflecting on that change that's already happened what do you think are the sort of short medium and long term risks to families and children i suppose in accessing which services the short medium and long term risks accessing services from the experience of what we have in integration so far i mean certainly the views of our members will be mixed because not all will have that experience some will some won't you know personally you know i haven't but i do think and so i guess if there is bits of this that i feel like an answer afterwards as we go out we'll do that because i do think you know it's important question and i do think you know the benefits are gained from better communication less and maybe better understanding about times gdpr you know things about how we share information and the ease of sharing information maybe a challenge in the fears around in that i think can be a short medium firm win and i think also what we learn from each other's professions is definitely potentially a long term win for families i think when we have a shared language i mean again you'll look at some of the kind of shared language that the gerfec achieves over a period of time but when you have certain services that have to work closely together and are governed more closely together maybe we have more opportunity to build on that so i don't want to say too much because i know in an overstep kind of what my own at what i could recall myself from that but certainly we could approach members to ask more specifically because there will be i think that thing or you know in both structures you know that the children families exist in there will be pros and cons and but i also think that there will be um to implication for children families i think it just could be that are we looking at things holistically and looking at a community based not just help you know i don't know i think it's that balance between you know a medical and a social approach that needs a balance and you know we need our leaders and managers in those structures to understand so that we as colleagues can work well and understand each other's world but i think there's a benefit there but there's also a lot of challenges sure that's helpful and martin do you have any reflections on that well not so much on that i was just going to come back to your accountability point because i think you know an interesting issue is about so what metrics do you use to hold national services accountable and there's always the danger that what you focus on is is what's relatively easy to measure and is you know bald figures and the example i'd use is cams waiting times so you know we have a very specific cams waiting time it gets reported against and you know if if it goes down we say cams is doing better and and so on actually you know the experience that we see on the ground is that it's not so much about the waiting time it's the fact that when families actually get to the front of the queue in some areas of scotland the majority of families don't meet the criteria so they've sat on a waiting list for a substantial period of time that's what gets measured but actually for them it's much more devastating that when they get there for various reasons they don't get a service at all thank you and your organisation have reflections on on the risks looking back at integration of health and social care i mean as i said right at the start i mean in all honesty it's kind of passed us by you know the focus has been very much on adult services and you know we see some good examples where you know there is a greater joining up i think sometimes some of the sort of substance misuse areas it's made the positive impact but it's been relatively minor in scheme of things okay thank you convener do you want to come in finally just before we close the session thank you yes but i always try to think of you know practical examples that maybe come to mind when the questions are asked and that i think you know again it's not a structural thing but a relationship thing you know in working with cams often we can't eradicate the waiting list as you say you know that that exists but certainly i've had personal experience of just the good relationships we can have around consultations about being able to understand what we're still having to engage with live and make sure that we're still being responsive it may not be the response that we would hope or strive for you know at that point of need for that child but certainly in terms of understanding each other's worlds and that's what i mean you know regardless you know between health and social care colleagues and also you know ourselves in a local authority setting or wherever you know we do try to still try and find those solutions and so and we will keep doing that no thank you very much and thank you both for your time today the public part of today's meeting is now at an end and we will consider our final agenda items in private thank you jude and thank you martin thank you