This briefing paper examines the impact of child poverty on children's lives; what the Scottish Government, local government and others are doing to reduce and prevent child poverty; spending on tackling child poverty since the Scottish Government published its first tackling child poverty delivery plan in 2018; progress towards meeting the targets for reducing child poverty. The briefing suggests that the Scottish Government has not yet demonstrated a clear shift to preventing child poverty. In 2019/20, over a quarter of children were living in poverty, affecting every aspect of their wellbeing and life chances and having wider implications for society. This is higher than when targets were set in 2017, and the current increases in the cost of living risk more children experiencing poverty. It is not possible to assess the success of the Scottish Government's first four-year plan to reduce child poverty, launched in 2018. Children and families have been supported with social security payments and other measures but the Scottish Government did not set out what impact the plan was expected to have on levels of child poverty. And the impact of Covid-19 on data collection means data on child poverty is only available up to 2019/20, the halfway point in the four-year plan. The key policy actions to reduce child poverty in Scotland rest with the UK Government, the Scottish Government and local government. The Scottish Government's second child poverty delivery plan sets out a more joined-up approach across central and local government and with their partners. There now needs to be detailed joint planning between the Scottish Government and local government to deliver the actions and evaluate their impact. The views of children and families living in poverty are not always meaningfully considered as policies and actions are developed, implemented and evaluated. Gaps in data at both national and local levels hinder the development of sufficiently targeted policies, and limit effective impact assessment. The Scottish Government's modelling predicts it will meet the 2023/24 interim target for reducing one of the key measures of child poverty, largely through social security measures. But the modelling also predicts that it will not meet the target for another measure that reflects the current increases in the cost of living. The current delivery plan runs to 2025/26. The Scottish Government is working on identifying how the 2030/31 targets will be met, and early planning is essential.
(Edited publisher abstract)
This briefing paper examines the impact of child poverty on children's lives; what the Scottish Government, local government and others are doing to reduce and prevent child poverty; spending on tackling child poverty since the Scottish Government published its first tackling child poverty delivery plan in 2018; progress towards meeting the targets for reducing child poverty. The briefing suggests that the Scottish Government has not yet demonstrated a clear shift to preventing child poverty. In 2019/20, over a quarter of children were living in poverty, affecting every aspect of their wellbeing and life chances and having wider implications for society. This is higher than when targets were set in 2017, and the current increases in the cost of living risk more children experiencing poverty. It is not possible to assess the success of the Scottish Government's first four-year plan to reduce child poverty, launched in 2018. Children and families have been supported with social security payments and other measures but the Scottish Government did not set out what impact the plan was expected to have on levels of child poverty. And the impact of Covid-19 on data collection means data on child poverty is only available up to 2019/20, the halfway point in the four-year plan. The key policy actions to reduce child poverty in Scotland rest with the UK Government, the Scottish Government and local government. The Scottish Government's second child poverty delivery plan sets out a more joined-up approach across central and local government and with their partners. There now needs to be detailed joint planning between the Scottish Government and local government to deliver the actions and evaluate their impact. The views of children and families living in poverty are not always meaningfully considered as policies and actions are developed, implemented and evaluated. Gaps in data at both national and local levels hinder the development of sufficiently targeted policies, and limit effective impact assessment. The Scottish Government's modelling predicts it will meet the 2023/24 interim target for reducing one of the key measures of child poverty, largely through social security measures. But the modelling also predicts that it will not meet the target for another measure that reflects the current increases in the cost of living. The current delivery plan runs to 2025/26. The Scottish Government is working on identifying how the 2030/31 targets will be met, and early planning is essential.
(Edited publisher abstract)
Subject terms:
government policy, evaluation, children in need, children, poverty;
This report looks at the progress made by councils and integration authorities in implementing Scotland's 10 year self-directed support (SDS) strategy, identifies some of the enablers and barriers to its implementation. It also examines the impact of self-directed support on people with support needs, their carers and families and at how effectively the Scottish Government is evaluating this impact. It draws on interviews with staff and service users in five case study areas; online survey and focus groups with service users and carers; and a survey of social work staff. It discusses the findings in the areas of: directing your own support; assessing needs and support planning; commissioning for SDS; and implementing the national SDS strategy. The report identifies many examples of positive progress, but finds that more needs to be done for authorities to fully implement SDS strategy and ensure that everyone has the opportunity to choose and control their own social care. The key messages include: better information and help for people using services to understand SDS and make their choices; more reliable data on the number of people choosing different; training for frontline staff to help them be better equipped to try new approaches. The report also highlights pressures of increasing demand and limited budgets for social care services as a barrier to changing services.
(Edited publisher abstract)
This report looks at the progress made by councils and integration authorities in implementing Scotland's 10 year self-directed support (SDS) strategy, identifies some of the enablers and barriers to its implementation. It also examines the impact of self-directed support on people with support needs, their carers and families and at how effectively the Scottish Government is evaluating this impact. It draws on interviews with staff and service users in five case study areas; online survey and focus groups with service users and carers; and a survey of social work staff. It discusses the findings in the areas of: directing your own support; assessing needs and support planning; commissioning for SDS; and implementing the national SDS strategy. The report identifies many examples of positive progress, but finds that more needs to be done for authorities to fully implement SDS strategy and ensure that everyone has the opportunity to choose and control their own social care. The key messages include: better information and help for people using services to understand SDS and make their choices; more reliable data on the number of people choosing different; training for frontline staff to help them be better equipped to try new approaches. The report also highlights pressures of increasing demand and limited budgets for social care services as a barrier to changing services.
(Edited publisher abstract)
Subject terms:
direct payments, access to services, user views, self-directed support, policy implementation, choice, social care provision, local authorities, needs assessment;
This report provides a high-level, independent view of councils’ management and performance. It draws on the findings from local government audit work in 2015, including audits of 2014/15 financial statements, Best Value, Community Planning and performance. Part 1 reviews the financial context in which councils are operating and gives a national overview of councils’ financial performance. Part 2 considers how councils are performing in delivering services and how they are changing the way they operate in the context of increasing pressures. It looks at the implications for councils’ workforces and highlights key aspects of governance. The report finds that councils’ responses to budget reductions have mainly focused on incremental savings to existing services and suggests that in the face of further funding reductions they should be evaluating options for more significant changes to delivering key services, beyond health and social care integration. Despite reducing their spending, performance measures show that councils improved in areas such as educational attainment, the quality of council housing and waste recycling, in 2014/15. Most councils have reduced their workforces to save money, and many are planning further staff reductions. In doing so, they need to ensure they have people with the knowledge, skills and time to design, develop and deliver effective services in the future. Councils and their partners also need to respond to the Community Empowerment (Scotland) Act 2015, by involving local people more in making decisions about services, and empowering local communities to deliver services that are sustainable and meet local needs.
(Edited publisher abstract)
This report provides a high-level, independent view of councils’ management and performance. It draws on the findings from local government audit work in 2015, including audits of 2014/15 financial statements, Best Value, Community Planning and performance. Part 1 reviews the financial context in which councils are operating and gives a national overview of councils’ financial performance. Part 2 considers how councils are performing in delivering services and how they are changing the way they operate in the context of increasing pressures. It looks at the implications for councils’ workforces and highlights key aspects of governance. The report finds that councils’ responses to budget reductions have mainly focused on incremental savings to existing services and suggests that in the face of further funding reductions they should be evaluating options for more significant changes to delivering key services, beyond health and social care integration. Despite reducing their spending, performance measures show that councils improved in areas such as educational attainment, the quality of council housing and waste recycling, in 2014/15. Most councils have reduced their workforces to save money, and many are planning further staff reductions. In doing so, they need to ensure they have people with the knowledge, skills and time to design, develop and deliver effective services in the future. Councils and their partners also need to respond to the Community Empowerment (Scotland) Act 2015, by involving local people more in making decisions about services, and empowering local communities to deliver services that are sustainable and meet local needs.
(Edited publisher abstract)
Subject terms:
local authorities, financial management, performance evaluation, cutbacks, local government finance;
AUDITOR GENERAL FOR SCOTLAND, ACCOUNTS COMMISSION FOR SCOTLAND
Publisher:
AuditScotland
Publication year:
2016
Pagination:
42
Place of publication:
Edinburgh
This report identifies new local models of care in Scotland which are shifting the balance of care from hospitals to more homely and community-based settings. It aims to help to support new integrated authorities to implement new ways of working, address the challenges facing health and social care services and help increase the pace of change. The report draws on: analysis of national and local information to help hospitals, councils and community-based services to identify pressures in the system, including performance, activity and financial data; projection analysis to estimate the potential effect of increasing pressures in health and social care; desk research and interviews. Part 1 looks at the increasing pressures facing health and social care in Scotland. It highlights an increase in the numbers of older people complex health and social care needs, an increase in emergency hospital admissions, and how services need to adapt to cope with the effects of a changing population. Part 2 highlights examples of some of the new approaches to providing health and social care, which shifting the balance of care from hospitals to more homely and community-based settings. These include: community preventative approaches, enhanced community care models, intermediate care models, and initiatives designed to reduce delayed discharges. Part 3 looks at what still needs to be done to achieve the transformational change needed to deliver the Scottish Government’s 2020 Vision for health and social care and actions required to address them. It concludes that a lack of national leadership and clear planning is preventing the wider change urgently needed if Scotland’s health and social care services are to adapt to increasing pressures. Two supplements accompany the report, which provide details of the case studies referenced in the report and a model of East Lothian’s whole-system approach.
(Edited publisher abstract)
This report identifies new local models of care in Scotland which are shifting the balance of care from hospitals to more homely and community-based settings. It aims to help to support new integrated authorities to implement new ways of working, address the challenges facing health and social care services and help increase the pace of change. The report draws on: analysis of national and local information to help hospitals, councils and community-based services to identify pressures in the system, including performance, activity and financial data; projection analysis to estimate the potential effect of increasing pressures in health and social care; desk research and interviews. Part 1 looks at the increasing pressures facing health and social care in Scotland. It highlights an increase in the numbers of older people complex health and social care needs, an increase in emergency hospital admissions, and how services need to adapt to cope with the effects of a changing population. Part 2 highlights examples of some of the new approaches to providing health and social care, which shifting the balance of care from hospitals to more homely and community-based settings. These include: community preventative approaches, enhanced community care models, intermediate care models, and initiatives designed to reduce delayed discharges. Part 3 looks at what still needs to be done to achieve the transformational change needed to deliver the Scottish Government’s 2020 Vision for health and social care and actions required to address them. It concludes that a lack of national leadership and clear planning is preventing the wider change urgently needed if Scotland’s health and social care services are to adapt to increasing pressures. Two supplements accompany the report, which provide details of the case studies referenced in the report and a model of East Lothian’s whole-system approach.
(Edited publisher abstract)
Subject terms:
models, health care, social care, integrated care, case studies, service development, community care, prevention, intermediate care, delayed discharge, long term conditions, older people;
Reports on the progress of integration of health and social care in Scotland to date following the reforms implemented in the Public Bodies (Joint Working) (Scotland) Act 2014. The Act sets out a framework for integrating adult health and social care services to ensure that people receive the care they need at the right time and in the right setting, with a focus on community-based and preventative care. This report highlights the risks that need to be addressed if the reforms are to succeed and present a series of recommendations based on the findings. Evidence for the audit was collected from available documents and integration plans; the work of local auditors, the Care Inspectorate, and Healthcare Improvement Scotland; questionnaires sent to the new integration authorities (IAs) with statutory responsibilities to coordinate local health and social care services; and interviews with key stakeholders. The audit found support for the principles of integration from the individuals and organisations implementing the changes. Risks identified which need to be addressed if integration is to change the delivery of health and care services included: difficulties in (IAs) agreeing budgets, lack of comprehensive strategic plans, lack of clear targets and timescales showing how they will make a difference to people who uses health and social care services complex governance arrangements; and workforce issues, such as different terms and conditions for NHS and council staff, and difficulties in recruiting and retaining GPs and care staff. Recommendations are provided to help address potential risks.
(Edited publisher abstract)
Reports on the progress of integration of health and social care in Scotland to date following the reforms implemented in the Public Bodies (Joint Working) (Scotland) Act 2014. The Act sets out a framework for integrating adult health and social care services to ensure that people receive the care they need at the right time and in the right setting, with a focus on community-based and preventative care. This report highlights the risks that need to be addressed if the reforms are to succeed and present a series of recommendations based on the findings. Evidence for the audit was collected from available documents and integration plans; the work of local auditors, the Care Inspectorate, and Healthcare Improvement Scotland; questionnaires sent to the new integration authorities (IAs) with statutory responsibilities to coordinate local health and social care services; and interviews with key stakeholders. The audit found support for the principles of integration from the individuals and organisations implementing the changes. Risks identified which need to be addressed if integration is to change the delivery of health and care services included: difficulties in (IAs) agreeing budgets, lack of comprehensive strategic plans, lack of clear targets and timescales showing how they will make a difference to people who uses health and social care services complex governance arrangements; and workforce issues, such as different terms and conditions for NHS and council staff, and difficulties in recruiting and retaining GPs and care staff. Recommendations are provided to help address potential risks.
(Edited publisher abstract)
Subject terms:
health care, social care, integration, inspection, organisational structure, integrated services, governance, staff, outcomes, NHS, planning, joint financing;
This audit report examines councils’ progress in implementing the self-directed support strategy in Scotland and their readiness for the Social Care (Self-directed Support) (Scotland) Act 2013. It focuses on councils because they have the lead role, working in partnership with users, carers, third and private sector providers, NHS boards and other organisations. The audit work was carried out between December 2013 and February 2014. It involved a review of a range of published information, case studies in four councils, and interviews with staff and representatives from range of public, private and third sector organisations. The report highlights that councils still have a substantial amount of work to do to fully implement self-directed support. Some have made slower progress than others and they will have to implement the cultural and practical changes more quickly over the next few years. Councils need effective leadership from senior managers and councillors and continued support from the Scottish Government through detailed guidance and regular communication on how implementation is progressing across the country. While different methods of allocating the money have been adopted there are risks and advantages with each model, which need to be managed carefully without unnecessarily limiting people’s choice and control over their support. The audit also found that social care professionals have welcomed self-directed support because it has the potential to improve support for people who need it. The report recommends to work more closely with people who need support, their carers and families, providers and communities, to involve them in planning, agreeing and implementing self-directed support strategies.
(Edited publisher abstract)
This audit report examines councils’ progress in implementing the self-directed support strategy in Scotland and their readiness for the Social Care (Self-directed Support) (Scotland) Act 2013. It focuses on councils because they have the lead role, working in partnership with users, carers, third and private sector providers, NHS boards and other organisations. The audit work was carried out between December 2013 and February 2014. It involved a review of a range of published information, case studies in four councils, and interviews with staff and representatives from range of public, private and third sector organisations. The report highlights that councils still have a substantial amount of work to do to fully implement self-directed support. Some have made slower progress than others and they will have to implement the cultural and practical changes more quickly over the next few years. Councils need effective leadership from senior managers and councillors and continued support from the Scottish Government through detailed guidance and regular communication on how implementation is progressing across the country. While different methods of allocating the money have been adopted there are risks and advantages with each model, which need to be managed carefully without unnecessarily limiting people’s choice and control over their support. The audit also found that social care professionals have welcomed self-directed support because it has the potential to improve support for people who need it. The report recommends to work more closely with people who need support, their carers and families, providers and communities, to involve them in planning, agreeing and implementing self-directed support strategies.
(Edited publisher abstract)
Subject terms:
self-directed support, social care provision, financing, resource allocation, risk, user participation, user views, care planning, direct payments, choice, evaluation;
Reshaping Care for Older People (RCOP), Scotland's programme to improve care for older people has brought together the different bodies involved in services costing £4.5 billion a year. These organisations now need to better target resources at preventing or delaying illness and at helping people to keep living at home. This report reviews progress three years into the Scottish Government’s ten-year project to improve health and social services for people aged 65 or over. The Scottish Government is supporting the project with a 4-year, £300 million Change Fund, but this report suggests better information is needed on its impact. RCOP is a complex programme, requiring joint action by a number of organisations if it to be successful, and has yet to demonstrate how significant changes will be achieved. This report indicates that national data shows significant variation in how NHS boards and councils use money to provide services for older people across Scotland; and that to implement RCOP successfully, partners need to make better use of data, focus on reducing unnecessary variation, monitor and spread successful projects, and have clear plans for shifting resources to community-based services.
(Edited publisher abstract)
Reshaping Care for Older People (RCOP), Scotland's programme to improve care for older people has brought together the different bodies involved in services costing £4.5 billion a year. These organisations now need to better target resources at preventing or delaying illness and at helping people to keep living at home. This report reviews progress three years into the Scottish Government’s ten-year project to improve health and social services for people aged 65 or over. The Scottish Government is supporting the project with a 4-year, £300 million Change Fund, but this report suggests better information is needed on its impact. RCOP is a complex programme, requiring joint action by a number of organisations if it to be successful, and has yet to demonstrate how significant changes will be achieved. This report indicates that national data shows significant variation in how NHS boards and councils use money to provide services for older people across Scotland; and that to implement RCOP successfully, partners need to make better use of data, focus on reducing unnecessary variation, monitor and spread successful projects, and have clear plans for shifting resources to community-based services.
(Edited publisher abstract)
Subject terms:
social care provision, older people, health care, interagency cooperation, NHS, local authorities, joint working, cost effectiveness;
The aim of this audit was to review how effectively the public sector in Scotland commissions social care services. Evidence was gathered through analysis of national and local guidance, reports and data, information from inspection bodies, interviews with key stakeholders, and focus groups and surveys with users, carers and providers. The findings are presented in 4 main parts: social care in Scotland, strategic commissioning, delivering social care services, and impact on users and carers, with short case study examples included. The key messages are that commissioning social care is complex and challenging, that councils and NHS boards have been slow to develop strategic commissioning, that there is scope to improve provider involvement and management of risks associated with providers closing, and that users and carers should have a say in what services have the best impact on their lives. The report sets out key recommendations for councils and their partners and the Scottish government.
The aim of this audit was to review how effectively the public sector in Scotland commissions social care services. Evidence was gathered through analysis of national and local guidance, reports and data, information from inspection bodies, interviews with key stakeholders, and focus groups and surveys with users, carers and providers. The findings are presented in 4 main parts: social care in Scotland, strategic commissioning, delivering social care services, and impact on users and carers, with short case study examples included. The key messages are that commissioning social care is complex and challenging, that councils and NHS boards have been slow to develop strategic commissioning, that there is scope to improve provider involvement and management of risks associated with providers closing, and that users and carers should have a say in what services have the best impact on their lives. The report sets out key recommendations for councils and their partners and the Scottish government.
Subject terms:
local authorities, public expenditure, service users, social services, social care, social care provision, carers, commissioning, cost effectiveness, government policy;
This report presents key messages from community health partnerships in Scotland and their impact in improving people’s health and quality of life by joining up health and social care services and moving more services from hospitals into the community. The report says that the Scottish Government should work with NHS boards and councils to undertake a fundamental review of the various partnership arrangements for health and social care in Scotland to ensure that they are efficient and effective and add value. It should work with NHS boards and councils to help them measure CHP performance, including the effectiveness of joint working. This should include streamlining and improving performance information for SOA, HEAT and other performance targets to support benchmarking. Also, the report suggests that the Scottish Government should update and consolidate guidance on joint planning and resourcing for health and social care. This should cover the use of funding, staff and assets to support NHS boards and councils develop local strategies for joining up resources across the whole system.
This report presents key messages from community health partnerships in Scotland and their impact in improving people’s health and quality of life by joining up health and social care services and moving more services from hospitals into the community. The report says that the Scottish Government should work with NHS boards and councils to undertake a fundamental review of the various partnership arrangements for health and social care in Scotland to ensure that they are efficient and effective and add value. It should work with NHS boards and councils to help them measure CHP performance, including the effectiveness of joint working. This should include streamlining and improving performance information for SOA, HEAT and other performance targets to support benchmarking. Also, the report suggests that the Scottish Government should update and consolidate guidance on joint planning and resourcing for health and social care. This should cover the use of funding, staff and assets to support NHS boards and councils develop local strategies for joining up resources across the whole system.
Subject terms:
integrated services, NHS, resource allocation, social care provision, staff management, collaboration, financing, health care;
This report looks at community health partnerships in Scotland and their impact in improving people’s health and quality of life by joining up health and social care services and moving more services from hospitals into the community. The report says that the Scottish Government should work with NHS boards and councils to undertake a fundamental review of the various partnership arrangements for health and social care in Scotland to ensure that they are efficient and effective and add value. It should work with NHS boards and councils to help them measure CHP performance, including the effectiveness of joint working. This should include streamlining and improving performance information for SOA, HEAT and other performance targets to support benchmarking. Also, the report suggests that the Scottish Government should update and consolidate guidance on joint planning and resourcing for health and social care. This should cover the use of funding, staff and assets to support NHS boards and councils develop local strategies for joining up resources across the whole system.
This report looks at community health partnerships in Scotland and their impact in improving people’s health and quality of life by joining up health and social care services and moving more services from hospitals into the community. The report says that the Scottish Government should work with NHS boards and councils to undertake a fundamental review of the various partnership arrangements for health and social care in Scotland to ensure that they are efficient and effective and add value. It should work with NHS boards and councils to help them measure CHP performance, including the effectiveness of joint working. This should include streamlining and improving performance information for SOA, HEAT and other performance targets to support benchmarking. Also, the report suggests that the Scottish Government should update and consolidate guidance on joint planning and resourcing for health and social care. This should cover the use of funding, staff and assets to support NHS boards and councils develop local strategies for joining up resources across the whole system.
Subject terms:
integrated services, NHS, resource allocation, social care provision, staff management, collaboration, financing, health care;