A new dawn for Scottish care?

The eagerly awaited 21st Century Social Work Review has now concluded its work and the review has been presented to the Scottish Executive.
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The man at the helm of the review group, since it was commissioned by Minister Peter Peacock in June 2004, has been Willy Roe. On presenting the report, he had this to say:
“Throughout the review, the evidence we drew and considered was remarkably consistent, with one single message at the core: doing more of the same won’t work. Social work must change to meet our expectations of high quality, accessible, personalised services that are equipped to respond to increasingly complex problems in a fragmented and ageing society.
“Now we need to harness all our resources and expertise – across all sectors – to design services around the needs of people and shift the focus from dealing with crises, to prevention and early intervention.”

Changing Lives, the report of the 21st Century Social Work Review Group sets out 13 high level recommendations, which aim to:

– Personalise the delivery of services, so that they better meet people’s needs and aspirations
– Take a public sector wide approach to prevention, helping people before they reach a crisis point in their lives
– Strengthen the social work profession so that social workers are better equipped to practise using the best evidence of what works, with steps to keep the best practitioners in practice
– Develop an organisational approach to risk management and governance which promotes excellence and learning from mistakes
– Develop a culture of performance improvement in social work services.
Sam Cairns, speaking on behalf of the review group’s Users’ and Carers’ Panel, made it clear what he believed the central issue to be:
“The truth is that we should all be working towards the same goal in social work – how to achieve a good quality of life. Our hope is that the Changing Lives report will lead everyone involved in social work services to that thought. And we also hope that bureaucracy and well-intentioned policies become secondary to finding practical and innovative ways to help people achieve a good life.”{mospagebreak}

Professor June Andrews, Director of the Dementia Services Development Centre at the University of Stirling welcomed the review and echoed Willy Roe’s sentiments that maintaining the status quo simply wasn’t good enough. She also suggested that there are lessons to be learned from the NHS in how the necessary changes can be effected.
“The Review is very welcome, and you can’t argue with the analysis that says ‘Doing more of the same won’t work.’ A major programme of cultural change and service redesign is recommended, and that too is self evident. What is less clear is how you can go about making that change happen. For example, there is a significant investment in change in Health Services in Scotland. The Centre for Change and Innovation provides a well funded platform for change that works directly with frontline staff. Staff are working quite differently. At the local GP surgery you will find nurses holding clinics, doctors answering the phone, receptionists taking blood samples. Patients love it and waiting times are dropping. All this would be unthinkable in the NHS a few years ago. The CCI, and changes in staff contracts, changes in pay structures and changes in culture, alongside a focus on delivery have started to turn round that huge ship.
“At present, there is nothing of equivalent size or significance for Social Work. Part of the strength of the change management in health, is that the health service has some continuity over Scotland. Although there are local Boards, there is coherence and a sense of shared purpose.
“The NHS is not often held up as a good example, but it is to be hoped that the system learns from the success of change programmes there, and does not end up spending a fortune on management consultants to tell us what works to make change happen in the systems that we know very well. The change programme needs to be coherent across Scotland. Our citizens deserve no less.”
According to Education and Young People Minister Peter Peacock, this review, the biggest overhaul of social work for 40 years, will deliver better care and a more motivated, focused profession. The Minister said radical change was needed to provide social work services that could meet the challenges of the 21st century.

Mr Peacock, speaking at the launch, said:
“The review makes clear that the current response to growing demand for services is unsustainable and, we in Government have not only the opportunity to act on the reports findings, but an obligation to do so. It is clear we need to take radical and comprehensive action to transform our social services sector – to build new confidence, stronger leadership and the kind of management culture that supports the empowerment of front line social workers.
The Minister also stated that providing support and backing for frontline social workers is one of the Executive’s priorities.
“We fully intend to get in behind and support social work through a period of necessary change, to equip it to better meet contemporary needs and ever changing demands. Local authorities have played a key role in the delivery of social work over much of the last 40 years and they should continue to be central to future delivery but with an ever increasing array of partners in other parts of the public, private and voluntary sectors.{mospagebreak}

The sector’s response to the review’s findings seems to have been a reasonably positive one across the board. Clearly, representatives from subsections of the sector have their own concerns and caveats but the mood seems generally to be one of acceptance.
The Association of Directors of Social Work were quick to present their response to both the review and the Minister’s response. Colin Mackenzie, President of ADSW said:
“We would like to congratulate the Review Group for keeping away from quick fix solutions and instead focusing on a long-term strategic plan to strengthen the profession. The Minister’s recommendations today gives social work a clear focus and a central steer – something we have long needed. We are particularly pleased to see the setting up of a national Social Work Forum that will be chaired by the Minister. This will be a vital mechanism, ensuring that social work policy develops in an integrated and co-ordinated way.
“We welcome the additional resources as a change fund but the fundamental question about whether social work is adequately resourced remains. Such is our concern that ADSW has agreed to commission a high level, independent report into the funding of children’s social work services. This will examine the numerous funding streams, how resources are deployed, levels of need and the growing demand for services.
“Nonetheless, we are up for change and are keen to get started on implementing the changes that the Minister has announced today.”
Bryan Ritchie, Director of The Fostering Network Scotland acknowledged the potential benefits within the report for practitioners and service users within the fostering sector.
“The Fostering Network welcomes the proposed changes and in particular welcomes the concept of “freeing up” social workers time to undertake direct work with children. This is an area that has suffered over the last ten years and children in foster care have consistently asked for more quality time with their worker. Moreover the proposals acknowledge the continued requirement to provide improved services to our nations most vulnerable. Our hope is that the Report’s vision is matched by the courage to take the reforms forward.”{mospagebreak}

Duncan Macaulay of Edinburgh City Council sounded a positive note about the review but opined the apparent omission of one crucial issue.
“I broadly welcome the report and am particularly pleased to see the opportunity for staff to develop their career and remain at the frontline and the strengthening of the CSWO role. We have to ensure that we have sufficient resources to do the job and my own particular bugbear of a national salary scale doesn’t seem to be addressed.”
“Not a moment to waste,” was COSLA’s Social Work Spokesperson Councillor Eric Jackson’s initial reaction to the publication of the Report on the 21st Century Social Work Review and the Scottish Executive’s outline Response.

Councillor Jackson said: “Social Work is about changing lives, I endorse any proposals that seek to improve people’s lives and people’s life opportunities. Our society is an increasingly challenging place right now and our social work services and social work staff are in the front line doing a tremendous job day in day out, protecting people and promoting inclusion.
“It is vital that in moving forward and responding to the challenges presented by our society that Ministers listen to the agendas set out by COSLA and ADSW. COSLA has worked with the social work profession to develop a clear and deliverable vision of where social work as a profession goes from here; there are some stern challenges ahead as we seek to put cohesion and pride back into our society. To do this we must value, support and promote our social work services and that is exactly what local government does and will continue to do as it organises and delivers these vital services.”

David Williams, service director, gave Care Appointments Scotland the view from Quarriers Village on Changing Lives:
“Quarriers absolutely endorses the view that the basis for any service provision to the most vulnerable members of our communities is that a ‘person centred approach’ is taken in every instance and where full inclusion in the planning and delivery of services by recipients of services is the norm. These standards of practice are and have been in recent years, the staples of Quarriers’ work and are fundamental to how we operate across the organisation, generally seen hitherto as ‘added value’ in terms of our work, and it’s reassuring that these approaches will be seen as mainstream expectations in future.
“However, there is a considerable challenge facing providers in achieving this against a backdrop of continuous and significant cuts to funding, short term funding streams, and complex and uncertain mixed funding packages all of which seriously compromise a consistent ability to assure the maintenance of such needs led and rights based approaches.”
From the education sector Professor Bryan Williams OBE, Director, Scottish Institute for Excellence in Social Work Education told Care Appointments Scotland the following:
“The Institute welcomes publication of the report of the 21st Century Social Work Review, Changing Lives, together with the Scottish Executive response. As was shown at yesterday’ debate in the Parliament, there is strong cross-party support for the agenda to strengthen and improve social work services through investment in the workforce, clearer governance arrangements and improving the evidence base for practice.
“Rarely in the years since the founding 1968 Act has there been such public interest in social work and social workers and the Review Report’s endorsement of the distinctive nature, social importance and key place of the profession within Scottish public services is of vital significance in combatting low morale, difficulties in recruitment and retention and lack of clarity about future direction evidenced therein.{mospagebreak}

Professor Williams also stressed the Institute’s willingness to get involved in the evolution of the reports recommendations:
“At the Institute, we look forward to playing a full part in shaping the detail of the implementation plan promised by the Minister. Through their collaborative work on strengthening social work education, improving the practice knowledge base through research and contributing to the embedding of a culture of continuous professional development, member universities will play a significant part in taking forward the change agenda. Working together with partners, we believe that it will be possible to bring about the transformational change envisaged by the Review Group.”

Janet Birks, Director of Housing and Social Work at Falkirk Council, welcomed the review but stressed that it represented an opportunity that must not be wasted:
“The conclusions of the Review and the Minister’s initial response are very welcome. They succinctly express the issues and challenges that, I think, the social work profession has been aware of for some time. They describe a societal context that is very different from 1968, when major SW legislation was last enacted in Scotland, and it should be no surprise that there is a need to change and re-energise. But the expectations of the Review go far beyond Social Work and transformational change is needed across society as a whole if they are to be realised. Social Work has an important contribution to make but it is one contribution and changing Social work will not, of itself, bring the change that is required. Having said that, I am excited by the Review and by the Minister’s clear commitment to social Work, this is a tremendous opportunity that we must all make the very most of.”

Forthright as always, Andrew Lowe, Director of Social Work at Scottish Borders Council, spoke passionately to Care Appointments Scotland about his view of Changing Lives and the future for the sector:
“I am heartened by much of this report, though it is in truth an odd mix of 1960’s rhetoric and good contemporary ideas. Disappointingly, there seems to be no linkage to “Getting It Right for Every Child” or “Building A Health Service Fit For The Future”. However, it does seem to be free from Tom McCabe’s passion for organisational reform and runs counter to the centralising tendency underlying the new Community Justice Authorities. Reassuringly, unlike the recent changes in England, it seems to be strengthening social work as a discrete occupational entity to be valued and improved.
“I warmly welcome the emphasis on transformational change. At the launch Willy Roe said “more of the same won’t do.” and I agree with him. While we can always do with more money, the real change has to be in the way we approach the task. Working in partnership with users and carers; exploring the potential of direct payments and personalised budgets; confident leadership around a set of core values; sweeping away some of the more primitive institutional responses to need.
“I have been an advocate for a new Social Work Scotland Act for some time. An underpinning statutory framework that can help define and enthuse a new generation of social workers as the 1968 Act did for me. The world has changed greatly since those days and a new framework to define the changed relationships, expectations and values is something to be excited by. The Mental Health (Care and Treatment) (Scotland) Act 2003 prefigures this with its principles, roles and responsibilities clearly set out and appropriate to modern practice.
“Changing Lives, together with the prompt reply from the Scottish Executive gives us the chance to recast social work. To empower the frontline and revise our entire view of the task – from welfare to well being as it is described. The SE has promised to legislate in 2008. At the launch Peter Peacock, Minister for Education and Young People promised to legislate to establish national priorities and a performance improvement framework. I asked him if he could offer any improvement in financial planning to bring more certainty to our work. His response was fair. He said he had recently issued an executive letter to education authorities regarding three-year budgets for schools and would consider further whether such a move could be considered for social work.
“On 10th March we hold a local conference at Peebles Hydro where we will sit down with users cares and other stakeholders (including the Executive) and continue our progress to define how we will be Changing Lives in Scottish Borders.”
Brian Corrigan, Scotland Officer, Social Care Association congratulated all involved in the process leading to the production of what he described as a ‘critical piece of work’:
“The SCA is particularly interested in the proposals to deliver additional resources in support of the proposed changes and in the quest for improved service delivery. We also support the re-stated commitment to partnership working in pursuit of performance improvement and enhanced service quality.{mospagebreak}

Whilst we recognise the need to confirm the role of the Professional Social Worker we would also stress the importance of continuing to support the promotion of opportunities for skills development and consequently “professionalism” throughout the social care sector as a whole by ensuring that appropriate resources are made available for social care staff at all levels.”
Jacquie Roberts, Chief Executive of the Care Commission, warmly welcomed the review and highlighted her belief that it will improve the standards of care for young and vulnerable people.
“We have always believed that services should meet the needs of people, people shouldn’t have to fit services. We welcome the strong support for carers of people who use care services, the emphasis on early intervention and recognition of the importance of the mixed-economy of care. We particularly welcome focus on performance improvement and the development of strong leadership. Greater participation of those who actually use care services will deliver improved outcomes for Scottish people.”

Janet Miller, Director of the Voluntary Sector Social Services Workforce Unit, was particularly pleased at the recognition within ‘Changing Lives’ of the need to develop new partnerships between the public, voluntary and private sector.
“The voluntary sector accounts for approximately 25% of the total workforce and is the fastest growing provider of services, yet this report notes the relationship between the voluntary sector and local authority staff involved in delivering care is often “inequitable, inconsistent and lacks a strategic approach.”
We would welcome any moves to ensure participation from the voluntary sector throughout the planning and commissioning processes.”

Carole Wilkinson, Chief Executive, SSSC, applauded the report’s emphasis on the need for a well educated and trained workforce.
“It highlights that investing in the continuing development of the workforce will enable workers to operate as confident, accountable professionals. The National Strategy for the Development of the Social Service workforce in Scotland 2005-2010 sets out the actions that will bring this about. I believe that the review offers both challenges and opportunities to build a confident and competent workforce.”

All of the contributors above, I’m sure, would agree that it is what happens in the short to medium term by way of legislation, implementation and follow-through that really matters. Care Appointments Scotland has learned that between now and Easter the Executive will be taking soundings from local authorities and other parties with a vested interest as to how best to implement the points raised by the review.