SOCIAL care providers "cannot wait for a National Care Service to deal with financial, workforce and service demand challenges", a report by Scotland's public spending watchdog warns today.

In a damning assessment of the pressures engulfing the sector, Audit Scotland warns that the workforce is under "extreme pressure" and that "action is needed now if we are to improve the outcomes for people who rely on health and social care services".

It adds that there remains "considerable uncertainty" around the planning for a National Care Service, with legislation currently delayed and pleas from critics that the money would be better-invested now in frontline services.

READ MORE: What next for Scotland's National Care Service reforms? 

Audit Scotland says projections that implementing the NCS will cost between £241-£527 million by 2026/27 are "likely to significantly understate the margin on uncertainty and range of potential costs".

The report by Audit Scotland is a financial analysis of the situation facing Integrated Joint Boards (IJBs), the bodies which oversee delivery of social care through partnerships between the NHS and councils.

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Demand for social care is increasing due to the ageing population and the growing proportion of people living with complex care needs.

The watchdog said IJBs have a projected funding gap of £124 million for 2022/23, and are having to manage "immense pressures on the health and social care workforce".

The Herald:

Nonetheless, the Scottish Government confirmed in January of this year that it planned to recover £321 million - nearly two thirds - of the ring-fenced Covid-19 funding still held in reserve by IJBs as of March 2022.

This had been provided to help support the impact of the pandemic.

In 2021, the proportion of care services reporting vacancies had increased from 11% to 47%, with a 30% turnover rate for staff.

READ MORE: Union warning over proposal to cut £22m from social care in Glasgow

The report states: "The most common reasons for vacancies not being filled were too few applicants, and too few who were experienced and qualified.

"The effects of the pandemic exacerbated existing pressures on the workforce with low pay, antisocial hours and ‘burnout’ causing experienced staff to leave their posts."

It adds that the scale of the financial challenge facing IJBs "means that services will need to change if they are to be sustainable in the future".

This should include more of a focus on prevention, it said.

It comes days after Glasgow Health and Social Care Partnership (HSCP) signed off on budget cuts worth £22m.

The savings are expected to see the equivalent of 197 full-time jobs being lost, with a report from the IJB warning that some disabled people could face waits of up to 13 months for a care package as a result of reduced funding for self-directed support.

The Herald:

It came as inspectors also highlighted "significant weaknesses" in adult social care and social work services in Edinburgh.

A report by the Care Inspectorate in March said that there was "insufficient support for unpaid carers" in the capital, and that hard-working staff "were under considerable pressure and sometimes overwhelmed".

William Moyes, chair of the Accounts Commission at Audit Scotland, said: “Change is needed now - it cannot wait for a National Care Service.

"Action is needed to tackle funding pressures, which are under increasing stress from rising demand and cost pressures.

"The workforce challenges are considerable, with mounting unmet need.

“We need to see services focus on prevention, with appropriate funding in place to transform the way services are delivered and to improve lives.”

Social Care Minister, Maree Todd, said social care had been hit by a "triple whammy" of Brexit, the pandemic, and rising costs of energy and inflation.

She added: “We absolutely agree that significant transformation is needed to ensure long-term sustainability – that’s why we are taking forward ambitious plans to build a National Care Service, to deliver consistency and quality of care.

“Additional Scottish Government funding has already helped deliver two pay rises for workers within adult social care commissioned services in two years and we are currently working to improve wider terms and conditions.

“The health budget provides investment of over £1.7 billion for social care and integration meaning the social care spending has increased by over £800 million compared to 2021-22 – well ahead of our trajectory to increase funding by 25% over the life of the Parliament.”

READ MORE: Vulnerable Scots failed by care system, say inspectors 

Meanwhile, the Royal College of Nursing has urged Scotland's new Health Secretary, Michael Matheson, to ensure that the views and experiences nursing staff inform the Scottish Government's 'Nursing and Midwifery Taskforce'.

The taskforce, which is due to meet for the first time today, was established in response to the RCN's strike negotiations during winter.

The taskforce is expected to make a series of recommendations to address current staff shortages, including measures to support the retention and to encourage more people to consider a career in nursing.

At the end of 2022, more than 8% of nursing and midwifery posts in NHS Scotland were unfilled, with many more vacancies in the care home and social care sectors.

Colin Poolman, director for RCN Scotland, said: “We need to act now to stop more experienced nursing staff leaving the profession and to attract the workforce of the future.

“The views and experiences of nursing staff, those studying nursing and those considering nursing as a career, will be essential in informing and shaping what is actually required to guarantee nursing becomes a career of choice once again.

“The Cabinet Secretary must ensure the taskforce delivers funded, timely and meaningful actions to retain nursing staff, to address the unsustainable level of vacancies, to expand routes into nursing and ultimately to grow Scotland’s nursing workforce to ensure the profession can meet the health and care needs of the people of Scotland today and in the future.”