Response 562575682

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About you

3. What is your name?

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Elaine Cruickshank

National Care Service strategy

1. What is your view of the proposed National Care Service strategy (see proposed new sections 1A to 1E)?

Please select one item
Radio button: Unticked Strongly support
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Radio button: Unticked Partly support and partly oppose
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Please use the text box below to expand on your answer
Unclear of the added value, or added efficiency it will bring/result in.

National Care Service Board

2. What is your view of the proposal to create a National Care Service Board, and the provisions about the role and functions of the Board (see in particular new Chapter 1B of Part 1, and new schedule 2C)?

Please select one item
Radio button: Unticked Strongly support
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Radio button: Ticked Partly support and partly oppose
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A new NCS Board may be of a level of potential support in improving and ensuring standards across non-health services.
Although it is extremely difficult to foresee how this can be introduced, or established, with cost efficiency and in a manner that brings clarity and streamlining

Creation of local boards and removal of other integration models

3. What is your view of the proposal to establish National Care Service local boards and to remove other integration models (see in particular Chapter 1A of Part 1, and new schedules 2A and 2B)?

Please select one item
Radio button: Unticked Strongly support
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Radio button: Ticked Tend to oppose
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Please use the text box below to expand on your answer
Unclear rationale for, and anticipated benefits of, replacing already established IJB structures with something new.
A refresh, even re-naming of existing local structures with a new NCS Board overarchingly would seem more efficient

Monitoring and improvement and commissioning

4. What is your view of the proposed new provisions on monitoring and improvement (see new sections 12K and 12L) and on commissioning (see new section 12M)?

Please select one item
Radio button: Unticked Strongly support
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Please select one item
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National Chief Social Work Adviser and the National Social Work Agency

5. What is your view of the proposed new provisions to designate a National Chief Social Work Adviser and for the creation of a National Social Work Agency (see new section 26A)?

Please select one item
Radio button: Unticked Strongly support
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Amendments to the Public Bodies (Joint Working) (Scotland) Act 2014

6. What is your view of the proposed amendments to the Public Bodies (Joint Working) (Scotland) Act 2014, as set out in the marked up version of the Act?

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Areas of further work

7. What is your view of the Scottish Government’s proposed approach to addressing the areas of further work outlined in the Minister’s covering letter?

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Please select one item
Radio button: Unticked Strongly support
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Radio button: Ticked Strongly oppose
Radio button: Unticked Undecided / no opinion
Please select one item
Radio button: Unticked Strongly support
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Radio button: Unticked Partly support and partly oppose
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Please select one item
Radio button: Unticked Strongly support
Radio button: Ticked Tend to support
Radio button: Unticked Partly support and partly oppose
Radio button: Unticked Tend to oppose
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Please use the text box below to expand on your answer referring to the specific areas of further work that you are commenting on
The proposed inclusion of community HEALTH services.

The possible inclusion of community child health services e.g. Health Visiting, Family Nurse Partnership, School Nursing, Care Experienced Young People Medical/Nursing, (Community Midwifery) and Childhood Immunisation services into an NCS raises significant concern and risks. My understanding is that this concern is felt across a range of NHS leaders, in varying roles, across a number of Health Boards. This includes within the National Child Health Commissioner Group.

It is understood, and supported, that Local Authority (LA) children's services e.g. Children & Families Social Work and Education services will move into NCSLBs/an NCS

It is not my view, or that of other strategic child health leaders that NHS community child health services and LA children's services require to be within the same national structure to be more effective. Human relationships, and other factors, are more key and crucial to that improved effectiveness.

From the 5 years of experience and learning from the current (approx) 50:50 national split of (community) child health services and LA children's services being 'out of' or 'within' a HCSP, there is NO reported evidence of improvements for the workforces or for children/families of these services sitting within a joint HSCP/IJB structure.

Ref: Children's Services Reform Research study (Dec 2023) - commissioned by Scottish Gov.

There is a view held, borne out in NHS Tayside since 2018, that the incorporation of community child health services as part of an NHS Board's whole 'Women/Children & Families' operational services structure has significant advantages to both children/families and the respective workforces. This cannot, nor should not, be overlooked. Patient/family journeys are enhanced, crucial relationship building across services are enabled and 'transitions' (known as 'discharges' pre 2018 locally) across services are improved.

The proposal to separate the connected and interdependent suite of children's health services causes concern amongst leaders, and raises risks to children/families. Not to mention added confusion/lack of clarity/reduced understanding for the population served.

The proposal to separate these connected and interdependent NHS children's services, based on the rudimentary criteria of where they are, primarily, delivered i.e. in a hospital or in a community would benefit from being understood/considered/discussed further. It is not the location of the service which a child receives that is crucial to safe, effective & quality care delivery. It can, however, be the knowledge, skill, job satisfaction level and feelings of belonging/value of the staff which a child encounters. There is a real risk that some of the latter would be adversely affected by (re) introducing a separation of this unique and distinct proportion of the health service workforce i.e. children's services staff

Draft National Care Service Charter

8. What is your view of the initial draft of the National Care Service Charter?

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Other comments

9. Do you have any other comments on the Scottish Government’s proposed draft Stage 2 amendments to the National Care Service Bill?

Please use this text box to provide your answer
The rationale and case for the inclusion of community child health services has not been made clear, articulated effectively and could appear to be being made without due regard to the complexities nor any true understanding of the detail of the current status position.

More generally, there is difficulty in seeing how a new NCS structure, as proposed, will allow efficiencies and support simplicity. It is also difficult to visualise how it will contribute to the economic benefits required. Additional complexity, is somewhat anticipated at this stage.