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I agree that there is a lot of variation in how teams are set up around the country, and that that presents challenges for people. As we try to drill down and understand what is happening and what is leading to the acute pressures that are being felt at the moment, we have come across situations in which social work has not been involved, even though it has had capacity. There are definitely barriers to do with the way that teams are set up locally that are making things difficult.

An exciting piece of work that the Government is doing is our work on GIRFE—getting it right for everyone—which is an approach for adults with complex needs. You will be aware of the GIRFEC—getting it right for every child—approach. GIRFE involves taking a proper multidisciplinary and, indeed, multi-agency approach to more complex cases, in recognition of the fact that some people require services to coalesce around them and provide a package of care that means that they cannot fall through the net. It is about ensuring that we find ways to deliver that care to people with complex needs.

Our services operate in silos, but human beings do not, so we are always trying to crack that one. There are a few GIRFE pathfinders currently operating across the country. They will give us an understanding of how we can provide a more personalised way to access help and support when it is needed, and put the person at the centre of the decisions that affect them in order to achieve the best outcomes.

There is an overlap with the GIRFEC approach, which is about putting a team around the child. GIRFE is about putting a team around the person and making sure that all the public services are involved. I have mentioned previously that some individuals whom I meet are like a pinball, pinging back and forth between different systems and struggling to have their rights upheld and their needs met. The approach of ensuring that the person is at the centre and the team is around them, working together to ensure that their needs are met and that their rights are upheld, will help.

We are currently working carefully on that, and I think that it will really help with those complex cases in which there are not just multiple disciplines, but multiple agencies, involved.

That is fine.

We can go back and look at it. It was long before I was elected, and certainly long before I was in my position as minister. We will go back and have a look at what was discussed around the time that the bill that became the 2013 act was introduced, with regard to the metrics that were put in place to ensure that it was delivered appropriately. Times have moved on somewhat since then, but Sandesh Gulhane is right to highlight that it is important that we look at what the intention was at the time that the bill was introduced.

I think that the three-year commitment to the landscape in which we are operating shows the intent of Government. We see that as crucial. We know that the third sector is playing a really important role, and we know how important it is for it to have secure funding.

I am delighted that there is secure funding over three years, which demonstrates the on-going commitment to that particular aspect of self-directed support.

It is challenging to achieve consistency across the board. We work not only with COSLA, but directly with chief officers in each local authority area. A few years ago, we updated the statutory guidance to make it clearer how we expect the policy to be implemented and to tackle the risk-averse approach that we see being taken in some parts of the country and the organisational or cultural barriers that might undermine the flexibility, autonomy and choice that are at the core of SDS.

My colleagues are probably best placed to comment on this, but we have funded Social Work Scotland to update the SDS framework of standards and to create the practitioners toolkit, both of which will help us to improve consistency across the country. However, I think that there is a strong case for a national care service. You would expect me to say that, but I think that it is really important that, in circumstances in which there is inconsistency and the situation is challenging for local areas, we will be able to provide national oversight and national support frameworks, and to ensure that different areas can learn from one another. At the moment, they are working in isolation, and we need to improve the learning that takes place across the country.

I think that everyone acknowledges just how challenging the landscape is at the moment, given the pressures that we face. This has been a long review of SDS, and some pressures were building before the pandemic. We have an ageing population demographic—it is great that people are living longer, but they are living longer with more complex health issues and are, therefore, requiring more social care support—and people with certain conditions are living independently in a way that they would not have been able to do in the past, so some pressures are built in.

There have been 14 years of austerity, which have, as nearly everyone acknowledges, challenged all our local services. All our public services are feeling stretched to the limit. Any changes that could be made to improve efficiency have been made, so any further savings have an impact on delivery. People are feeling like that across the board.

The pandemic has caused a real challenge. The health portfolio team has a meeting every week before the Cabinet meeting, and this morning we discussed some of the challenges that we face in relation to the stage at which people present with an illness, because people are presenting further on in their illnesses and when they are more acutely unwell. There is more complexity than there was before the pandemic, and there are also more Covid cases—there has been an increase in the level of Covid in our community.

All those issues still exert pressure on our health and social care system, so it is undoubtedly an exceptionally challenging time at the moment. In order to rise to meet the challenges and address the pressures that we face, we have weekly charging for residential accommodation guidance—CRAG—meetings where we look at the whole system in order to assess what is happening in health and social care in Scotland and to consider what can be done to improve the situation.

You will have heard from the First Minister that there is a real focus on delayed discharge, for example. The figure for delayed discharges used to vary by season—it would go down in the summer and up in the winter—but the pressure from delayed discharges has been relentless all year round for a number of years, since the start of the pandemic. Over the next few months, there will be a real focus on trying to improve the situation in order that we have some headroom.

From the letter that I sent to the committee yesterday about the national care service, you will know that we have paused our discussions on one or two amendments that have still not been agreed by me and COSLA in order to free up the space to focus on acute system pressures over the next few months, rather than on the systemic solutions that might be a little further down the line.

I do not know whether my colleagues want to say a bit more about eligibility options in the future.

In my casework as a constituency MSP, I certainly hear that concern. People think that option 1 is SDS, and that concerns me, because it suggests that people who are trying to access social care at the coalface are not being talked through the whole suite of options that are available to them, and that option 1 is being used as the default setting. That is a real challenge that we recognise.

As Rachael McGruer said earlier, we are working closely with NCS colleagues to ensure that the SDS principles are embedded within the creation of the NCS bill, and that the SDS improvement plan, which we are working through at the moment, is completed and embedded into the national care service, so that improvements in practice, that genuine offer of flexible choice and that change in practice are embedded in future social care delivery and available to everyone across the country.

Joanne Finlay, do you want to say a little bit more about that?

You are right. Everybody working in the health and social care system as a whole needs to have an understanding of how social care in Scotland works. One of the aims of our current work to tackle the acute issues that the system faces, as Ruth Maguire was alluding to, is working with healthcare systems to try to ensure that there is early referral, with early discharge planning for example. That requires an understanding of what is available in the community and who needs to be involved in the process of putting together a package of care post-discharge.

There needs to be a level of working knowledge in both the healthcare system and the social care system to ensure that things are operating efficiently and effectively across the board.

Certain professions are crucial, though. Social workers are crucial to the high functioning of the system—I am more and more convinced of this every day. From my perspective, as a general rule, it is really important that we support that profession and that we ensure that they are supported to make the professional and statutorily underpinned decisions that they are meant to be making to support individuals’ human rights as they access social care. We can do that by tackling both undergraduate and postgraduate support and training.

The work that we mentioned earlier to support and mentor newly qualified social workers and to ensure that there is a pathway in place for social workers who want to pursue higher qualifications—postgraduate qualifications—is really important. That needs to reflect not only the practical operation of SDS, but the culture and ethos of SDS, which is about flexibility, choice and upholding people’s independence. I joke with the SDS audience, “I’m all about independence.” I absolutely get how important it is to individuals that they have the autonomy to make decisions to have social care that supports them to work, for example, or to do whatever it is that they want to do. That is crucial.

For people who are working in the system, we have an opportunity, through NHS Education for Scotland and Scottish Social Services Council registration, to provide training packages that work in a multidisciplinary way right across the system. I think that that will be really helpful in tackling some of the barriers.

People with learning disabilities are one of the communities that struggle to have their rights upheld. There are good training opportunities for everyone who works in the system in how to engage with people with a learning disability. NES offers multidisciplinary, postgraduate and post-qualification or post-registration training to everyone who might come across such people so that they can help them to engage fully in the process of decision making and make good informed decisions that suit them, that uphold their rights and that fulfil their dreams and ambitions for their lives.

I am going to ask Joanne Finlay to come in on that.

On the need for flexibility, we are doing work around the country to try to ensure that SDS is delivered as flexibly as possible. At the moment, we have a request in from Highland Council to clarify some of the flexibilities that it might need in very remote communities where everybody is related, frankly. That is a challenge that I have in my constituency.

We have to ensure that there are tight controls on the possibility of exploitation of vulnerable people, but we also need to recognise that family support might well be the only option that people who live in very remote and rural communities have. We are working with the council on ensuring that we can deliver those flexibilities while safeguarding individuals’ human rights, and also on ensuring that it works for people, because saying, “We are not going to do that” is not an appropriate answer.

We also have work going on across all parts of the country on exactly the same challenges. One of the challenges that we have, and one of the reasons for variation across the country, is the level of risk averseness that individual local authorities and integration authorities have. We are trying to support them with that to ensure that they know that they are empowered to be flexible.

Rachael McGruer, do you want to comment on that? Were there plans to measure it before 2013, or were there plans in place on metrics when the legislation was introduced to measure whether the vision had worked?