Seòmar agus comataidhean

On recruitment and retention, if the Government committed to supporting on-going, continuing professional learning to unburden providers with regard to the financial aspects of having to send people away to do online or face-to-face training, would you welcome that?

I have a wee final question, which might go to Nick. We heard last week that the integration joint board in Dumfries will work with the Granite Care Consortium to examine what you are doing in Aberdeen, which could then be mirrored. Really good work has taken place and you have highlighted local authorities and IJBs that offer good examples of collaborative working and ethical delivery of care; I would like to see that work go forward.

Should we take those bits of good work and build them into the co-design so that, when the care service is delivered, we are using really good examples of work that exists out there now? That is part of what we are hearing about the Granite Care Consortium, which is now linking with Dumfries and Galloway.

I have a wee final question. Nick, you said earlier that, when your chief officer put forward ideas, people were nervous about them. I know that it is difficult to accept and adopt change; some folk are total change agents, while others need a lot of coercion. Do we need to harness your chief officer’s approach, given that a lot of trust was required to deliver the change that was necessary for the Granite Care Consortium and that you are now leading the way? Indeed, I have heard that you are now working with Dumfries and Galloway Council with regard to the lessons that it can take from you on how to deliver things in the south-west of Scotland. I am interested in hearing about the change aspect.

Both Margaret McCarthy and Nick Price spoke about trust, and Jim Gatherum, from Notwen House care home, in Dumfries, said that we should focus on trust and relationship-centred care, which all relate to the previous questions about autonomy. Do the witnesses think we should ensure that the bill focuses on autonomy, trust and relationship building as ways in which the national care service should support people?

I know that we have already talked a little about those issues. Rachel, I have brought up on my iPad the paper that CCPS submitted to us, in which you made recommendations about amendments that you would like to see. That sort of evidence is fantastic, because we really want to hear about amendments that you think will be good for the bill and which will ensure that it delivers the national care service—or, at least, a way forward with co-design. Thank you for that—I found it really helpful.

I am interested to hear the panel’s views on commissioning and procurement, on what “ethical” means and on how we move forward with that. That question is for Rachel Cackett, first of all, and then for Julie Welsh from Scotland Excel.

Yes, thanks. The time-and-task model came up during the committee’s visit to Dumfries. Euan McLeod, who is from the Dumfries team, said that the team is working with the Granite Care Consortium and that part of what it hopes to do is move away from the time-and-task model. Will you tell us what that means and what we need to do better when we are planning the national care service to make care more deliverable?

In the last evidence session, we heard about ethical commissioning and procurement. The language around ethical commissioning is really important with regard to how we procure services. The bill refers to reserving the right

“to participate in procurement by type of organisation”.

I am interested to hear what your involvement has been in how services are commissioned. What do you want to see in the bill specifically to support an ethical commissioning and procurement framework?

You want that to be part of the bill or considered through the co-design process in the future. What you are describing, such as someone looking down the line to their pension, is a huge consideration for people with regard to the job that they do. We heard in the evidence that we took way back at the beginning of the process that most care staff are women who are aged between 50 and 65 and who are often carers themselves.

When we are considering the way in which contracts are created and delivered, we need to bear in mind the particular groups of individuals who provide the care. Would you want that consideration to be part of the co-design process, once the bill moves forward and we look at the devil in the detail?

I will be quick and will cite some specific information that we heard in Dumfries, which will also be directly relevant for Julie Welsh. I am using that example because Dumfries is in my patch and I was at the table when it was said. We heard that Scotland Excel can sometimes be challenging to work with and heard examples of delays in passing on uplifts in pay, which led to staff leaving, and of delays in processing variations or refusals to consider variations. I do not know the specific details, but there was a standard rate, despite local differences in costs. It would be interesting to hear from Julie Welsh about any direct experience of how Scotland Excel works with providers and about what would happen if Scotland Excel were no longer involved in commissioning arrangements for social care.

Not all training is done away from any place. As a former clinical educator, I used to go right into the intensive care unit, operating theatre or ward and do direct education. Education can be delivered on the ground in the area where care is provided as well.